Update on stress ulcer prophylaxis in critically ill patients.

Mitchell J. Spirt is an assistant clinical professor of medicine in the Division of Gastroenterology, University of California, Los Angeles School of Medicine, Los Angeles, Calif, and is the chief of gastroenterology at Century City Doctors Hospital in Century City, Calif. Sandra Stanley is a gastrointestinal staff nurse at the Specialty Surgical Center in Beverly Hills, Calif. Optimal management of stress ulcer prophylaxis requires a concerted effort among all members of the healthcare team. This article presents an overview of the epidemiology and pathophysiology of stress-related mucosal disease (SRMD), medical management of SRMD, and the role of intensive care unit (ICU) nurses in improving the care of patients at risk for SRMD.