Peptic ulcer What we need to know

Synonym: ulcer disease of the stomach and duodenum

Peptic ulcer is a disease caused by damage to the mucous membrane of the digestive tract - stomach and duodenum.

Pepsin and hydrochloric acid are the active components of gastric juice that participate in the chemical breakdown and digestion of food.

The gastro-intestinal tract is lined with a protective mucous membrane. During peptic ulcers, the protective ability of the mucous membrane decreases and the aggressive components of gastric juice cause damage to the walls. The resulting ulcer is an erosion of the wall, which can include all three layers (mucosal, muscular and connective tissue).

Peptic ulcer disease causes duodenal ulcers in 80% of cases, and gastric ulcers in 12% of cases. It is rare, but it is possible to develop an ulcer disease:

In the esophagus - as a result of chronic reflux (passage of stomach juice into the esophagus)

Jejunal ulcer – small (middle part of the small intestine) intestinal ulcer and others.

Distribution

5-10% of the world's population will develop peptic ulcers during their lifetime. It can occur at any age, but is more common in middle-aged adults. It is more common in men than in women.

Symptoms

Almost 70% of patients with peptic ulcer disease do not report any symptoms. The most typical symptom is epigastric pain and digestive disorders. The mentioned symptoms are characterized by periodic exacerbation.

Symptoms of indigestion are associated with food intake and include: pain and burning in the epigastrium, which begins when eating and lasts for a long time.

Without examinations, it is difficult to determine the location of the ulcer, however, both gastric and duodenal ulcers are characterized by specific symptoms: in the case of a gastric ulcer, the pain begins within 12 minutes after eating food, and in the case of a duodenal ulcer - within 30-12 hours after eating.

Patients with duodenal ulcer often report pain in the middle of the night. The same pain, only milder, characterizes a jejunal (small intestine) ulcer. The pain is localized near the navel.

Esophageal ulcer is characterized by heartburn, which also peaks at night and in a horizontal position.

Other symptoms of peptic ulcer are:

Bloated tummy

Bokin

Ingratitude

Nausea and vomiting

Complications

Untreated peptic ulcers for a long time may cause complications:

Gastrointestinal bleeding:

Blood in the stool

Dark color of stool

Vomiting of contents like coffee grounds

Weakness and dizziness

Pallor

Tachycardia

ulcer perforation

Sudden, severe, acute abdominal pain

Abdominal swelling and pain to the touch

Fever and chills

What causes a peptic ulcer?

Mucous membrane of the gastrointestinal tract performs a protective function, especially in the stomach and duodenum, to protect the walls from the aggression of digestive juices.

Under the influence of chronic, long-term factors, the protective ability of the mucous membrane decreases, and under the influence of the aggressive components of gastric juice, an ulcer disease develops.

There are many reasons that weaken the function of the mucous membrane:

• Infectious process caused by Helicobacter pylori. Pylori is a bacterium that lives in the gastrointestinal tract and does not cause any pathology within the normal range, but its excessive growth leads to the development of an inflammatory process.
• Excessive use of non-steroidal anti-inflammatory drugs. These medicines are used for pain relief in various diseases. Medicines of this group block the production of prostaglandins, which perform a restorative function when the digestive tract is damaged.

Other causes of peptic ulcer:

• other infections
• Ischemia (impaired blood circulation in the digestive tract)
• stress
• Chemo or radiation therapy
• Zollinger-Ellison syndrome
• Crohn's disease
• Stomach cancer
• Autoimmune diseases
• etc

Risk factors

The combination of alcohol and tobacco use with infection caused by Helicobacter pylori or excessive use of NSAIDs increases the risk of developing peptic ulcer disease.

Diagnosis

If the existing symptoms and risk factors indicate the presence of an ulcer disease, it is necessary to determine the cause of the ulcer. Helicobacter pylori infection can be determined by endoscopic material examination, as well as by serological tests, urease breath test and stool tests.

An endoscopic imaging study confirms the presence of an ulcer in the stomach or duodenum.

Treatment and management

Medications to reduce stomach acidity and accelerate the regeneration of the mucous membrane are considered to be the first line of treatment for peptic ulcers. It is also important to eradicate the main factor causing the ulcer - Helicobacter (if present).

Antibiotics, cytoprotective agents, blockers of histamine receptors, proton pump inhibitors are the main groups of medicines for the treatment of peptic ulcer.

forecast

In most cases, peptic ulcers heal in 2-3 months. In chronic pathologies such as Zollinger-Ellison syndrome, treatment lasts a lifetime.

Rarely, there are persistent ulcers that do not respond to treatment. In such a case, the question of operative treatment arises.

 Laboratory "Synevo" We offer the following studies:

Health care starts with accurate analyzes

Resources

https://www.synevo.ro/sindromul-zollinger-ellison-boala-pancreasul/

n.manjaparashvili@synevo.ge