Peptic Ulcer causes and prevention

Peptic ulcer is defined as mucosal erosion of the gastrointestinal tract that is usually acidic and thus extremely painful.

As many as 80% of ulcers are associated with Helicobacter pylori, a spiral shaped bacterium that lives in the acidic environment of the stomach.

Mostly peptic ulcers arise in the duodenum (first part of the small intestine, just after the stomach) than in the stomach.

Generally, stomach ulcers are malignant, but deuodenal ulcers are generally benign.

Types of peptic ulcers:
Type I: Ulcer along the lesser curve of stomach
Type II: Two ulcers present - one gastric, one duodenal
Type III: Prepyloric ulcer
Type IV: Proximal gastroesophageal ulcer
Type V: Anywhere along gastric body
Causes:
Chronic inflammation due to Helicobacter pylori
Drugs such as aspirin, NSAIDS
Sress
Smoking
Spicy foods
Signs and symptoms:
Adominal pain, classically epigastric with severity relating to mealtimes, after around 3 hours of taking a meal (duodenal ulcers are classically relieved by food, while gastric ulcers are exacerbated by it)
Bloating and abdominal fullness
Waterbrash (rush of saliva after an episode of regurgitation to dilute the acid in esophagus)
Nausea, and copious vomiting
Loss of appetite and weight loss
Hematemesis (vomiting of blood); this can occur due to bleeding directly from a gastric ulcer, or from damage to the esophagus from severe/continuing vomiting.
Melena (tarry, foul-smelling feces )
Diagnosis:
• Gastroscopy

• Direct culture of Helicobacter

• Stool antigen test

• X- rays

Complications:

• Gastrointestinal bleeding

• Perforation ( hole in the wall)

• Penetration (into adjacent organs)

• Gastric outlet obstruction (scarring due to ulcers)

• Pyloric stenosis

Treatment:

• Antacids

• Antibiotics

• Perforated peptic ulcer is a surgical emergency and requires surgical repair of the perforation

• Most bleeding ulcers require endoscopy urgently to stop bleeding with cautery, injection, or clipping.

Dr Geetha is associated with medical auditing services and Online Medical coding Training