Wednesday November 23, 2005
SRMD and PUD

We commonly use terms Stress ulcer (Stress Related Mucosal Disease = SRMD) and Peptic ulcer (PUD) interchangeably in ICU while talking "GI prophylaxis". But both are 2 different conditions. (Probably what we are worried in our "unit" patients is mostly SRMD).

SRMD is multiple superficial erosions occurring in proximal gastric bulb involving superficial capillaries secondary to mucosal hypoperfusion and perforations are rare.

PUD is few deep erosions occurring usually in duodenum involving one vessel secondary to other reasons (drugs, H.Pylori, hypersecretory states etc.) and perforation is common.

From Dr. David C. Metz, nationally renowned in Acid-Peptic Diseases, lecture in Aspire 2005 (Acid Suppression Pharmacotherapy in the ICU: Re-evaluating the Evidence), an initiative to provide a critical assessment of the most current data on therapeutic approaches in acid suppression and the prevention of peptic ulcer rebleeding and stress-related mucosal disease. Launch Aspire 2005 here. Highly recommended for Critical Care nurses and house-staff.