In critically ill patients, stress ulcers can develop. Which preventive measure is commonly used?

• A. Enteral feedings
• B. Proton pump inhibitors
• C. NPO with IV fluids
• D. Sucralfate

Answer: (B)

Stress-related mucosal disease in critically ill patients is driven by mucosal ischemia and damaging acid exposure; preventing acid injury to the gastric lining is key. Proton pump inhibitors block the final step of acid production in the stomach (the hydrogen-potassium ATPase pump), giving strong, long-lasting suppression of gastric acid. This directly lowers the risk of stress ulcers and upper GI bleeding, making these agents the most effective and commonly used preventive measure in the ICU. Enteral feedings help support mucosal integrity but don’t provide as robust ulcer prophylaxis on their own, while sucralfate coats the mucosa but isn’t as consistently protective as acid suppression. Being NPO with IV fluids doesn’t address the acid-mediated injury.