It id defined as a mucosal erosion of lining of
the stomach. Peptic Ulcers is a general term used to define hole in the
gut lining of the stomach, duodenum, or esophagus.
About 2% of population has active form of ulcers and ten percent have
developing ulcers in United States.
Causes:
It may occur because acidic digestive juices secreted by secretory
cells of mucosa injure the protective layer of stomach. The causes for
this are:
1.Infection- caused by bacterium H. pylori.
2.Prolonged intake of nonsteriodal anti-inflammatory drugs (NSAIDs) -
Prostaglandins are substances which are important in helping the gut
linings resist corrosive acid damage. NSAIDs cause ulcers by
interfering with prostaglandins in the stomach.
3.Cigarette smoking- not only causes ulcer formation, but also
increases the risk of ulcer complications such as ulcer bleeding,
stomach obstruction and perforation. Cigarette smoking is also a
leading cause of ulcer medication treatment failure.
4.Alcohol intake.
5.Prolonged used of spicy food.
6.Stress- one of the most important causation of development of gastric
ulcers.
Symptoms:
1.Abdominal pain, classically epigastric with severity relating to
mealtimes, after around 3 hours of taking a meal.
2.Bloating and abdominal fullness;
3.Waterbrash.
4.Nausea, and copious vomiting;
5.Loss of appetite and weight loss;
6.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.
A history of heartburn, gastroesophageal reflux disease (GERD) and use
of certain forms of medication can raise the suspicion for ulcer.
Diagnosis:
The diagnosis of an ulcer is made by either a barium upper GI x-ray or
an upper endoscopy (EGD-esophagogastroduodenoscopy) The barium upper GI
x-ray is easy to perform and involves no risk or discomfort. Barium is
a chalky substance administered orally. Barium is visible on x- ray,
and outlines the stomach on x-ray film. However, barium x-rays are less
accurate and may not detect ulcers up to 20% of the time.
An upper endoscopy is more accurate, but involves sedation of the
patient and the insertion of a flexible tube through the mouth to
inspect the stomach, esophagus, and duodenum. Upper endoscopy has the
added advantage of having the capability of removing small tissue
samples (biopsies) to test for H. pylori infection. Biopsies can also
be examined under a microscope to exclude cancer. While virtually all
duodenal ulcers are benign, gastric ulcers can occasionally be
cancerous. Therefore, biopsies are often performed on gastric ulcers to
exclude cancer.
Complication:
1.Gastrointestinal bleeding is the most common complication. Sudden
large bleeding can be life-threatening.[2] It occurs when the ulcer
erodes one of the blood vessels.
2.Perforation (a hole in the wall) often leads to catastrophic
consequences. Erosion of the gastro-intestinal wall by the ulcer leads
to spillage of stomach or intestinal content into the abdominal cavity.
Perforation at the anterior surface of the stomach leads to acute
peritonitis, initially chemical and later bacterial peritonitis. The
first sign is often sudden intense abdominal pain. Posterior wall
perforation leads to pancreatitis; pain in this situation often
radiates to the back.
3.Penetration is when the ulcer continues into adjacent organs such as
the liver and pancreas.[3]
4.Scarring and swelling due to ulcers causes narrowing in the duodenum
and gastric outlet obstruction. Patient often presents with severe
vomiting.
5.Pyloric stenosis
Treatment:
1.Self care-Patients with gastric ulcers can make several lifestyle
changes to prevent their recurrence, including avoiding unnecessary use
of aspirin and NSAIDs, giving up smoking, and cutting down on alcohol,
tea, coffee, and sodas containing caffeine. Other preventative measures
include eating balanced, nutritious meals, learning how to manage
stress, getting plenty of rest and exercising as recommended.
2.Homeopathy offers some very good medicines for gastric ulcer disease.
But for a homeopath, the symptoms of the disease are much more
important than the ulcer itself. This is because to select the right
medicine a homeopaths needs to differentiate between the finer
presentations of a disease which, vary from person to person. A
homeopath not only tries to heal the ulcer, but also tries to remove the
general predisposition to acquire it and to find a medicine the
homoeopath has to take a complete case history of the patient including his/her
past history, family history, medical history and other characteristics
features of the patient.
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