Do you know what a peptic ulcer disease icd 10 is? Many people do not know what causes ulcers or what foods and drugs to take that wouldn’t disturb them as ulcer patients, others don’t even know they have ulcers because they don’t know the symptoms hence the need to read about the A-Z of ulcers.
What is Peptic Ulcer Disease icd 10?
Stomach ulcers are also known as peptic ulcers are sores in the stomach lining. Peptic ulcers are of two types:
- Ulcers that affect the upper part of the stomach intestine (duodenal ulcer)
- Ulcers that affect the inside of the stomach lining (gastric ulcer)
Stomach ulcers occur when the thick layer of the mucus that protects the digestive tract is reduced by digestive juices (stomach acid). A person can have one or both types of ulcers at the same time and having both types is known as a gastroduodenal ulcer.
Peptic Ulcer Disease icd 10 Code
ICD-10-CM K27.9 is grouped within Diagnostic Related Group(s) (MS-DRG v38.0):
- 380 Complicated peptic ulcer with mcc
- 381 Complicated peptic ulcer with cc
- 382 Complicated peptic ulcer without cc/mcc
- 383 Uncomplicated peptic ulcer with mcc
- 384 Uncomplicated peptic ulcer without mcc
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Causes of Peptic Ulcer Disease
Peptic ulcer occurs when the acid in the digestive tract eats away the inner surface of the stomach or small intestine. This acid can create painful open sores that may bleed. The most common causes of peptic ulcers are infection with the bacterium helicobacter pylori (H. pylori) and long-term use of Non-Steroidal Anti-inflammatory Drugs (NSAIDs) such as ibuprofen, naproxen sodium, diclofenac, aspirin, etc.
Helicobacter pylorus is a bacterium that commonly lives in the mucus layer that covers and protects tissues that line the stomach and small intestine. Often, the H. pylori bacterium causes no problems but can cause the inflammation of the stomach’s inner lining layer, hence producing ulcers.
Also, people who use or rely on Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), such as aspirin, ibuprofen, naproxen, etc. are more likely to develop peptic ulcers because NSAIDs can irritate and damage the stomach and intestinal lining.
Rarely, a condition known as Zollinger-Ellison syndrome can cause stomach and intestinal ulcers by increasing the body’s production of acid. This syndrome is suspected to cause less than 1% of all peptic ulcers.
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Risk factors of Peptic Ulcer Disease icd 10
In addition to having risks related to taking NSAIDs, you may also have an increased risk of peptic ulcers if you:
- Smoke: smoking may increase the risk of peptic ulcers in people who are infected with H. pylori.
- Alcohol: this can irritate and erode the mucous lining of the stomach, and it increases the amount of stomach acid that is produced.
- Eating spicy foods also increases the risk of peptic ulcers and worsens the case, for those already infected.
- Unnecessary stress: while doctors often recommend NSAIDs for health conditions such as arthritis or joint inflammations, NSAID is also a risk factor for developing. Additional medication that may increase the risk for gastric, duodenal, and bleeding ulcers increase;
- Osteoporosis treatments such as alendronate (Fosamax) and risedronate (Actonel).
- Anticoagulants like warfarin (Coumadin) or clopidogrel (pladox)
- Selective serotonin reuptake
- Being 70years old or older
- Having an ulcer history
- Severe injury or physical trauma.
Note: these factors do not cause ulcers but they can make ulcers worse and more difficult to heal.
Symptoms of a Peptic Ulcer
A number of symptoms are associated with stomach ulcers. The severity of the symptoms depends on the severity of the ulcer. The most common peptic ulcer symptom is burning stomach pains or sensations in the middle of the abdomen between the chest and belly button. The pain will be more intense when the stomach is empty and stomach acid makes the pain worse. This pain can last for a few minutes to several hours.
Other common symptoms of ulcers include:
- Dull pain in the stomach
- Weight loss
- Loss of appetite
- Nausea or vomiting
- Pain that may improve when you eat, drink, or take antacids
- Heartburn, which is a burning sensation in the chest
- Acid reflux or burping
- Dark tarry stools
- Anemia, whose symptoms can include fatigue, shortness of breath, or paler skin
- Intolerance of fatty acids
- Vomiting blood
- Shortness of breath
One way of telling if you may have a gastric or duodenal ulcer is to figures out where and when your symptom occurs. For some, the time between meals aggravates an ulcer and for others, eating may be a trigger for the pains. The exact location of the pain doesn’t always match up with the ulcer, though sometimes, the pain is referred to, this means that a person may have pain in a location away from the actual ulcer.
It is important to get a stomach ulcer taken care of because if left untreated, ulcers and H. pylori can cause;
- Bleeding; from the ulcer, a site can become life-threatening and severe blood loss may cause black or bloody vomits, or black or bloody stools.
- Penetration; occurs when the ulcer goes through the wall of the digestive tract and into another organ such as the pancreas.
- Perforation (a hole in the stomach wall); peptic ulcers can eat and make a hole through the walls of one’s stomach or small intestine, putting the person at risk of serious infection of the abdominal cavity (peritonitis).
- Obstruction; peptic ulcers can block the passage of food through the digestive tract which is due to swelling of inflamed tissues. This obstruction causes one to become full easily, to vomit, and to lose weight.
- Stomach (gastric) cancer; studies have shown that people infected with H. pylori have an increased risk of gastric cancer, specifically non-cardia gastric cancer.
Symptoms of these complications are
- Sudden, sharp pain in the abdomen that does not go away
- Trouble or difficulty in breathing.
- Red/black vomit/stool
If any of these symptoms are seen or noticed, it is advisable to call a doctor immediately.
Diagnosis of a peptic ulcer
When you see a doctor, be sure to let your doctor know where and when you normally or most often have the symptoms. Gastric and duodenal ulcers can cause pain in different parts of your abdomen. A variety of tests can be recommended because abdominal pain has many causes. To rule out H. pylori infection, a laboratory test such as; blood, stool, or breathe test may be ordered.
Laboratory tests for H. pylori:
- The breath test: during this test, you will be instructed to drink a clear liquid or swallow a pill that contains a special formulation of urea and then breath into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher than normal levels of carbon dioxide.
- Blood test: the presence of certain infection-fighting cells would mean you have an H. pylori infection.
- A stool antigen test: in this test, a stool sample is sent to the laboratory for testing. The test looks for a certain protein in the stool that is related to the pylori.
Endoscopy (Esophagogastroduodenoscopy) test:
This type of test involves passing a lighted flexible instrument with a camera on its end, known as a scope, through the mouth and down into the esophagus, stomach, and small intestine. This test is used to look for ulcers, bleeding as well as abnormal areas. If an ulcer is detected, a small tissue sample (biopsy) may be removed for examination in a laboratory. A biopsy can also identify whether the H. pylori is in the stomach lining.
Upper gastrointestinal series
This is sometimes called a barium swallow. In this test, you drink a thick white liquid (barium) that coats the upper GIT and helps the doctor see the stomach and small intestine on an X-ray. This liquid makes ulcers more visible.
Peptic Ulcer Treatment
Treatment for peptic ulcers varies depending on the cause. Usually, treatment will involve killing the H. pylori bacterium if present, eliminating or reducing the use of NSAIDs if possible, and helping the ulcer to heal with medications.
If your stomach ulcer is a result of H. pylori, you will need antibiotics and the class of drugs called Protein Pump Inhibitors (PPIs) and other medications to fight the bacteria and promote healing, some of which are:
- Antibiotic medications to kill H. pylori: if H. pylori are found in your digestive tract, your doctor may recommend a combination of antibiotics to kill the bacterium. This may include
- Amoxicillin (Amoxil)
- Metronidazole (Flagyl)
- Levofloxacin etc.
Medications that block acid production and promote healing
- Protein Pump Inhibitors help to reduce stomach acid by blocking the action of the parts of the cells that produce this acid. These drugs include;
- the prescription and over the counter medications
- Pantoprazole etc.
Medications to reduce acid production
- Acid blockers also called histamine (H2) blockers, reduces the amount of stomach acid released into the digestive tract, which relieves ulcer pains and encourages healing. These drugs include;
- The prescription and over the counter medications
- Nizatidine etc.
Antacids that neutralizes the stomach
- Some doctors may recommend or include an antacid in your drug regimen and this is because antacids neutralize the existing stomach acid and can provide rapid pain relief. Antacids being recommended is used to provide symptoms relief and not to heal the ulcer. The most commonly used ones are;
- Aluminum hydroxide
- Magnesium hydroxide
- Calcium carbonate etc.
Medications that protect the lining of the stomach and small intestine
- In some cases, cytoprotective agent medications are prescribed to help protect the tissues that line your stomach and small intestine.
- If NSAIDs caused the peptic ulcer, you will be advised on how to reduce or eliminate the use.
- Bismuth supplements are also recommended.
In very rare cases, a complicated stomach ulcer may require surgery and this may be the case for ulcers that;
- Continue to return
- Do not heal
- Tear through the stomach
- Keep foods from flowing out of the stomach into the small intestine.
Surgery may include;
- The removal of the entire ulcer
- Taking tissue from another part of the intestines and patching it over the ulcer site
- Cutting off the nerve supply to the stomach to reduce the production of stomach acids
- Tying off a bleeding artery.
Additionally, since people with stomach ulcers may have accompanying acid reflux disease, it is advised to stay away from spicy and sour foods while undergoing treatment.
Side Effects of Peptic Ulcer Treatment
The symptoms of an ulcer may relieve or subside quickly with treatment but even if your symptoms disappear, you should continue to take any of the prescriptions by your doctor. This is at most important with the H. pylori infections, to make sure that all bacteria are eliminated. Some of the side effects of medications seen when treating peptic ulcers are:
- Abdominal pains etc.
If any of these side effects cause extreme discomfort, it is advised to see your doctor.
Ulcers that fail to heal
Peptic ulcers that do not heal with treatments are called refractory ulcers. There are many reasons why an ulcer may fail to heal, some of which are
- Regular use of pain reliefs such as NSAIDs while treating ulcer]
- H. pylori resistance to antibiotics
- Not taking medications according to directions
- Regular use of tobacco
But rarely is refractory ulcer a result of:
- Stomach ulcer
- An infection other than H. pylori
- Extreme overproduction of stomach acid, such occurs in Zollinger-Ellison syndrome; this syndrome causes the development of both cancerous and non-cancerous tumors. These tumors release hormones that cause extremely high levels of stomach acid that can lead to gastric and duodenal ulcers. These tumors most often develop in the pancreas and duodenum although they can occur in other places throughout the body.
The treatment for refractory ulcers generally involves eliminating factors that may interfere with healing.
Prevention of Peptic Ulcer
You may reduce your risks of peptic ulcer by
- Protecting yourself from infections: although the spread of the H. pylori is not certain, there is some evidence that it could be transmitted from persons to persons, or through food and water and as such, washing your hands with soap and water and eating foods that have been completely cooked is important.
- Lower your intake of NSAIDs or switch to another medication, if you are taking NSAIDs regularly, it is advisable to take them with meals or medications that protect the stomach linings like the Protein Pump Inhibitors.
- Refrain from smoking, as it can also slow healing and increase your risk of digestive tract cancers. Smoking also increases stomach acid.
- Take steps to increase physical activity. Regular exercise can activate the immune system and help lower inflammation throughout cells.
- Limit or avoid alcohol: excessive use of alcohol can irritate and erode the mucous lining in the stomach and intestine, causing inflammation and bleeding.
- Eating probiotic-rich foods such as yogurt (especially with lactobacillus and saccharomyces), sauerkraut, and miso.
- Eating apples, strawberries, blackberries, and leafy greens (spinach and kale).
A peptic ulcer disease icd 10 can pose a very big threat to human health and life hence, it is very important to get properly diagnosed and treated if symptoms related to its surface. In some cases, gastric ulcers can increase the risk for cancerous tumor growth.
Many people do not know what causes ulcers or what foods and drugs to take that wouldn’t disturb them as ulcer patients, others don’t even know they have ulcers because they don’t know the symptoms hence the need to read about the A-Z of ulcers.