Peptic ulcers are open pocks that develop in the inside stuffing of the esophagus,
stomach, and upper portion of the small intestine( duodenum) as a result of erosion from
stomach acids. A peptic ulcer is present in the stomach then called a gastric ulcer of the
duodenum, a duodenal ulcer, and of the esophagus, an oesophageal ulcer. Peptic ulcers
do when the stuffing of these organs is eroded by the acidic digestive( peptic) authorities
which are buried by the cells of the stomach. A peptic ulcer usually differs from that
erosion because the ulcer extends deeper into the stuffing of the esophagus, stomach, or
duodenum and excites further an inflammatory response from the tissues that are
eroded. It’s an ulcer of the gastrointestinal tract at an area exposed to the acid pepsin
amalgamation( APM). The mucosa present in the gastrointestinal tract( GIT) in this area is
digested by pepsin( peptic digestion). It’s almost constantly caused by Helicobacter pylori
infection.
Vast maturity of peptic ulcer occurs in
- Stomach( Gastric ulcer).
- First part of duodenum( Duodenal ulcer).
- The lower end of the esophagus ( as a result of affluence from the stomach into the
esophagus)
CAUSES OF PEPTIC ULCER
- Helicobacter pylori(H. Pylori): It’s a gram-bacteria set up in the gastric and duodenal
al mucosa of the utmost person, particularly senior. They, while in the mucosa, split
urea into ammonia and therefore elevate the original pH and damage the original
region of the mucosa by high alkalinity. In this way, they explosively help peptic
ulcer development( PUD).
- Acid: Hydrochloric acid( HCI) is buried by the parietal cells of the gastric glands.
Redundant acid product from gastronomes( it is an excrescence in the pancreas or
duodenum that secretes an excess of gastrin leading to ulceration), excrescences of
parietal cells of the stomach increase acid affair.
- Non-steroidal anti-inflammatory medicines( NSAID): Non-steroidal seditious
medicines, similar to naproxen, ibuprofen, and anti-aspirin, specifics can irritate or
inflame the filling of numerous pain of the stomach and small intestine. Indeed safety
carpeted aspirin and aspirin in powdered form can constantly beget ulcers.
- Stress: Emotional stress is no longer allowed to be a cause of ulcers, still, people
with ulcers frequently report that emotional stress increases ulcer pain.
Physical stress may increase the threat of developing ulcers, particularly in the
stomach. For illustration, people with injuries, similar to severe becks, and people
witnessing major surgery frequently require treatment to help ulcers and ulcer-related
complications, similar to bleeding.
- Genetics: A significant number of individuals with peptic ulcers have close
cousins with the same problem, suggesting that inheritable factors may also be
involved. The inheritable complaint Zollinger- Ellison pattern( ZES) is responsible
for some ulcers. Zollinger- Ellison pattern is a rare complaint in which excrescences
cache large quantities of the hormone gastrin. This hormone causes the stomach to
produce redundant acid which attacks the filling of the stomach and begets ulcers.
- Smoking: People who regularly bomb tobacco are more likely to develop peptic
ulcers compared to non-smokers.
- Alcohol consumption: Regular heavy intake of alcohol has an advanced threat of
developing peptic ulcers. In a normal person, the defense medium is acceptable, and no
ulcer develops. Where the defense medium is weakened, or, is the aggressive
medium, ie APM strengthened, peptic ulcer develops.
EPIDEMIOLOGY
The advanced frequency of peptic ulcers is in developing countries. Helicobacter Pylori is
occasionally associated with socioeconomic status and poor hygiene.
According to the rearmost WHO information, peptic ulcer complaint death in India
reached to1.20 of total death. The age-acclimated death rate is 12.37 per of the population
ranking India 5th in the world.
Mortality of rate has dropped dramatically in the once 20 years.
SYMPTOMS OF PEPTIC ULCER
Mild inflammation due to small ulcers may not beget any major symptoms and may heal
on their own as mouth ulcers do. Still, some ulcers can beget serious symptoms.
Stomach pain is the most common symptom. The type of pain can vary from mild to
severe and may generally at night. It may indeed come severe as the stomach empties
and in some cases may be relieved after having food. In some cases, pain may vanish for
many days and also reappear.
Other less common signs include
- Bloating,
- Heartburn,
- Nausea or vomiting.
In severe cases, symptoms can include - Dark or black stool( due to bleeding),
- Vomiting blood,
- Weight loss,
- Severe pain in the medial to upper tummy.
COMPLICATIONS
Gastrointestinal bleeding is the most common complication. Unforeseen large bleeding
can be life-changing. It occurs when the ulcer erodes one of the blood vessels, similar as
the gastroduodenal artery.
Perforation( a hole in the wall of the GIT) frequently leads to disastrous consequences if
left undressed. Corrosion of the gastrointestinal wall by the ulcer leads to spillage of
the stomach or intestinal content into the abdominal depression. Perforation at the anterior
face of the stomach leads to acute peritonitis, originally chemical and after bacterial
peritonitis.
Gastric outlet inhibition is the narrowing of the pyloric conduit by scarring and lump of gastric
antrum and duodenum due to peptic ulcers.
Cancer is included in the discriminational diagnosis illustrated by vivisection. Helicobacter pylori are
the main etiological factor that makes it 3 to 6 times more likely to develop
stomach cancer from the ulcer.
DIAGNOSIS OF PEPTIC ULCER
Diagnosis substantially depends on characteristic symptoms and the inflexibility of
the ulcer. Stomach pain is generally the first signal of a peptic ulcer. Some tests will be
ordered so that opinion can be verified, similar as
- General Investigation: Physical examination and recording of the case’s history.
There are no established blood tests that can reliably prognosticate the presence
of peptic ulcer complaints. Still, a complete blood count and blood including
liver function tests, amylase, chemistries lipase, and serum calcium situations)
are generally attained. H Pylori can be diagnosed by a urea breath test, blood test,
stool antigen assays, and rapid-fire urease test on a biopsy sample.
- Blood, urea breath, and stomach towel tests: These tests are performed to descry
the presence of H. pylori. Although some of the tests for H. Pylori may sometimes
give false-positive results or may give false-negative results in people who have
lately taken antibiotics, omeprazole, or bismuth. These tests can be helpful in
detecting the bacteria and guiding treatment.
- Radiology: Upper GI series( also called barium swallow): A test that
examines the organs of the upper part of the digestive system the esophagus,
stomach, and duodenum. A fluid called barium( a metallic, chemical, chalky, liquid
used to cover the inside of organs so that they will show up on an X-ray) is
swallowed. X-rays are also taken to estimate an ulcer, scar towel, or a blockage
that’s preventing food from passing through the digestive organs typically.
- Endoscopy: Endoscopy is the most accurate individual test for peptic ulcer
complaints. It involves fitting a small, lighted tube( endoscope) through the throat
and into the stomach to look for abnormalities. Endoscopies are also performed if
the case has other signs or symptoms, similar as weight loss, puking( especially if
blood is present), black droppings, anemia, and swallowing difficulties.
• Endoscopic biopsy: During the endoscopy, a piece of stomach towel is removed,
so that it can latterly be anatomized for the exact cause of peptic ulcer development.
This type of test is generally used for aged people or those that have endured
weight loss or bleeding.Other discriminational diagnoses: - Lump of the stomach,
- Pancreatitis,
- Pancreatic cancer,
- Non ulcer dyspepsia( also called functional dyspepsia), Cholecystitis,
- Gastritis,
- GERD (Gastroesophageal Reflux Disease),
- MI( myocardial infarction, not to be missed if having chest pain).
TREATMENT
The type of treatment is generally determined by what caused the peptic ulcer.
Treatment is concentrated on either lowering stomach acid situations so that the ulcer
can heal or eradicating the Helicobacter pylori infection. Treatments can include
- Antibiotic specifics to kill H. Pylori: Antibiotic combination medicine remedy
authority generally used to treat H. Pylorus is set up in the digestive tract. It probably
needs to take antibiotics for two weeks and fresh specifics to
reduce stomach acid. Eg. Amoxycillin, tetracycline, metronidazole, etc.
- Medications that block acid production and promote healing: Proton pump
impediments reduce stomach acid by blocking the action of the corridor of cells
that produce acid and include Omeprazole, Lansoprazole, Rabeprazole,
Esomeprazole, and pantoprazole.
- Medicines to reduce acid product: Acid blockers, also called histamine( H2)
blockers, they reduce the quantum of stomach acid released into the digestive tract,
which relieves ulcer pain and encourages mending including Ranitidine, Famotidine,
Cimetidine and Nizatidine.
- Antacids that neutralize stomach acid: Antacids neutralize stomach acid and
can give rapid-fire pain relief including Aluminum hydroxide, Magnesium hydroxide,
Calcium carbonate and Sodium bicarbonate.
- Medications that cover the filling of the stomach and small intestine: In some cases,
specifics called cytoprotective agents that help to cover the tissue that lines
the stomach and small intestine include Sucralfate and misoprostol. Another nontraditional cytoprotective
agent is bismuth sub salicylate can also be used.
Precautionary rules have been shown to dramatically reduce the threat of
NSAID- convinced gastric and duodenal ulcers to include the use of a prostaglandin
analog or proton pump inhibitors.
- Surgery: In veritably rare cases, a complicated stomach ulcer will bear surgery,
especially people who don’t respond to drugs, or who develop complications.
Surgery may include junking the entire ulcer, taking the towel from another part of
the bowel and sewing it over the ulcer point, tying off a bleeding roadway and
cutting off nerve force to the stomach to reduce the production of stomach acid.
- Vagotomy: It involves cutting the vagus whim-whams to intrude dispatches
transferred from the brain to the stomach to reduce acid stashing.
• Antrectomy: It involves the removal of the lower part of the stomach( antrum), which
produces a hormone that stimulates the stomach to cache digestive authority. A
Vagotomy is generally done in confluence with an antrectomy.
- Pyloroplasty: Pyloroplasty is an optional surgical procedure in which the lower
portion of the stomach, the pylorus, is cut and resutured, to relax the muscle and widen
the opening into the small intestine, enabling contents to pass further freely from the
stomach. It may be performed along with a Vagotomy.
PREVENTION
Peptic ulcers can be averted by avoiding effects that break down the stomach’s
defensive hedge and increase stomach acid stashing. These include alcohol, smoking,
aspirin,non-steroidal anti-inflammatory medicines, and caffeine.
Precluding infection with H. Pylori is a matter of avoiding defiled food and water and
clinging to strict norms of particular hygiene. Wash hands precisely with warm water
and cleaner every time the restroom is used, diaper changed, and ahead and after
preparing food.
Certain life changes can reduce the threat of developing peptic ulcers by duly managing
emotional and physical stress.
What is the main cause of peptic ulcer?
A peptic ulcer is a condition where there is a sore or erosion in the lining of the stomach or small intestine. The main cause of peptic ulcer is the bacterium Helicobacter pylori (H. pylori). This bacterium is a common cause of stomach inflammation (gastritis) and is found in the stomach of many people around the world.
H. pylori can damage the protective lining of the stomach, allowing stomach acid to irritate the stomach lining and cause an ulcer. In addition to H. pylori, long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen can also lead to the development of peptic ulcers. Other factors that can contribute to peptic ulcer disease include smoking, excessive alcohol consumption, and stress.
What are the symptoms of a peptic ulcer?
The symptoms of a peptic ulcer may vary, but common symptoms include:
- Abdominal pain usually felt in the upper abdomen
- Indigestion, bloating, or discomfort after eating
- Nausea or vomiting
- Loss of appetite or feeling full after eating only a small amount of food
- Heartburn or acid reflux
- Dark or tarry stools
- Unexplained weight loss
- Fatigue or weakness
- Difficulty breathing or shortness of breathIt is important to note that some people with peptic ulcers may not experience any symptoms at all. If you are experiencing any of these symptoms, especially severe or persistent abdominal pain, it is important to see a doctor for evaluation and treatment.
Is a peptic ulcer serious?
Peptic ulcers can be a serious condition if left untreated or if complications develop. The most common complications of peptic ulcers include:
Bleeding: Ulcers can erode into blood vessels, leading to bleeding that can be life-threatening if not treated promptly.
Perforation: Ulcers can create a hole in the stomach or small intestine, allowing contents to leak into the abdominal cavity, which can be a medical emergency.
Obstruction: Ulcers located in the stomach can cause swelling and inflammation that can obstruct the passage of food and lead to vomiting and weight loss.
However, with proper treatment, most peptic ulcers can be effectively managed and healed. Treatment typically involves a combination of medications to reduce acid production and eliminate H. pylori, as well as lifestyle modifications such as avoiding irritants like alcohol, caffeine, and spicy foods. In rare cases, surgery may be necessary to treat complications of peptic ulcers.
Can peptic ulcers be cured?
Yes, peptic ulcers can be cured with proper treatment. The most effective treatments for peptic ulcers include a combination of medications and lifestyle changes.
Medications that can help heal peptic ulcers include proton pump inhibitors (PPIs), which reduce the amount of acid produced in the stomach, and antibiotics to eliminate H. pylori bacteria if present. Other medications may be prescribed to help relieve symptoms or protect the lining of the stomach.
Lifestyle changes that can help manage peptic ulcers include avoiding irritants such as alcohol, caffeine, and spicy foods, quitting smoking, and reducing stress.
With prompt and appropriate treatment, most peptic ulcers heal within a few weeks to a few months. However, it is important to continue taking any prescribed medications and follow your doctor’s instructions to prevent the ulcer from recurring.