About peptic ulcer disease
What is peptic ulcer disease?
What is a peptic ulcer?
A peptic ulcer is a break in the inner lining of the esophagus, stomach, or duodenum. A peptic ulcer of the stomach is called a gastric ulcer; of the duodenum, a duodenal ulcer; and of the esophagus, an esophageal ulcer. Peptic ulcers occur when the lining of these organs is corroded by the acidic digestive (peptic) juices which are secreted by the cells of the stomach. A peptic ulcer differs from an erosion because it extends deeper into the lining of the esophagus, stomach, or duodenum and excites more of an inflammatory reaction from the tissues that are eroded.
Peptic ulcer disease is common, affecting millions of Americans yearly. Moreover, peptic ulcers are a recurrent problem; even healed ulcers can recur unless treatment is directed at preventing their recurrence. The medical cost of treating peptic ulcer and its complications runs into billions of dollars annually. Recent medical advances have increased our understanding of ulcer formation. Improved and expanded treatment options now are available.
What are the symptoms for peptic ulcer disease?
- Burning Stomach pain
- Feeling of fullness, Bloating or Belching
- Intolerance to fatty foods
The most common peptic ulcer symptom is burning Stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night.
Many people with peptic ulcers don't even have symptoms.
Less often, ulcers may cause severe signs or symptoms such as:
- Vomiting or Vomiting blood — which may appear red or
- Dark blood in stools, or stools that are or tarry
- Trouble breathing
- Feeling faint
- Nausea or Vomiting
- Unexplained Weight loss
- Appetite changes
What are the causes for peptic ulcer disease?
Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the stomach or small intestine. The acid can create a painful open sore that may bleed.
Your digestive tract is coated with a mucous layer that normally protects against acid. But if the amount of acid is increased or the amount of mucus is decreased, you could develop an ulcer.
Common causes include:
A bacterium. Helicobacter pylori bacteria commonly live in the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, the H. pylori bacterium causes no problems, but it can cause inflammation of the stomach's inner layer, producing an ulcer.
It's not clear how H. pylori infection spreads. It may be transmitted from person to person by close contact, such as kissing. People may also contract H. pylori through food and water.
- Regular use of certain pain relievers. Taking aspirin, as well as certain over-the-counter and prescription pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs) , can irritate or inflame the lining of your stomach and small intestine. These medications include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox DS, others), ketoprofen and others. They do not include acetaminophen (Tylenol, others).
- Other medications. Taking certain other medications along with NSAIDs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax) and risedronate (Actonel), can greatly increase the chance of developing ulcers.
What are the treatments for peptic ulcer disease?
For many years, excess acid was believed to be the major cause of ulcer disease. Accordingly, the emphasis of treatment was on neutralizing and inhibiting the secretion of stomach acid. While acid is still considered necessary for the formation of ulcers and its suppression is still the primary treatment, the two most important initiating causes of ulcers are infection of the stomach by a bacterium called "Helicobacter pyloricus" (H. pylori) and chronic use of nonsteroidal anti-inflammatory medications or NSAIDs, including aspirin. Cigarette smoking also is an important cause of ulcers as well as failure of ulcer treatment.
Infection with H. pylori is very common, affecting more than a billion people worldwide. It is estimated that half of the United States population older than age 60 has been infected with H. pylori. Infection usually persists for many years, leading to ulcer disease in 10% to 15% of those infected. In the past, H. pylori was found in more than 80% of patients with gastric and duodenal ulcers. With increasing appreciation, diagnosis and treatment of this infection, however, the prevalence of infection with H. pylori as well as the proportion of ulcers caused by the bacterium has decreased; it is estimated that currently only 20% of ulcers are associated with the bacterium. While the mechanism by which H. pylori causes ulcers is complex, elimination of the bacterium by antibiotics has clearly been shown to heal ulcers and prevent their recurrence.
NSAIDs are medications used for the treatment of arthritis and other painful inflammatory conditions in the body. Aspirin, ibuprofen (Motrin), naproxen (Naprosyn), and etodolac (Lodine) are a few examples of this class of medications. Prostaglandins are substances which are important in helping the linings of the esophagus, stomach, and duodenum to resist damage by the acidic digestive juices of the stomach. NSAIDs cause ulcers by interfering with the production of prostaglandins in the stomach.
Cigarette smoking not only causes ulcers, but it also increases the risk of complications from ulcers such as ulcer bleeding, stomach obstruction, and perforation. Cigarette smoking also is a leading cause of failure of treatment for ulcers.
Contrary to popular belief, alcohol, coffee, colas, spicy foods, and caffeine have no proven role in ulcer formation. Similarly, there is no conclusive evidence to suggest that life stresses or personality types contribute to ulcer disease.
What are the risk factors for peptic ulcer disease?
In addition to having risks related to taking NSAIDs, you may have an increased risk of peptic ulcers if you:
- Smoke. Smoking may increase the risk of peptic ulcers in people who are infected with H. pylori.
- Drink alcohol. Alcohol can irritate and erode the mucous lining of your stomach, and it increases the amount of stomach acid that's produced.
- Have untreated stress.
- Eat spicy foods.
Alone, these factors do not cause ulcers, but they can make ulcers worse and more difficult to heal.
Is there a cure/medications for peptic ulcer disease?
Structures like boils or sores on the digestive mucus lining of the stomach (gastric ulcers) and the upper part of the small intestine (Duodenal ulcers) are called Peptic Ulcer Disease. It is associated with thinning and weakening of this lining due to excess gastric acids or pepsin.
These ulcers develop in the digestive tract and lining damage stomach tissues if not cured on their own or treated. This result in pains, bloating and disrupting digestion all the time.
PUD is very common; it is easy for a patient to get diagnosed with the help of:
- Breath Test: To discover bacterial infection in the stomach.
- CT Scan and X-Rays: Helps in detecting through imaging tests.
- Endoscopy: A tube with light and camera inserted by doctors into a body to check for ulcers.
Prevention of this common disease can help control the production of bacteria and enhance good bacteria called probiotics. In addition to that, Doctors prescribe the following to stop PUD:
- The mix of Antacids (to reduce excess gastric acid production)
- Cytoprotective Agents (Helps in healing the ulcers)
Drinking a minimum of 2-3 liters of water every day prevents the occurrence of ulcers only. So prevention is better than a cure.
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