Peptic Ulcer

What is a peptic ulcer?

A peptic ulcer is a small sore which occurs in the mucous membrane. Mucous membrane is the membrane lining hollow organs of the body such as stomach and duodenum. Any destruction to this lining causes peptic ulcer. The destruction is caused due to bacterial infection or by the long-term use of nonsteroidal anti-inflammatory agents (NSAIDs), like aspirin and ibuprofen. Cancerous tumors in the stomach or pancreas may also cause ulcers in a few cases.
What is H. pylori?

Helicobacter pylori (H. pylori) is a type of bacteria which is believed to be responsible for the majority of peptic ulcers.
Research is still going on about how people contract H. pylori, they think it may be through food or water. The bacteria may also spread through mouth-to-mouth contact such as kissing since H. pylori has been found to dwell in the saliva of some infected people.


How does H. pylori cause a peptic ulcer?

The protective mucous coating of the stomach and duodenum is weakened by H. pylori, which allows the acid to get through to the sensitive lining. Both the acid and the bacteria may damage the lining by causing irritation which leads to formation of a sore, or ulcer.

H. pylori secretes enzymes that is able to neutralize the acid so the bacteria is able to survive in stomach.This mechanism allows H. pylori to be safe inside the protective mucous lining and once it reaches there, the spiral shape of the bacterium helps it burrow through the lining.


Symptoms of an ulcer

Abdominal discomfort is the most common symptom.

1. It is a dull, gnawing ache.

2. This comes and goes for several days or weeks.

3. It occurs 2 to 3 hours after eating a meal.

4. It occurs usually in night, when the stomach is empty.

5. The pain is relieved by eating.

6. The pain is also relieved by antacid medications.


Other symptoms include

• bloating

• poor appetite

• weight loss

• burping

• nausea

• vomiting

Some people may experience only very mild symptoms others may not.


Emergency Symptoms

There are some emergency symptoms during which medical assistance is needed. They are as follows:

1. A sharp, sudden, persistent stomach pain.

2. Blood appears in the stools.

3. Stools appear black.

4. Bloody vomit or vomit that gives a coffee ground appearance.

As the disease progresses some signs of serious problem may arise, which are as follows:


1. Perforation:

This occurs as the ulcer burrows through the stomach or duodenal wall.

2. Bleeding:

This happens when the acid or the ulcer breaks a blood vessel.

3. Obstruction:

This occurs when the ulcer blocks the path of food that tries to leave the stomach.


Diagnosis of ulcer

Gastrointestinal series

An X-ray of the esophagus, stomach, and duodenum is taken and this is called as an upper gastrointestinal series. The patient is made to drink a chalky liquid called barium to make these organs more prominent so that ulcers can be seen more clearly on the X-ray.

Endoscopy

An endoscopy uses an endoscope, which is a thin, lighted tube with a tiny camera on the end. The patient is given sedative and then doctor carefully inserts the endoscope into the mouth and down to the stomach and duodenum. This helps the doctor to examine the lining of the esophagus, stomach, and duodenum.


Diagnosing H. pylori

1. Urea breath tests

2. Stool tests

3. Tissue tests

All these tests help to diagnose the infection created by H. pylori.


Treatment

The objective of H. pylori peptic ulcer treatment includes:

1. To kill the bacteria

2. Reduce stomach acid

3. Protect the stomach lining

Certain antibiotics are used to kill bacteria. Acid-suppressing drugs such as H2 blockers and proton pump inhibitors are used for treating peptic ulcers. Thus a combination of antibiotics, acid suppressors, and stomach protectors are used for treatment.

Peptic ulcer patients must never be under stress and should never eat spicy food, since they may aggravate the ulcers and make one to feel worse.

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