Stomach or duodenal ulcer
Peptic ulcer is a condition in which sores/ulcers appear on the inner wall of the stomach or the first part of the small intestine (the duodenum). Under normal conditions, a thick layer of mucus protects the inner wall of the stomach from the influence of its digestive juices and other harmful agents. The loss of this protective mucus,the influence of the acidic content of gastric fluid and other toxic factors (smoking, alcohol, use of non-steroidal anti-inflammatory drugs, etc.), result in the formation of peptic ulcer.
Cause of ulceration
The formation of stomach ulcers and duodenal ulcers can be caused by a variety of factors such as:
Infection with a type of bacteria called Helicobacter pylori (H. pylori).
Toxic factors such as: alcohol, smoking, stress, diet, drugs
Use of non-steroidal anti-inflammatory drugs , such as aspirin, naproxen , ibuprofen , and many others.
Excessive acid production from a condition called Zollinger-Ellison syndrome (gastrinoma). Gastrinoma, a tumor of stomach acid-producing cells that increases acid production.
Other risk factors for the occurrence of ulcers are the advanced age of the patient (>60 years), family history and the presence of concomitant health problems such as diabetes, cardiological history, kidney disease, etc.
Symptoms
In the case of gastric or 12-style ulcers, patients may experience symptoms such as burning pain in the middle or upper stomach area between meals or at night, bloating, a feeling of fullness or postprandial discomfort, nausea or vomiting. In more severe cases, symptoms may include dark or black stools (due to bleeding), weight loss, localised pain in the middle or upper abdomen
Complications
Although ulcers often heal on their own, we should not ignore their warning signs. If not treated properly, they can lead to serious health problems, including bleeding from the ulcer, perforation , gastric obstruction due to swelling of the mucous membrane or scar tissue formation.
The risk is particularly increased for those over 75 years of age and those with a history of peptic ulcers.
Diagnosis
The test of choice for the diagnosis and treatment of complications is gastroscopy. Radiological examinations such as barium meal are considered obsolete, and the role of CT is limited to the detection of complications
Addressing
The treatment of the ulcer consists of reducing the secretion of gastric acid through medication. The most effective treatment is the administration of proton pump inhibitors (PPIs) which, by reducing gastric acid secretion and its damaging effect on the gastric and duodenal epithelium, allows ulcers to heal.
When the ulcer is due to Helicobacter pylori, immediate eradication with gastric acid secretion inhibitors (PPIs) and the use of antibiotics is recommended. If non-steroidal anti-inflammatory drugs are used, it is recommended to avoid them or to use PPIs for gastroprosthesia.
Therapeutic endoscopy also plays an important role in the treatment of peptic ulcer complications such as bleeding, peptic strictures, while in cases of more serious complications such as perforation or gastric obstruction, surgical treatment may be required.
