Case scenario

Jocelyn, a 39-year-old personal trainer, presents to you in the pharmacy requesting pain relief. On questioning, Jocelyn reports her pain is located right below her ribs. She has been waking at night with pain, feels nauseous, has been vomiting, and has what she thinks is heartburn. Jocelyn has been taking antacids, which have provided some relief. She has been regularly taking high-dose diclofenac for back pain for the past year. You refer Jocelyn to her general practitioner, as you suspect she may have an NSAID-induced peptic ulcer.

Learning objectives

After successful completion of this CPD activity, pharmacists should be able to:

  • Describe the symptoms of and management options for peptic ulcers
  • Discuss the complications of peptic ulcers
  • Explain how pharmacists can translate knowledge into practice when managing patients with peptic ulcers.

Competency standards (2016) addressed: 1.1, 1.4, 1.5, 2.2, 3.1, 3.5

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Introduction

A peptic ulcer is an open sore that develops in the gastrointestinal mucosa.1 They range in size from several millimetres to centimetres. Depending on the location, there are three types of peptic ulcers: gastric ulcers (develop in the stomach), duodenal ulcers (develop in the first few centimetres of the proximal duodenum) and oesophageal ulcers.2

Peptic ulcers differ from gastrointestinal erosions, as they are deeper and extend below the level o

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