Peptic Ulcer
A peptic ulcer is a sore that develops on the lining of the stomach, upper part of the small intestine (duodenum), or esophagus. These ulcers occur when the protective lining of the stomach or intestine is eroded, typically due to stomach acid and pepsin. Here’s a detailed look at peptic ulcers:
Types of Peptic Ulcers:-
Gastric Ulcers:
- Occur on the inside of the stomach.
Duodenal Ulcers:
- Develop in the first part of the small intestine (duodenum).
Esophageal Ulcers:
- Form in the esophagus.
Causes:
Helicobacter pylori (H. pylori) Infection:
- A bacterium that can weaken the stomach’s mucous lining, making it more susceptible to damage from stomach acid.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):
- Medications like aspirin, ibuprofen, and naproxen can irritate or inflame the stomach lining.
Excessive Acid Production:
- Conditions like Zollinger-Ellison syndrome can lead to increased stomach acid production.
Lifestyle Factors:
- Smoking, excessive alcohol consumption, stress, and spicy foods can exacerbate ulcers.
Symptoms:
- Burning stomach pain that may improve or worsen with eating.
- Nausea or vomiting.
- Bloating or a feeling of fullness.
- Heartburn or acid reflux.
- Dark or black stools (indicating bleeding).
- Vomiting blood or material that looks like coffee grounds.
- Unintended weight loss.
Diagnosis:
Endoscopy:
- A flexible tube with a camera (endoscope) is used to view the stomach and duodenum directly and take a biopsy if necessary.
Barium Swallow:
- X-rays are taken after drinking a barium solution, which coats the digestive tract, making ulcers more visible.
Tests for H. pylori:
- Urea breath test, stool antigen test, or blood test.
Treatment:
Medications:
- Antibiotics: To eradicate H. pylori infection.
- Proton Pump Inhibitors (PPIs): Reduce stomach acid production (e.g., omeprazole, esomeprazole).
- H2-Receptor Antagonists: Also reduce acid production (e.g., ranitidine, famotidine).
- Antacids: Neutralize stomach acid and provide quick relief.
- Cytoprotective Agents: Protect the stomach lining (e.g., sucralfate, misoprostol).
Lifestyle and Dietary Changes:
- Avoid NSAIDs if possible.
- Reduce or eliminate smoking and alcohol.
- Eat smaller, more frequent meals.
- Avoid foods that irritate the stomach (spicy, acidic, or fatty foods).
Surgery:
- Rarely needed, but may be required for complications such as bleeding, perforation, or obstruction.
Complications:
- Internal Bleeding: Can lead to anemia or severe blood loss.
- Perforation: A hole in the wall of the stomach or duodenum, which is a medical emergency.
- Gastric Outlet Obstruction: Swelling or scarring can block the passage of food through the digestive tract.
- Increased Risk of Stomach Cancer: Especially with chronic H. pylori infection.
Peptic ulcers are manageable and often curable with appropriate treatment and lifestyle adjustments. Early diagnosis and treatment are crucial to prevent complications.