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Peptic Ulcer Disease

Definition

An peptic ulcer is a sore in the lining of the stomach.

Anatomy and Function of the Stomach

The body has a number of defense mechanisms that protect the stomach from the acid it produces. Any agents or conditions that decrease these normal defense mechanisms can predispose the development of an ulcer in the stomach.

Causes

  1. Helicobacter Pylori: Also called H.Pylori. This germ can be found in the stomach of infected individuals and can increase the risk of peptic or stomach ulcers. Some doctors think H. pylori may be spread through unclean food or water or by mouth-to-mouth contact, such as kissing. Even though many people have an H. pylori infection, most of them never develop an ulcer
  2. Aspirin and Arthritis Medications: Medications that are taken to help with inflammation of joints and muscles can interfere with the protective lining of the stomach being formed as needed. This leaves the stomach more likely to suffer the ill effects of acids used to digest foods.

Symptoms

Symptoms of a gastric ulcer may be indigestion, burning upper abdominal pain, or intolerance to certain foods. Some people complain of pain in the pit of their stomachs (the soft part of the stomach just below the breastbone) or slightly to the left. Classically, this pain is relieved by eating food; but, one or two hours later the pain returns. Others say eating makes the pain worse. If an ulcer is located near the valve at the end of the stomach (pylorus), it may interfere with the valves' function and prevent adequate emptying of the stomach contents into the small intestine. This may result in nausea and/or vomiting. Ulcers may start to bleed. This can lead to blood being present in the material vomited or blood may pass in the stool (bowel movement). If a large amount of blood has been passed, it may be digested and the stool will appear black and sticky and have a bad odor. Persons who pass such a black stool or have strong stomach pain that does not go away should consult their physicians immediately!

Diagnosis

Diagnosis is made with testing. These tests include breath tests, x-rays and endoscopy.

Treatment

  1. Medical: Antibiotics may be given to kill the H.Pylori germ.  Medications that decrease stomach acid may also be used. The patient may be asked to stop taking medications that affect the protective lining of the stomach; these medications are often called non steroidal antiflammatory drugs or NSAIDs.
  2. Surgical: There are surgeries to repair the damage done by ulcers in the stomach lining. There are also surgeries which can decrease the production of stomach acid. 
  3. Lifestyle Changes: Maintaining a healthy diet and limiting stress can help the stomach to not over produce acid.  Daily exercise and proper water intake can help the stomach empty the properly.
  4. Neither stress nor spicy food causes peptic ulcers but they can make symptoms worse. Smoking or drinking alcohol can make ulcers worse and prevent healing.
  5. Medicines that reduce stomach acid and protect the lining of the stomach and duodenum help ulcers heal.
  6. Tips to help prevent ulcers caused by H. pylori infection include;
  1. stopping NSAIDs, if possible
  2. taking NSAIDs with a meal
  3. using a lower dose of NSAIDs
  4. talking with your doctor about medicines to protect your stomach and duodenum while taking NSAIDs
  5. asking your doctor about switching to a medicine that won’t cause ulcers

Summary

Peptic or stomach ulcers are sores in the lining of the stomach. These can bleed at times which can be a serious health issue. There are medications and germs that can increase risk of getting ulcers.

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