Peptic ulcer is a chronic relapsing disease, occurring with alternating periods of exacerbation and remission, the main feature of which is the formation of defects (ulcers) in the wall of the stomach and duodenum.
An ulcer is different from the erosion of the stomach and intestines that press oneself deeper into the wall - in the layers beneath the mucosa. The prevalence of peptic ulcer disease among adults is around the 5 to 15% (7-10%).
Duodenal ulcer occur 4 times more common than gastric ulcers. Among patients with duodenal ulcers men predominate over women, whereas among patients with stomach ulcers male to female ratio is approximately the same.
What is an ulcer?
The main morphological substrate of the disease is the plague - defect in the mucosa of the stomach or duodenum, the appearance of which most experts attributed to the aggressive action of gastric juice (primarily hydrochloric acid and pepsin). Most of the ulcers in their size rarely exceeds 1 cm
Causes of ulcers
Currently, the main reasons of gastric ulcer and duodenal ulcer specialists include:
bacterium Helicobacter pylori (H. pylori)
Regular use of nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen,
indomethacin, diclofenac
poor quality food
violation of the diet
acceptance of alcohol
Heredity plays a role.
The symptoms of peptic ulcer disease
The most characteristic manifestation of peptic ulcer disease is pain in the upper abdomen ("stomach sex"), which occurs more often on an empty stomach, ie, between meals. Pain may also occur at night, forcing the patient to wake up and take food or medicine (which either inhibit the secretion of hydrochloric acid in the stomach, or neutralize it - the so-called antacids.) The pain usually subsides within the first 30 minutes after eating or taking these drugs.
Less specific, but occurring in peptic ulcer symptoms include nausea, heaviness after eating, a feeling of fullness, rarely brings relief to vomiting, loss of appetite, weight gain, heartburn.
Diagnosis of peptic ulcer disease
The most accurate method for diagnosing ulcers in the stomach or duodenum is an endoscopic examination (fibroezofagogastroduodenoscopy). The method not only allows you to "see" the plague, but, having received a piece of mucosa from the outlet of the stomach (a favorite place of the colonization of H. pylori), to diagnose / exclude infection with this organism. In addition, during endoscopy can be performed local treatment ulcers, including bleeding to stop.
How to treat an ulcer?
With regard to security measures, the patient with an ulcer should avoid foods that cause pain or increasing (coffee, soft drinks, strong coffee, tea, tomatoes, and some other products).
Recommend smokers to stop smoking, as experts conclusively proven that smoking is not only difficult to heal (lengthens the duration of treatment), but also increases the risk of relapse (recurrence of) ulceration.
Also, patients with ulcers should avoid taking aspirin, nonsteroidal anti-inflammatory drugs.
Drug therapy of ulcer disease (regardless of the cause - H. Pylori and nonsteroidal anti-inflammatory drugs, aspirin) must include antisecretory drugs. Preference is given proton pump blockers. If an ulcer caused by infection with H. pylori - two appointed by the addition of antibacterial drugs for at least 7 days. The choice of proton pump blocker, as well as the antibiotic is determined by what the patient taken antibiotics in the past (they usually are not assigned because there is potential for resistance to them, H. pylori).
