Peptic ulcers (stomach)

January 2017


Definition


An ulcer is a degradation of the inner wall of the digestive organs, which pierces the muscularis mucosa and exposes the underlying layer. It affects two main organs in the digestive system, the stomach and the initial part of the small intestine called the duodenum. The main mechanisms of aggression include increased gastric acidity, chronic use of certain medications such as Non Steroidal Anti-Inflammatory Drugs (NSAIDs), and bacteria that can colonize the stomach, called Helicobacter pylori. Other factors such as coffee, hard alcohol, nicotine, stress, certain medications and the presence of other diseases can also lead to this disorder. If it is not treated in time, the damage is muscular and peptic ulcers appear.

Symptoms


The symptoms of peptic ulcers are typically as follows:
  • a sharp pain in the upper abdomen, called the epigastrium;
  • abdominal cramps;
  • continuous pain;
  • pain appearing a few hours after food intake;
  • loss of appetite;
  • medicines against digestive acidity have an effect;
  • pain is daily for several weeks.

Diagnosis


The diagnosis of a peptic ulcer is suspected following the description of these fairly typical symptoms, and confirmation is possible with an endoscopic examination. An upper GI endoscopy is performed in the duodenal during which the characteristic lesions are observed with a mini-camera, and samples (or biopsies) are taken to be analyzed. This biopsy can rule out the theory of a stomach cancer, but also to search for the presence of the Helicobacter pylori bacteria. A blood test is frequently done and can also search for specific antibodies to the germ.

Treatment


In case of identified NSAIDs, the latter must be addressed. Tobacco use must be stopped because it promotes gastric acidity. In the absence of the bacterium Helicobacter pylori, treatment is carried out with the use of inhibitors of the Proton pump (PPIs) for a few weeks. If the bacterium is present, the treatment involves taking antibiotics before the IPP. Surgery is considered only in the most severe cases, when the ulcer has perforated the bowel wall or the medical treatment is not effective. As a follow-up, anti-acid drugs can be given and taken after meals.

Prevention


There are some measures to prevent a stomach ulcer as limiting the consumption of alcohol and coffee. Smoking should be avoided as well as the regular use of pain relievers. Food should not be too fatty, too spicy or eaten too quickly.

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Published by Jeff. Latest update on October 18, 2013 at 10:27 AM by Jeff.
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