What is Peptic Ulcer?
The word peptic refer to promoting digestion . Ulcer refers to an area of tissue paper corrosion . Hence , peptic ulcer means tissue wearing away in the digestive system .
Peptic ulcer is a break in the inside lining of the esophagus , duodenum or stomach . If peptic ulceration bod in the abdomen , it is term as gastric ulcer , likewise if it forms in the duodenum a duodenal ulcer , and esophageal ulcer if it forms in the esophagus .
Peptic ulcers are take form when the lining of any of these organs is corrode by the acidic digestive juices which are secrete by the stomach . A peptic ulcer is pretty unlike from erosion as it extends deeper into the lining of the esophagus , duodenum or stomach and triggers more of an incitive reaction from the tissue that are eroded .
Classification and Types of Peptic Ulcer
There are three unlike types of peptic ulceration .
Epidemiology of Peptic Ulcer
H. pylori contagion is very rough-cut strike more than a billion people worldwide . Half of the United States population sr. than the age of 60 is estimated to be infected with H. pylori . contagion commonly die hard for year together run to ulcer disease in 10 % to 15 % of septic individuals . H. pylori was find in more than 80 % of the patients in the past with gastric and duodenal ulcer ; however , the prevalence of infection with H. pylori as well as the proportion of ulcers because of the bacterium has lessen with increased appreciation , diagnosing , and treatment over a catamenia of meter . It is forecast that only 20 % of ulceration are associated with the bacteria presently .
Pathophysiology of Peptic Ulcer
Peptic ulcers are defects or corrosions in the gastric or duodenal mucous membrane that extend through the muscularis mucosa . The epithelial cells of the stomach and duodenum secrete mucus as a result of cholinergic stimulation in reply to excitation of the epithelial liner . The trivial portion of the gastric and duodenal mucous membrane is a form of a gel level , which is resistant to pepsin and acid . In the event that pepsin and acid enters the epithelial prison cell , there are other additional mechanism in place to reduce the trauma .
Under normal condition , a physiologic balance be between gastroduodenal mucosal defense and stomachic acid secretion . Peptic ulcer happen when the balance between the belligerent constituent and the defensive mechanisms is disrupted . fast-growing divisor , such as H pylori infection , NSAIDs , alcohol , acid , pepsin and bile salts , can alter the mucosal Department of Defense by allowing back diffusion of atomic number 1 ion and subsequent epithelial cell injury . The defensive mechanism include tight intercellular junctions , mucosal rakehell flow , mucus , epithelial reclamation and cellular regaining .
Causes and Risk Factors of Peptic Ulcer
Peptic ulcer are commonly get by either Helicobacter pylorus also known as H pylorus bacteria or NSAIDs i.e. , non - steroidal anti - incendiary drug . H Pylori bacteria are know to be responsible for about 4/5 of all gastric ulcer and about 95 % of duodenal ulcers . NSAIDs are acknowledge to be responsible for about 20 % of stomachal ulcers and 5 % duodenal ulcer .
Signs and Symptoms of Peptic Ulcer
The most vulgar symptoms of peptic ulceration are stomach upset - like pain . The pain can be felt anywhere in the domain from the abdomen button to the breast bone . It can last from a couple of minutes to a figure of hours . It can be more stark when the stomach is empty or can be defective during the night . It is relieved temporarily after eating certain foods and goes off and then render for a few days or hebdomad .
Less Frequent or Uncommon Symptoms of Peptic Ulcers are:
These symptom should be considered and treated as medical emergencies .
Tests to Diagnose Peptic Ulcer
Treatment for Peptic Ulcer
gastric antacid : Antacids counteract the acid present in the breadbasket . alkaliser such as Mylanta and Maalox are safe and effective treatments ; however , the neutralize military action of these agents is dead - lived , and uninterrupted dosing is require . alkalizer like Mylanta and Maalox which contain Magnesium can cause diarrhea , while aluminum containing agents like Amphojel can cause constipation . Ulcers return often when gastric antacid are discontinued .
PPIs (Proton Pump Inhibitors)
PPIs slim the amount of superman raise by the stomach and are give for individuals who tested minus for H. pylorus contagion . intervention generally run for from one to two months and if the ulcer is severe treatment can last longer .
Side effect , if they happen , are usually mild and go away as before long as the treatment stops . Some of them are :
H2-receptor Antagonists
H2 blocker or histamine antagonist are drug contrive to obstruct the activeness of histamine on stomachal cells and reduce window pane output in the stomach .
H. Pylori Treatment : Elimination of this bacterium may decrease the risk of recrudesce stomachic malignant neoplastic disease in the time to come .
NSAIDs ( Non - Steroidal Anti - Inflammatory Drugs):Individuals whose peptic ulceration was due to choose NSAIDs will have to stop taking them or replace them with another analgesic such as Tylenol . In cases where it may not be possible to stop taking nonsteroidal anti-inflammatory drug , the dosage has to be minimized and kept under continuous check . PPI or an H2 - sensory receptor resister may be added to counter the effects of nonsteroidal anti-inflammatory drug in such cases .
Sucralfate and Misoprostol : These agents strengthen the bowel lining against onset by acid digestive juice . Sucralfate cater protective finishing to the ulcer Earth’s surface and promotes healing . It has very minimal side personal effects . The most common side gist is stultification and the disturbance with the absorption of other medications . Misoprostol is commonly used to counteract the ulcerogenic effects of NSAIDs . Diarrhea is a uncouth side outcome . Misoprostol can stimulate miscarriages in fraught women , and hence should be avoided in women of childbearing historic period .
take down : The most important step in diagnosing of stomach ulcer is to confer with a gastroenterologist . The clinical interrogatory , rendition of determination of examination and depth psychology of examination result has to be evaluated by expert in the force field of gastroenterology organisation . Our good word is , if you abide with any of interchangeable symptoms then , confer gastroenterologist as before long as possible .
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