Peptic ulcer disease is a chronic process. It takes a long time. Manifestations of the disease depends on its stage, season, sex and age of the patient. The disease onset is usually acute. However, acute onset is usually preceded by symptoms that are called predyazvennym period. Patients have pain in 1-1,5 hours after eating, hunger pains, sometimes at night the pain in the stomach.
The examination and fibrogastroduodenoscopy ulcer can not be detected. However, it can be revealed chronic gastritis, chronic erosive gastritis, or erosive gastro. Secretory activity and acidity of gastric juice is usually increased. Increased content of hydrochloric acid in the stomach on an empty stomach. All this is accompanied by a violation of gastric motility and accelerated movement of bolus from the stomach into the duodenum.
Recently, the term predyazvennoe state refused. Patients with clinical manifestations are considered high-risk group for the development of peptic ulcer disease. Primary ulceration is manifested by pain. Pain also serves as the main symptom of gastric ulcer and duodenal ulcer. Pain arises in the epigastric region.
Gastric ulcer pain is localized on the left side or on the midline of the abdomen, the upper part of it. If a patient has a duodenal ulcer - pain occur on the right of the midline. Sometimes the pain may be retrosternal, or give away in the back. The nature of pain can be quite varied. One-third of patients with pain can be very strong. In most of them dull, aching, or boring, stabbing, cramping.
Pain in peptic ulcer can be:
Early pain typical of ulcers of the upper stomach and there are a half an hour after the meal. Gradually, they become stronger, as in the stomach increases the concentration of hydrochloric acid. Over time, the food moves from the stomach into the duodenum, gastric contents, and decreases after 1-2 hours of pain decreased.
Late pain occur in 1.5-2 hours after eating. They are characteristic also for chronic pancreatitis.
Hunger pains occur within 5-6 hours after ingestion. They are reduced or terminated after the patient drink milk or eat.
Night pain, similar to hunger pains, they occur at night. Night and hungry pains occur in ulcerative process in the duodenum.
Another common symptom is heartburn ulcer. This is a burning sensation behind the breastbone, in the neck. Heartburn is usually caused by hitting the stomach contents into the esophagus through the lower opening of the esophagus. Sometimes, heartburn can be the first and only sign of peptic ulcer disease. Heartburn occurs more frequently with pain, but in some patients it may not be associated with food intake. Quite often in patients with peptic ulcer disease occurs belching. Most often it has a sour taste, due to the high acidity of gastric contents.
During the period of exacerbation of peptic ulcer in patients with nausea. Most nausea occurs during duodenal ulcers, gastric ulcers rarely. Vomiting is usually at an altitude of pain. Vomit are partially digested food in the stomach. After vomiting, the patient feels relief, reduced pain.
Weight loss in patients with peptic ulcer disease may occur during an exacerbation of ulcerative process. At other times, the appetite may be normal or elevated. However, among patients with peptic ulcer disease obesity is very rare. Approximately half of patients complain of constipation. Constipation can be caused by a concomitant breach of intestinal motor function, and taking antacids.
For peptic ulcer disease is characterized by Power phase flow. Phase acute illness lasts from one week to two months, then followed by a phase of remission. In remission, patients can feel healthy. In addition to ulcers, especially duodenal ulcer, characterized by seasonality. This means that the ulcerative process is often exacerbated in the spring and fall. In some patients (10%) ulcers are combined. First, they have a duodenal ulcer, a few years later formed a stomach ulcer. Some patients have found multiple ulcers of the stomach or duodenum.
Diagnosis of peptic ulcer disease is carried out using X-ray of the stomach and intestine with barium contrast, fibrogastroduodenoscopy with the mandatory portions of the fence at the edge of the mucous membrane ulcers, and study them for the presence of Helicobacter. Carried out the study of the functional state of the stomach and duodenum. Appointed by the general and biochemical blood tests, fecal occult blood.