PEPTIC ULCER DISEASE

PEPTIC ULCER DISEASE

Peptic ulcers are part of a heterogeneous group not disorders in which acid and pepsin play a role. They’re characterized with a breach on the mucosal lining of the gastrointestinal tract and open sore that develop on the mucosal lining of your stomach and the upper parts of the small intestine. The ulcer is > 5mm at the level of the muscularis mucosa and < 5mm erosion.

Peptic ulcer can also be defined breach in the protective lining (mucosa) of the digestive tract caused by digestion of the mucosa by pepsin and acid. This may occur when pepsin and acid are present in abnormally high concentrations or when some other mechanism reduces the normal protective mechanisms of the mucosa. These include Helicobacter pylori infection and the use of aspirin and other NSAIDs. A peptic ulcer may be found in the oesophagus (oesophageal ulcer, associated with reflux oesophagitis); the stomach (see gastric ulcer); duodenum (see duodenal ulcer); jejunum (jejunal ulcer, usually in the Zollinger-Ellison syndrome); in a Meckel’s diverticulum; and close to a gastroenterostomy (stoma ulcer, anastomotic ulcer, marginal ulcer).
It occurs when mucosa lining of the digestive tracts get eats away by acid. The mucosa layer is made naturally to protect against acid but if the percentage of acid is raised or the later has reduced or lost its effectiveness, ulcer can set in.

 

 

TYPES
Peptic ulcer include
• Gastric Ulcer; in the stomach part of the G.I
• Duodenal Ulcer; in the first upper portion of your small intestine

 

EPIDEMIOLOGY
• It’s more prevalent in developing countries
• Duodenal ulcers are 2-3 times more common than gastric ulcer
• 60% of the world population is infected with H.pylori.

 

 

ETIOLOGY

It include:
• Infection: The most common cause of peptic ulcers is Helicobacter pylori bacteria commonly live in the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, the H. pylori bacterium causes inflammation of the stomach’s inner layer, thus, an ulcer. The H. pylori is transmitted close contact like kissing and also through food and water.
• NSAIDSs : Long term use of non steroidal anti-inflammatory drugs like diclofenac, ibuprofen aspirin and others can irritate the mucosal lining of your gastrointestinal tract.
• Medications: Certain medications such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax) and others can greatly cause peptic ulcer.
• Alcohol

 

 

Symptoms
• Burning stomach pain
• Feeling of fullness,
• Bloating or belching
• Dyspnea
• Change in appetite
• Unexplained weight loss
• Intolerance to hunger
• Intolerance to fatty foods
• Intolerance to spicy foods
• Intolerance to stress
• Heartburn
• Nausea

 

 

FACTORS
There are some factors which are protective or aggravating factors for peptic ulcer, they include: prostaglandin, bicarbonate, tight junction, genetic component ph. gradient, implicating H. pylori, Steroid, alcohol, heroes infection, calcium channel blockers, burns and others

 

Risk factors
There are very much risk factors associated with peptic ulcers, they either precipitate the causative agents or increase the severity. They include;
• Smoking;. Smoking induce infection of H. pylori and thus increase the risk of peptic ulcers.
• Heavy Alcohol; Alcohol irritate, inflamed and erode the mucous lining of your stomach and small intestine.
• Untreated stress.
• Spicy foods

 

Complications
Mismanaged or unmanaged peptic ulcers can result in:
• Internal bleeding. Bleeding can occur as slow blood loss that leads to anemia or as severe blood loss that may require hospitalization or a blood transfusion. Severe blood loss may cause black or bloody vomit or black or bloody stools.
• A hole (perforation) in your stomach wall. Peptic ulcers can eat a hole through (perforate) the wall of your stomach or small intestine, putting you at risk of serious infection of your abdominal cavity (peritonitis).
• Obstruction. Peptic ulcers can block passage of food through the digestive tract, causing you to become full easily, to vomit and to lose weight either through swelling from inflammation or through scarring.
• Gastric cancer. Studies have shown that people infected with H. pylori have an increased risk of gastric cancer.

 

Prevention
You may reduce your risk of peptic ulcer if you follow the same strategies recommended as home remedies to treat ulcers. It also may be helpful to:
• Protect yourself from infections. It’s not clear just how H. pylori spreads, but there’s some evidence that it could be transmitted from person to person or through food and water.
You can take steps to protect yourself from infections, such as H. pylori, by frequently washing your hands with soap and water and by eating foods that have been cooked completely.

• Use caution with pain relievers. If you regularly use pain relievers that increase your risk of peptic ulcer, take steps to reduce your risk of stomach problems. For instance, take your medication with meals.
• Visit your physician to find the lowest dose possible that still gives you pain relief.
• Avoid drinking alcohol when taking your medication, since the two can combine to increase your risk of stomach upset.
• Avoid using over the counter drugs and eschew drug abuse
If you need an NSAID, you may need to also take additional medications such as an antacid, a proton pump inhibitor, an acid blocker or other agent so as to lessen the effect on the lining of your stomach and small intestine .