1. Step 9
1.1. Review session 2
1.2. mechanism flow chart
1.3. 20 minutes
2. Step 10
2.1. Management
2.1.1. Goals of management
2.1.1.1. stabalize the patient
2.1.1.2. Reduce symptoms
2.1.1.2.1. pain
2.1.1.3. Eradicate H.pylori
2.1.1.4. neutralize acidity to allow natural healing
2.1.1.5. Education
2.1.2. Initial management
2.1.2.1. ABC
2.1.2.2. Correct hgb level
2.1.2.2.1. IV packed RBCs
2.1.2.2.2. IV fluids
2.1.2.3. IV PPIs may be given initially
2.1.2.3.1. for severe cases
2.1.2.3.2. + NG suction
2.1.3. ongoing management
2.1.3.1. Pharmacological
2.1.3.1.1. triple therapy regimen
2.1.3.1.2. PPIs
2.1.3.1.3. H2 blockers
2.1.3.1.4. prostaglandin analogues
2.1.3.1.5. sucralfate
2.1.3.2. Non-pharmacologica
2.1.3.2.1. cessation of NSAIDs
2.1.3.2.2. patient education
2.1.4. follow up
2.1.4.1. not recommended if treatment was successful
2.1.4.2. in some high risk patients biopsy follow up might be done
2.2. Prevention
2.2.1. primary
2.2.1.1. education to the public
2.2.1.2. education about NSAIDs
2.2.1.2.1. taking NSAIDs with meals
2.2.1.3. Hygein