MANAGEMENT AND TREATMENT OF DUODENAL AND GASTRIC ULCER
Peptic Ulcer popularly known as peptic ulcer is an injury to the internal lining (mucosal) of the stomach or the small intestine (duodenum). It is most often caused by a bacteria called Helicobacter pylori. However there are other factors that contribute to ulcer in the stomach or duodenum; such as smoking, drinking alcohol, drugs such as aspirin, steroids and stress. Ulcer is classified into Duodenal ulcer and gastric or stomach ulcer.
Most people believe that starvation causes ulcer but improper eating lifestyle also contribute to it causes considering people believe certain eating pattern but it most preferable to eat when ever you feel hungry and eat only an amount of food that satisfies you to avoid stomach ache.
This is ulcer that affect the small intestine (usually the duodenum a part of the small intestine where most digestion and absorbtion of food takes place); It is more higher in males than in females, it is common among the middle aged (30 – 50 years), more common to people of the ‘O’ blood group and smoker. However, the rate of Helicobacter pylori infection in duodenal ulcer is up to 95%.
This is also referred to as stomach ulcer: It is common in late middle age; it’s incidence and occurence increases with age; just like the duodenal ulcer. It is more commonly found in males than in females but in lesser ratio to that of duodenal ulcer; it is more common in patients with blood group ‘A’; the rate of helicobacter pylori infection is very less; almost about 80% of gastric ulcers occur in the absence of Helicobacter pylori infection. 10 – 20% of patients with gastric ulcer have a concomitant duodenal ulcer.
Symptoms of Ulcer
Most people get the symptoms of ulcer and most of the time overlook the pain which is usually the most common symptom associated with mucosal ulceration leadiing to an increase in ulceration owed to lack of care.
The major symptoms that cause ulcer;
- Pain: A lot of people ignore the pain until it so severe believe it a simple pain a pain reliever (analgesic) could treat. I suggest after taking anagesic and the pain can still be felt even in the slightest manner ever then a diagnosis from a doctor wuld be great especially when the pain is burning, groaming or aching pain.
- Nausea: The feeling and urge to vomit most of the time without feeling sick or pregnant.
- Chest discomfort: this is a maor symptom of gastric ulcer, it is mostly felt as a chest burn or heart burn.
Other symptoms include vomiting, belching, dyspeghia (difficulty in swallowing), anorexia(weight loss), andheamatemesis(vomit with blood).
When the symptoms start occuring it is most advisable to see a doctor who may ask that you go carry out a test to ascertain what exactly is wrong as the symptom may indicate a different disease and may just by a false positive. Some availabe test include;
- Stool for fecal occult blood.
- Urea breath test.
- Blood test.
- Stool antigen assays and rapid urease test on a biopsy sample.
- Upper gastrointestinal tract (stomach) endoscopy.
All of this test can not be carried out at home. It is advised that you go to a mediical laboratory to be tested.
Treatment of Ulcer
There are drugs that can be used to treat ulcer to avoid surgery such as pyloritomy(surgical removal of part of the stomach (pylory spinter: that conduct food to the intestine)).
The most common drug class people always refer to are the antacid: these usually come in milky suspensions used to reduce acid release thereby reducing the spread of the injury and reduce pain such aluminium compounds a common brand is the gestid, milk is also advised as well a reduction in pepper intake but other drugs are still needed such antibotics such as Ampicillin or Tetracycline to kill the bacteria, mucosal protective agent to help the injury and reduce pepsin (an acidic emzyme in the stomach) production (ulceration) heal such as Sucralfate and Collodial Bismuth. Other drugs class employed include;
H2 Receptor Blocker; They reduce basal and food stimulated gastric secretion, reduces pepsin activity,the promote mucosal healing and reduce pain. Examples include Cimetidine, Ranitidine, Famotidine and Nazatidine.
Proton Pump inhibitor: They inhibit proton pump that is responsible for the final step in gastric acid secretion from the pariental cell in the stomach. Typical examples are Omeprazole, Lanasoprazole and Pantoprazole.
As always drugs play wonderful role to disturbing condition but they have side effect hence it is important to take the right doses because when under dose your don’t get the right or no effect but when in over dosed it becomes a poison with toxic effect. Continuous medication is advise for the period prescribed is needed to avoid a relapse (re-occurrence of the diseased state)
Ulcers That Fail To Heal
Ulcers that do not heal with treatment are called refractory ulcers. There are many reasons why ulcer may fail to heal including;
- Not taking medications according to directions
- Resistance of Helicobacter pylori (H. Pylori) are resistant to antibiotics
- Regular exposure to tobacco especially smokers.
- Regualar use (Over dependence on some drugs) of certain drugs such as Non steriodal anti-imflamatory drugs (NSAID) including aspirin(salicylic acid), Ibuprofen.
Less often, refractory ulcers may be as a result of;
- Zollinger Ellison Syndrome where there is over secretion of stomach acid.
- Stomach cancer.
- An infection other than H. Pylori.
- Other disease that may cause ulcer like sores in the stomach and the small intestine such as crohn’s disease.
Treatment for refractory ulcers generally involves eliminating factors that may interfere with healing, as well as the use of different antibiotics (warning: care should be taking to avoid antibiotics tolerance by continuous administration of antibiotics especially when there is no need for it).
In summary; patients with ulcer are advised to take their medication according to direction by the prescriber, be mindful of what they eat, have a healthy stress free lifestyle, all this should help in relieve from pain and possible healing.
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