ULCER
Ulcers are painful sore that is present in the protective lining of the digestive tract in humans.
- The digestive tract is made up of the mouth, esophagus, stomach, duodenum and the intestine.
- Ulcers are relatively easy to treat but can cause problems if left untreated.
- Peptic ulcers are the most common ulcer types.
- Peptic ulcers are associated with the presence of pepsin (a substance found in the digestive system) along with hydrochloric acid in the stomach lining.
- Peptic ulcers are of three types and are named for their location in the body.
- A peptic ulcer that is present in the stomach is known as gastric ulcer
- If the peptic ulcer is in the duodenum, it is referred to as duodenal ulcer.
- A peptic ulcer that forms in the esophagus is called esophageal ulcer
- Other lesser-known types of ulcers are:
- Stress ulcer that is found in critically ill or intensely stressed patients.
- Bleeding ulcer, a peptic ulcer that has been left untreated can result in internal bleeding. Internal bleeding is a very critical matter and may require urgent medical attention. This is the most dangerous of all ulcers and if left unattended can lead to severe consequences.
- A refractory ulcer is a term used to describe a peptic ulcer that has not healed over a period of time.
CAUSES
An ulcer is formed when the mucus layer protecting the tissues of the body against digestive juices (acid) breaks down or wears out. This breakdown maybe as a result of:
- Helicobacter pylori, a bacteria that causes stomach infection and inflammation
- Frequent use of aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDS)
- Smoking
- Stomach cancer
- Radiation therapy
- Excessive alcohol intake
- Excessive stomach acid secretion
SYMPTOMS
- Abdominal pain that:
- Starts between meals or at night
- Is relived after the use of antacids
- That last for few minutes or hours
- Discomfort after meals
- Heartburn
- Bad breath
- Constipation
- Abnormal weight loss
- Nausea and vomiting
- Unusual headaches
- Sleep problems
- Changes in appetite
- Indigestion
- Bloody or dark stool
DIAGNOSIS AND TREATMENT
DIAGNOSIS
Diagnosing ulcer will depend on your symptoms and intensity of the ulcer. Your doctor will request for your medical history and review it and follow on your symptoms by asking questions about how the pain feels, how frequent it is, how long it lasts and any medications you are taking.
A blood, stool or breath test may be ordered to check for infections in your stomach caused by Helicobacter pylori bacteria.
In case of more serious symptoms like bleeding, other tests may be required
An upper endoscopy where a thin tube with a camera is inserted and passed down your throat into your stomach and small intestines to visualize and examine the area for ulcers.
Upper gastrointestinal test (upper GI). In this procedure, you will drink a thick white liquid called barium that coats your upper gastrointestinal tract and make it possible for your doctor to view and treat the ulcer on X-rays. This procedure is also referred to as barium swallow.
TREATMENT
The treatment may be non- surgical or surgical and depends on the underlying cause of the ulcer.
Non-Surgical Treatments
If an ulcer is due to Helicobacter pylori infections, the doctor will prescribe antibiotics to help kill infections and proton pump inhibitors to block acid-producing cells.
If Helicobacter pylori have been ruled out, proton pump inhibitors may be prescribed. This helps with blocking acid-producing cells.
Other non-surgical treatment may include:
Stopping all use of nonsteroidal anti-inflammatory drugs (NSAIDS)
H2 receptor blockers that reduce acid production
Antacids
Bismuth supplements
Surgical treatments
In rare cases where ulcer bleeds, refuses to heal, continue to occur or stops food from leaving the stomach, surgical treatment may be required. The surgery may include removal of ulcer, tying off the blood vessel or cutting off the nerve that produces acid in the stomach.