An ulcer on the lining of your stomach or duodenum, the first segment of your small intestine, is called a peptic ulcer. The predominant symptom is a burning sensation in the stomach. The suffering:
- Begins in between meals or at night.
- Stops for a moment if you eat or take an antacid.
- Endures for a few minutes to several hours.
- Arrives and departs over a few days or weeks.
The stomach or duodenum walls are harmed by the acids that aid in food digestion, which leads to peptic ulcers. The most frequent cause is an infection with the Helicobacter pylori bacteria. Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, is another factor. While they can exacerbate them, stress and spicy foods do not directly cause ulcers.
Your doctor may perform tests on your breath, faeces, or blood to determine whether you have an H. pylori infection. An endoscopy or x-ray may also be performed by your doctor to examine the inside of your stomach and duodenum.
If left untreated, stomach ulcers will deteriorate. Antibiotics to eradicate H. pylori or medications to lower stomach acids are possible forms of treatment. Peptic ulcers cannot be healed by milk or antacids. Avoiding alcohol and tobacco use can be beneficial. If your ulcers don’t heal, surgery might be necessary.
Causes of Peptic Ulcer
1. Helicobacter pylori (H. pylori) Infection
- Mechanism: The H. pylori bacteria cause harm to the duodenum’s and stomach’s protective mucous layer, which permits acid to reach the stomach’s sensitive lining underneath. Ulcers and discomfort may result from this.
- Transmission: Intact contact with an infected individual, contaminated food, or water can all spread the infection.
2. The Mechanism of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
- Mechanism: Ibuprofen, aspirin, and naproxen are examples of NSAIDs that might irritate or inflame the stomach lining when taken often or at high doses. Prostaglandins, which help shield the stomach lining from the corrosive effects of stomach acid, are inhibited by NSAIDs.
3. Additional Elements
- Smoking: Raises the chance of peptic ulcers, particularly in people with H. pylori infection.
- Overindulgence in Alcohol: May cause irritation and erosion of the stomach’s mucous lining, leading to an increase in the production of stomach acid.
- Stress: Although stress is rarely the direct cause of ulcers, chronic stress can weaken the stomach lining and increase the production of stomach acid.
- Nutritional Elements: Although they can aggravate the stomach, spicy foods and coffee are not the main causes of ulcers.
4. Health Issues
- Zollinger-Ellison Syndrome: An uncommon disorder in which the stomach produces an excessive quantity of acid due to one or more pancreatic or duodenal tumours, resulting in peptic ulcers.
- Crohn’s Disease: An inflammatory bowel condition known as Crohn’s disease can impact any area of the digestive system, including the stomach and duodenum, leading to ulceration.
5. Genetic Elements
- Family History: Some people are more prone to peptic ulcers due to a hereditary predisposition.
6. Additional Drugs
- Corticosteroids: NSAIDs and corticosteroids together may raise the risk of peptic ulcers.
- Anticoagulants: These drugs that thin the blood can make an ulcer already bleeding worse.
Symptoms
The following are typical signs of peptic ulcers:
- Stomach ache that burns
- Bloating
- Reflux
- Vomiting or feeling queasy
- Stools that are dark or black (showing bleeding)
- Throwing up blood or something that resembles coffee grounds
Diagnosis
The process of diagnosing a peptic ulcer usually entails:
- Endoscopy: A procedure in which the stomach and duodenum are examined by passing a thin, flexible tube equipped with a camera down the throat.
- Barium Swallow: A form of X-ray imaging in which the patient consumes a barium solution to make their digestive system more visible.
- Tests for H. pylori: These may consist of breath, stool, or blood tests.
Treatment
1. Medication
Antibiotics for H. pylori Infection
- Antibiotics: The H. pylori bacteria is treated with a mixture of medications. Typical routines consist of:
- Clarithromycin
- Amoxicillin
- Metronidazole
- Tetracycline
- Levofloxacine
For ten to fourteen days, they are frequently used with a bismuth subsalicylate or a proton pump inhibitor (PPI).
To Lower PPIs (Proton Pump Inhibitors) Induced by Stomach Acid
These medications prevent the stomach from producing acid, which promotes ulcer healing. Examples include:
- Meprazole
- Acetazolamide
- Lansoprazole
- Pantoprazole
- Rabeprazole
H2-Receptor Inhibitors
They lessen the quantity of acid that enters the digestive system. Examples include:
- Ronitidine
- Tamoxifidine
- Medication Cimetidine
- Zizidine
To Protect the Stomach Lining
- Antacids: These neutralise stomach acid and offer immediate symptom relief, protecting the lining of the stomach. They are not, however, usually used alone to treat ulcers.
- Cytoprotective Agents: These aid in the defence of the stomach and small intestine lining tissues. Sucralfate and Misoprostol are two examples (particularly effective for NSAID-induced ulcers).
- Bismuth Subsalicylate: Additionally has antibacterial properties against H. pylori.
2. Modifications to Diet and Lifestyle
- Steer clear of NSAIDs: If at all feasible, give them up. If required, they ought to be taken with food or in addition to prescription preventive drugs.
- Limit Alcohol: Alcohol should be avoided or consumed in moderation since it can irritate the stomach lining.
- Give Up Smoking: Smoking hinders the stomach lining’s defence against stomach acid and slows the healing process.
- Diet: Eating a balanced diet with frequent small meals can help lessen symptoms, while no specific diet is advised for those suffering with ulcers. Steer clear of foods that make you feel queasy, like fried, spicy, or acidic foods.
- Stress Management: While stress doesn’t directly cause ulcers, it can make symptoms worse. Methods such as yoga, counselling, and meditation have their uses.
3. Follow-Up Care Monitoring
Seeing a doctor on a regular basis is crucial.
- Monitoring: To track recovery and the effectiveness of treatment, routine follow-up visits with a medical professional are crucial.
- Examination for H. pylori Eradication: To verify that H. pylori has been eradicated during antibiotic treatment, further testing (endoscopy, stool, or breath testing) is required.
4. Medical Procedure
Nowadays, with the success of drugs, surgery is rarely necessary for peptic ulcers; nonetheless, it may be necessary in severe cases or if complications arise, such as:
- A perforation is a hole in the duodenum or stomach wall.
- An obstruction is a digestive tract blockage.
- Severe Bleeding: Bleeding that is ongoing or recurrent and cannot be stopped by other means.
Conclusion
Peptic ulcers are lesions on the duodenum or stomach lining that are primarily brought on by NSAID use over an extended period of time and H. pylori infection. One of the symptoms is a burning sensation in the stomach, which is usually experienced at night or in between meals and is momentarily eased by eating or using antacids. H. pylori tests, X-rays, and endoscopy are used in the diagnosis process. The main goals of treatment are to protect the stomach lining, eradicate H. pylori with antibiotics, and lower stomach acid with PPIs or H2-receptor antagonists. It’s critical to make lifestyle adjustments including avoiding NSAIDs, cutting back on drinking, giving up smoking, and controlling stress. Although the majority of ulcers heal with medical care, severe instances could need surgery.
