Stomach and duodenal ulcers

Stomach and duodenal ulcers are marked by long-term and recurring acute inflammatory conditions, when mucous membrane of stomach and duodenum is being damaged (mucosal defect).

Causative Factors

  1. Family history
  2. Causative agent – H. pylori
  3. Smoking cigarettes
  4. Use of alcohol
  5. Repeated stresses
  6. Irregular and unhealthy eating
  7. Taking some medicines, such as pain relievers, some antibiotics and glucocorticoids.

The main reason for the condition is imbalance between two factors – stomach defense media (mucus) and aggressive media (hydrochloric acid, Helicobacter pylori, medications and other factors). When aggressive factors overcome, and defense factors become weaker, a person forms a stomach ulcer.

Classification

  1. Combination of ulcers in stomach and duodenum
  2. Duodenal ulcer
  3. Gastric ulcer

Along with classification by area the condition may be classed by size and number of ulcers, manifestations and present complications (bleeding, narrowing, perforation, malignization and penetration).

Clinical Presentation

Usually, patients complain of pains in epigastric region that occur two hours after taking a meal and at bedtime; headaches when defect is in duodenum. Heartburn, nausea and constipations occur, though, they are non-specific symptoms.

Peptic ulcers are usually accompanied by complications, such as bleeding along with weakness, dizziness, decreased arterial pressure, coffee-ground vomit and black, tar-colored stool.

Diagnosing Peptic Ulcer

  1. FGDS with biopsy to find H. pylori or any cancerous tumours
  2. X ray
  3. Abdominal ultrasound
  4. Detection of H. pylori (detection of antibodies to infectious agent, urease test)
  5. Fecal occult blood test (in bleeding)
  6. Coagulogram
  7. Acid-base titration

Treating Peptic Ulcer

Treatment is based on eliminating the factors causing the defect. Eating regimen is set – 5 or 6 times per day, excluding spicy, greasy and fried foods, coffee and alcohol. GP will advise to quit smoking or taking narcotic drugs. GP will review the type of treatment if ulcer development results from taking certain medicines.

In treatment, proton pump inhibitors, antacids, h2-receptor antagonists are used. If test for H. pylori is positive, antibiotic eradication is required.