Peptic Ulcer Disease

Posted by Healthfitline On Monday, November 5, 2012
A peptic ulcer is basically a breakage or erosion occuring in the lining of  stomach, oesphagus or on the intestines (duodenum). An individual suffering from a peptic ulcer is described as suffering from a peptic ulcer disease.  Most peptic ulcers occur in the duodenal area and are less likely to occur in the stomach region. Esophageal ulcers occur as a result of backflow of the Hydrochloric acid from the stomach to the esophagus due to a condition known GERD (gastroesophageal reflux disease). 

Peptic Ulcer Causes
The most common cause of peptic ulcer is through H.Pylori (helicobacter pylori ) infection; a gram negative bacteria that can be transmitted by close contact or by coming into contact with vomitus of the infected person. It can also be acquired by consuming food that are contaminated with the H. pylori bacteria.   However, most people infected with the H.Pylori do not develop peptic ulcers and it is not clear why only a few get peptic ulcers.
 
What happens is that,  once the stomach lining is destroyed, it cannot secrete adequate mucus to act as a barrier against the HCl, hence leading to erosion.
 
Risk Factors of Peptic Ulcers
Risk factors associated with peptic ulcer disease are:
  • Prolonged use of Steroids and NSAIDS (non steroids anti-inflammatory drugs like aspirin and ibuprofen. These kinds of drugs inhibit the secretion of the mucus need to protect the gastric lining against HCl.
  • Male Gender (more common in male than woman until the age of menopause).
  • More common in individuals aged 40 - 60 years.
  • Stress and anxiety
  • History of H.Pylori infection.
  • Patients suffering from Zollinger Ellisson Syndrome (ZES - tendency to produce excessive HCl).
  • Cigarette smoking
  • Alcohol consumption
  • Chronic inflammation diseases
  • Eating spicy food may worsen the peptic ulcers.
 
Peptic Ulcers Symptoms
Some people suffering from peptic ulcer disease do not manifest any symptoms, initially and perforation may occur even without having preceding symptoms in 20% of the patients. Depending on type of peptic ulcers the person is suffering from, symptoms varies from person to person.
 
Stomach (Gastric) Ulcers Symptoms
  • Pain is evidenced immediately after eating.
  • Dull, gnawing or sharp pain
  • Pain is felt in the left midepigastrium area (left middle area of the abdomen). 
  • Pain may be relieved by vomiting.
  • Increase in pain after eating
  • The vomitus may contain fresh blood.
 
Duodenal Ulcer Symptoms
  • Pain expected 2-4 hours after eating.
  • The affected part is the upper area of the small intestine (duodenal).
  • Burning sensation pain
  • Pain is felt in right epigastrium area (upper right central area of the abdomen).
  • Decrease in appetite
  • Patient awakes at night due to increased pain.
  • Pain disappear after eating.
  • No vomiting but may pass stool with blood.
 
Peptic Ulcer Disease Treatment
Treatment or management of peptic ulcers disease involved three things; lifestyle changes, change in diet, medication and surgical intervention.
 
Lifestyle Changes
  • Reduction of stress causing situations
  • Regular meal schedule and proper administration of the medication.
  • Regular rest may help the patient especially during the acute phase.
  • Behavioral modification, relaxation techniques or massage may lessen the pain.
  • Advised to stop smoking
  • To eliminate gastric irritants drugs like Aspirin and NSAID.
 
Diet Modification
  • Avoiding food that can stimulate more acid production like spicy food, alcohol, coffee etc. 
  • Avoiding diet rich in cream and milk since it can stimulate acid secretion.
  • Advised to eat three regular meals in order to neutralize the acid.
 
Medication
  • Antibiotics - due to H.pylori infection
  • Antiacid - to neutralize the gastric acid secretion.
 
In most cases, peptic ulcer disease is treated by use of three combination of drugs; antibiotics, proton pump inhibitors such as omeprazole (to suppress gastric acid secretion) and bismuth salts.
 
Surgery
Peptic ulcer disease is usually treated with medication and surgery is only recommended for patients with ulcers that do not respond to medication, those that may be experiencing a life threatening hemorrhage, perforation or having an obstruction.  Surgery is also recommended for patients suffering from ZES (Zollinger Ellisson Syndrome). 
 
Surgery Management involves;
  • Vagotomy - surgical division of vagus nerve hence decreasing the rate of vagal stimulation and production of HCl acid.
  • Gastrectomy - Removal of the stomach.  Either total Gastrectomy (entire stomach is removed) or subtotal gastrectomy (2/3 of the stomach is removed).
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Labels: Diseases and Conditions, Health, home, Peptic Ulcer Disease

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