Peptic Ulcers - Causes, Symptoms, Prevention and Treatment
Health Education

Peptic Ulcers

Authored by DesiMD Doctor on 20 Mar 2013 - 15:16.

Peptic ulcers are erosions in the mucous linings of tissues lying in the stomach or the first part of the small intestine (which are parts of the gastrointestinal tract). These ulcers (sores) are normally very painful since the parts they occur in, are very acidic.

While there is no single defining cause of peptic ulcers, research has shown that conditions which result in imbalances between fluids in the stomach and duodenum (first part of the small intestine) have that effect.

The possible causes of Peptic ulcers are as follows:

Helicobacter pylori, better known as H.pylori is a type of bacterium that normally resides in the part of the GI tract separating the stomach from the duodenum. In cases of infection, inflammation of the affected area occurs, and overgrowth is unable to be taken care of by the immune system. Persons who suffer from recurrent episodes of peptic ulceration which only responds to treatment temporarily, most likely have H.pylori infection.

• Long term use of non-steroidal anti-inflammatory drugs (NSAIDs) used to treat pain and inflammation, which when used for a long time have the effect of depleting protecting gastric mucosa. NSAIDs work to block the action of an enzyme which produces a pain mediator (a prostaglandin). The downside of blocking this enzyme is the fact that the mediator also stimulates production of the mucous lining the stomach. Newer generation NSAIDs cause this unwanted effect much less, but have other effects that need to be considered (drugs such as Celebrex)

Diet and lifestyle, although these alone will not lead to development of peptic ulcers, individuals who possess borderline risk will likely develop them. High spice intake, along with chronic alcohol consumption or smoking are classified as ulcerogenic (ulcer making) triggers.

Gastrinomas are rare tumors which occur along the GI tract. These secrete gastrin and are known to cause multiple hard to treat ulcers. Gastrinomas are characteristic of Zollinger-Ellison syndrome.

Some of the symptoms and signs that may manifest with peptic ulcers are characteristic, while others may not be as clear cut. However, they often appear in conjunction with each other.

Common signs and symptoms include:

Pain in the abdominal region: This is perhaps the first indication of a peptic ulcer, however, the timing and frequency of the pain may be different depending on the afflicted area. The pain associated with stomach ulcers is worsened following a meal, while duodenal ulcers are relieved.

Peptic ulcers can affect anyone, but certain persons are more likely to develop them.
These persons include:
• Those who abuse/ use long term NSAIDs such as Ibuprofen, Diclofenac or Aspirin.
• Have a first degree relative that suffers from the ulcer.
• People who abuse alcohol / are alcoholics.
• Over 50 years and older people.

In most cases, a small ulcer will heal on its own. However, there is no need for you to suffer while believing that “eventually” it will heal. There are many effective forms of treatment available, either over the counter or by prescription. These include:

• H2 antagonists: These are effective, yet safe enough to be sold over the counter in your local pharmacy. They work to effectively block cells that signal the stomach to produce acid, in effect reducing the amount available at any time. Common ones include Zantac and Pepcid.

• Antacids: These are first line treatment for many persons, and while they will produce relief, it is for a short period unfortunately. Common antacids may contain salts of calcium, aluminum and magnesium, some common ones being Tums and Diovol Plus.

• Proton Pump Inhibitors: These drugs block an enzyme involved in acid secretion, and are the most effective drugs available. They can block up to 99 per cent of acid production, and are the best drugs for healing ulcers. Common available preparations are Losec and Nexium.

Lifestyle

Certain people are able to trace triggers; hence the first step is to eliminate them. Sources such as alcohol, smoking, spicy foods and overuse of painkillers can all be easily withdrawn. Lifestyle is the number one cause of peptic ulcer disease in India, where the diet consists of a spicy staple (curry) along with high incidence of alcohol abuse and smoking.

 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.