stomach ulcers
also known as a Peptic ulcers are open sores
that develop in the lining of the
esophagus, stomach or the
first part of the small intestine,
known as the duodenum. Over
25 million Americans will suffer
from an ulcer at some point
during their lifetime, according
to the Centers for Disease
Control and Prevention (CDC).Most ulcers are caused by an infection by Helicobacter
pylori bacteria (H. pylori), and can be treated in about two weeks with
antibiotics, according to the CDC."The two most common causes of ulcers are H. pylori,
a bacterial infection, and medications, most commonly aspirin and other nonsteroidal
anti-inflammatory medicines(NSAIDs), and iron tablets,.
"Psychological stress probably has no role in the development of ulcers, though biological
stress like being a very ill patients in the intensive care unit can definitely contribute to
ulcers," Swaminath said."Foods aren’t really thought to contribute to ulcers, but they
may make patients with already present inflammation or ulcers feel worse depending
on what’s eaten.
Symptoms
The most common symptom of peptic ulcers is a burning pain in the stomach, according to
the NIH. Typically, the pain starts between meals or during the night, and may stop if you
eat or take antacid
medications. The pain comes and goes for several days or weeks, and can be felt
anywhere from your navel up
to your breastbone, according
to Mayo Clinic.
Although the most common
symptom of ulcers is pain, the
condition can also present as
bleeding, or anemia,
Swaminath said. "There are a
lot of other organs around the
area of the stomach. Part of
the challenge of figuring out
what is causing the 'abdominal
pain' is to rule in or out things
like:
pancreatitis, gallstones, Crohn’s
s disease, or stomach cancer."
Psychological stress can
cause symptoms that mimic
the symptoms of ulcers,
Swaminath said. But because
stressed out people are at the
same risk for factors that really
can result in ulcers, they
should consult their doctor if
they have persistent
symptoms, he said.
Causes
Peptic ulcers happen when the
acids that help digest food
damage the walls of the
stomach or duodenum. The
insides of the digestive tract is
coated with a mucus layer that
protects against stomach acid,
but in some people who are
infected with H. pylori, the
bacteria get into the mucosal
lining in the stomach, creating
holes and exposing more
sensitive tissue to stomach
acid.
H. pylori is a common
infection, and it is possible that
the bacteria is spread between
people through contact with
infected stool, vomit or saliva.
It also may be contracted from
contaminated water or food.
According to the Mayo Clinic,
one in five young adults is
actually infected with the
bacteria. Still, for unknown
reasons it does not result in
ulcers in everyone.
Another cause is the regular
use of certain pain relievers,
specifically, NSAIDs such as
aspirin and ibuprofen (Advil).
These medications, as well as
naproxen (Aleve) and
ketoprofen, can irritate or
inflame the lining of the
stomach and small intestine.
Peptic ulcers are more
common in older adults who
take these pain medications
frequently or in people who
take these medications for
osteoarthritis.
Cigarettes, alcohol, and stress
can exacerbate symptoms by
further irritating the stomach
lining.
Diagnosis & tests
Doctors most commonly
diagnose ulcers using
endoscopy, Swaminath said.
This involves "taking a camera
directly into the stomach to
look for ulcers and taking
biopsies to make sure the
'ulcers' aren’t really cancer or
something else," he said.
There are several other tests
for the diagnosis of stomach
ulcers. A physician may use a
blood, stool, or breath test to
detect the presence of H.
pylori or antibodies to H. pylori,
according to the Mayo Clinic.
A breath test consists of
drinking a glass of liquid that
contains a radioactive
substance. This substance
reacts with H. pylori so that
when an individual with
stomach ulcers blows into a
bag, the breath will contain the
radioactive carbon in the form
of carbon dioxide.
Sometimes an X-ray exam
may be performed to visualize
the ulcer. A liquid containing a
metal element called barium is
ingested for this procedure. If
an ulcer is found, the physician
may then do an endoscopy in
which a flexible tube w
Treatment & medication
Treatment of stomach ulcers
consists of killing H. pylori and
decreasing the amount of acid
in the stomach. This requires
several types of medications.
Physicians may prescribe
several antibiotics at once, or
use a combination drug such
as Helidac to kill H. pylori.
Helidac contains two
antibiotics along with an acid reducing
drug and a
medication that protects
stomach tissue.
The doctors will also try to stop
other medications the patient
is taking and might have a role
in worsening the ulcers.
"Most of the time, we try to
withdraw the offending
medication, but that is not
always possible, for example
patients on aspirin who have
heart arrhythmias, or recent
heart stents," Swaminath said.
"We put patients on high
doses of the drug for eight
weeks by which time the area
will typically heal," Swaminath
said. "A low dose is continued
indefinitely if the offending
medication can’t be
discontinued."
Drugs called acid blockers (for
example, Pepcid) and antacids
may be recommended to
decrease the levels of
stomach acid. Other
medicines, called proton pump
inhibitors, such as Prilosec
and Prevacid, are another
option. They work by blocking
cellular pumps that release
acid into the stomach.
No comments:
Post a Comment