PEPTIC ULCER DISEASE

Peptic ulcer is an open sore that develops in the lining of the esophagus,  stomach or duodenum ( upper part of the small intestines). The most common symptom is a burning stomach pain. Peptic ulcer may occur at three different locations.

Esophageal ulcer : It occurs inside the esophagus which is the hollow tube that carries food from your throat to your stomach.

Gastric ulcer : It occurs inside the stomach.

Duodenal ulcer : It occurs inside the duodenum which is the upper portion of the small intestines.

CAUSES

It occurs when acid in the digestive tract eats away the inner lining of the esophagus, stomach and duodenum. This results  in a painful open sore that may bleed. Excessive acid production is  caused by  imbalance between digestive fluids in the stomach and duodenum.

Infection with Helicobacter pylori (H. pylori) may also cause an ulcer.

Certain over the counter and prescription medications like  ibuprofen (Advil, Motrin IB, ), naproxen (Aleve, Anaprox, ) and aspirin can irritate the lining of the stomach and cause an ulcer.

Gastronomas , tumors of the acid producing cells of the stomach  increases acid output and causes ulcers.

WHO IS A RISK OF PEPTIC  ULCER

You may be at increased risk of getting peptic ulcer if :

– you are a smoker 
– you are infected with the H. pylori bacterium
– you drink alcohol regularly
– you have a family history of the disease
– you are 50 years and older
– you have medical conditions such as kidney and liver disease
– regularly take pain medications such as aspirin, ibuprofen, or naproxen

SYMPTOMS

Signs and symptoms of peptic ulcer includes the following :

– a burning pain in the middle or upper portions of the stomach. The pain may get worse when stomach is empty or at  night.  It  may disappear and return for a few days or weeks.
– Eating foods that buffer stomach acid or that reduce acid production may  provide temporary relief.
– nausea and vomiting
– bloating
– heartburn

In severe cases, patients may

– have bloody stools
– vomit blood
– experience weight loss

TEST AND DIAGNOSIS

Doctors will diagnose peptic ulcer by asking  you about your symptoms. They may then perform  certain diagnostic test to confirm the disease. In the mean time your doctor may give you medications for heartburn to  improve symptoms.

Upper Endoscopy :  Your doctor will pass a  hollow tube equipped with a lens (endoscope) down your throat and into your esophagus, stomach and small intestine. This is done to check for ulcers

Test for for H. pylori : This is done to check if the bacterium is the cause of your symptoms. This test can be done using your blood, stool and breathe. The type used depends on your condition.

TREATMENT

Peptic ulcer may get worse if not treated. Treatment includes medications to reduce stomach acids, antibiotics to kills the H. pylori bacterium, lifestyle change and in more severe cases surgery.

Medications

Proton pump inhibitors : They  reduce stomach acid by blocking the action of the parts of cells that produce acid. They include Prevacid, Aciphex, Protonix, Prilosec,  Nexium and Dexilant.

Acid blockers : They are also known as histamine (H-2) blockers. They act to reduce stomach acid released into your digestive tract thereby relieving pain associatd with peptic ulcer. They include medications ranitidine (Zantac), famotidine (Pepcid) and  cimetidine (Tagamet).

Antacids : They neutralize stomach acid and provide rapid pain relief.

Antibiotics : They are  used to kill  H. pylori infection.  You’ll likely need to take antibiotics for two weeks, as well as additional medications like Pepto – Bismol .

Upper endoscopy : Some bleeding problems associated with peptic ulcer are  treated through upper endoscopy.

Surgery : One may need surgery if serious bleeding is involved.

COMPLICATIONS

Peptic ulcer can present complications such as
– internal bleeding
– infection of the abdominal cavity
– scar tissues  that can block passage of food through the digestive tract.

PREVENTION

Take these precautions to prevent peptic ulcer

Do not smoke.

Avoid alcohol.

Don’t overuse pain medications like aspirin and diclofenac

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