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Peptic Ulcer-Symptoms, Causes, Treatment

It is important to be aware of the symptoms of peptic ulcer so that the problem can be addressed as early as possible to avoid worsening or complications.

The Peptic ulcer disease is an impairment of the mucosa and the deeper structures of the esophagus, stomach and duodenum. Peptic ulcer happens when the gastric juices and stomach acids damage the linings of the stomach and duodenum. The cause of peptic ulcer is the bacterium, Helicobacter pylori causing symptoms of peptic ulcer to come out. Helicobacter pylori infection is usually due to eating raw or improperly cooked meats and fish. Peptic ulcer can occur at any age although it is rarely seen in children or teenagers.

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Two types of Ulcer: Duodenal Ulcer and Gastric Ulcer

Duodenal Ulcer is also called “executive ulcer” because it is primarily due to stress. It is more common in ages 25 – 50 years old or the working or peak years of life. Usually people affected by duodenal ulcer are well nourished.

Gastric Ulcer is also called “poor man’s ulcer” because it is primarily due to starvation. It is more common in ages 50 years and above because older people lose their interest in food. Usually individuals affected with gastric ulcer are malnourished.

Causes of peptic ulcer

There are different predisposing factors of peptic ulcer which cause the symptoms of peptic ulcer to be manifested. These are as follows:

  • Stress – When the body feels stressed out, the sympathetic nervous system (SNS) is triggered, however if the SNS is exhausted from too much stress then the parasympathetic nervous system (PNS) is activated. The activation of the PNS causes increased motility of the stomach and increased secretion of hydrochloric acid.
  • Cigarette smoking, alcohol and caffeine intake – These substances can stimulate increased hydrochloric acid secretion and cause vasoconstriction. They can damage and irritate the gastrointestinal mucosa.
  • Genetics – There are individuals who have higher parietal cell mass compared to other individuals.
  • Medications – Nonsteroidal anti inflammatory drugs, steroids and aspirin are the medications that can cause ulcers so it should be taken with meals to avoid gastric irritation.
  • Fatty, spicy and highly acidic diet – Foods that are fatty, spicy and highly acidic are stimulants which increase the gastric secretion and can irritate gastrointestinal mucosa.
  • Type A personality – The type A personality is also called the “stress personality” because it is characterized by perfectionism, workaholism and the inability to concentrate on one task only. The result of this personality would be stress which increases the hydrochloric acid secretion and gastric motility.
  • Blood type O – Individuals with blood type O can cause symptoms of peptic ulcer to come out since they have higher pepsinogen levels. Pepsinogens are activated into pepsins which are combined to hydrochloric acid for digestion.

Peptic Ulcer Symptoms and Signs

  • The most common symptom of peptic ulcer is a dull, aching, gnawing epigastric pain.

In gastric ulcer, the pain radiates to the left side of the abdomen since the      stomach is located on the left side; while in duodenal ulcer, the pain radiates   to the right side of the abdomen since the duodenum is found on the right side.

Gastric ulcer pain is not relieved by the intake of food while the duodenal ulcer pain can be resolved by food intake since food in the stomach delays the gastric acid emptying in the duodenum.

In gastric ulcer, pain is felt 1 to 2 hours after eating; while in duodenal ulcer, the pain is felt 3 to 4 hours after eating.

  • Another symptom of peptic ulcer disease is nausea, vomiting and hematemesis or vomiting of blood.
  • Melena or black, tarry stool can also be manifested because the blood is acted on by the gastric acid.
  • Loss of appetite and interest in food.
  • Sudden weight loss.
  • Tiredness and weakness is a symptom of peptic ulcer disease when there already is a bleeding ulcer. Bleeding results to anemia which brings about these symptoms.

Peptic Ulcer Disease Treatment

The symptoms of peptic ulcer should be relieved by encouraging the patient to have a healthy lifestyle. Avoiding foods rich in fats, spices and acid, quitting smoking, drinking alcohol and decreasing caffeinated drinks can help in preventing the symptoms of peptic ulcer from occurring.

There are different medications that can be taken to control the symptoms of peptic ulcer. Histamine 2 receptor antagonists reduce hydrochloride acid secretion, proton pump inhibitors suppress gastric acid secretion, antacids neutralize hydrochloric acid, cytoprotective drugs coat ulcers and enhance prostaglandin synthesis and prostaglandin analogues replace gastric prostaglandin and impede gastric acid secretion. When the cause of the peptic ulcer disease is the bacterium, Helicobacter pylori, antibiotics can be taken such as Amoxil and Biaxin.

There are surgical interventions that can prevent the worsening of symptoms of peptic ulcer. Vagotomy or resection of the vagus nerve decreases hydrochloric acid and gastric motility. Gastroduodenostomy (Billroth I) and Gastrojejunostomy (Billroth II) are surgical resection of the stomach anatomizing the duodenum or jejunum. Pyloroplasty or surgical dilatation of the pyloric sphincter improves the gastric emptying.

Peptic ulcer disease should be dealt with promptly. Consult the physician if you have symptoms of peptic ulcer to avoid further complications.

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