Peptic Ulcer Disease: Treatment, Symptoms, Causes

 

 

Peptic Ulcer Disease

Peptic ulcer disease, also known as duodenal ulcer, is a painful condition that occurs when the tissue in your stomach and digestive system becomes inflamed by bacteria. The symptoms of peptic ulcer disease include abdominal pain, nausea, and vomiting. This leads to weakness and dehydration almost immediately after eating and can last for a couple of days.

Peptic ulcer disease is a condition where an abnormal gastric or duodenal pepsinogen enzyme called HCl is present. Pepsinogen numbers are affected by stress, age, and hormonal changes (among others). Prolonged exposure to stress or prolonged anxiety may result in increases in the number of HCl secretions which leads to digestive upsets. As a result of these secretions, the lining of the stomach becomes inflamed and vulnerable to injury. Peptic Ulcer Disease occurs when stomach acids erode through the lining of the stomach creating holes in it.

Background of Peptic Ulcer Disease

Peptic ulcers are small openings in the lining of your stomach or intestine. Although the cause of Peptic Ulcer Disease is not fully known, there are some factors that can increase your risk of developing it. These include pregnancy, smoking, and drinking alcohol.

Peptic ulcer disease is one of the most common digestive disorders as well as one of the most frequently diagnosed conditions in the United States.[1] The main symptom of peptic ulcer disease is heartburn, which occurs when stomach acid becomes too concentrated or secreted upwards into the esophagus and/or back into the stomach. This can cause an unpleasant burning sensation in the throat and chest that may be accompanied by nausea or vomiting. Since people are unable to avoid this condition, there are many other symptoms associated with it.

Types of Peptic Ulcer

Peptic ulcers are a common digestive disorder. They can cause severe abdominal pain, excessive bleeding, and even death if left untreated.

There are the types of peptic ulcers:

Duodenal ulcers:

The lining of the duodenum is very thin and can be damaged by acid or spicy foods. Duodenal ulcers are more common in those who have had a previous episode of gastric or duodenal ulcers.

Gastric ulcers:

These occur in the stomach and can be caused by stress, poor nutrition, smoking, and alcohol abuse. Gastric ulcers often cause no symptoms until they reach an advanced stage when they may become painful and bleed irregularly.

Ulcerative colitis:

This is an inflammatory bowel disease that causes inflammation mainly in the colon (large intestine). It usually starts with diarrhea followed by rectal bleeding which may be bloody or black blood-streaked mucus. It can affect both men and women but is more common in women than men because their intestines are shorter than those of men (women tend to have long small intestines).

 

Anatomy of Peptic Ulcer Disease

The anatomy of peptic ulcer disease is complex and involves many different structures. The stomach, duodenum, esophagus, and small intestine are particularly affected by the disease.

The anatomy of peptic ulcer disease is different from the anatomy of gastric cancer. Gastric cancer starts in the stomach, whereas peptic ulcer disease is a condition that occurs in the digestive tract. The stomach, which is located in the upper left quadrant of our abdomen, contains four sections:

Cardia — The bottom part of the stomach.

Body — In middle part of the stomach.

Epigastrium — The uppermost part of the stomach.

Pylorus — A muscular ring at the point where food leaves the stomach and enters the duodenum or small intestine (a section of the large intestine).

The pylorus also plays an important role in digesting foods that contain calcium, magnesium, or vitamin D.

A peptic ulcer is a type of ulcer, or sore, in the stomach or duodenum (the first part of the small intestine). Peptic ulcers are caused by irritation and damage to the lining of the stomach or duodenum. These sores are usually painless but may cause discomfort.

There are two types of peptic ulcers:

Megacolon - this type of peptic ulcer affects only a small portion of the stomach and can lead to bacterial infection.

Gastric - this type of ulcer affects more than half of the stomach's surface area and can be caused by stress or inadequate nutrition.

Peptic ulcers occur when gastric acid from your stomach leaks into another part of your body through damaged tissue. The most common place for a peptic ulcer to develop is in your esophagus (food pipe), but they can also occur in other parts of your digestive system including your duodenum (first part of the small intestine) and rectum (last part of the large intestine).

Pathophysiology of Peptic Ulcer Disease

The pathophysiology of peptic ulcer disease (PUD) is complex and not fully understood. The most common hypothesis proposed to explain the development of PUD is that it occurs as a result of an acidic environment in the stomach, leading to damage to the stomach wall. This damage results in an increased risk of bleeding, which can then lead to perforation or erosion of the stomach lining.

In addition, there are other factors that may be involved in triggering PUD.

These include: 1) Low levels of acid in the stomach 2) Gastroesophageal reflux disease (GERD) 3) Smoking 4) A history of alcohol abuse.

The pathophysiology of peptic ulcer disease is complex and not fully understood. There are many contributing factors, including heredity, stress, smoking, a poor diet, and other medical conditions.

Heredity plays a large role in the development of peptic ulcers. This can be either genetic or acquired through a viral infection such as H. pylori infection or reflux esophagitis. Smoking increases the risk of developing peptic ulcers as it increases the production of gastric acid and decreases stomach pH levels. A poor diet also contributes to peptic ulcer disease as it causes an imbalance in the body's digestive system. The body needs adequate amounts of protein, fats, and carbohydrates for proper digestion and absorption of nutrients from food. A diet lacking one or more of these nutrients can cause an imbalance which results in gastric acid secretion instead of normal stomach acids that aid in digestion and absorption.

Gastric ulcers are a common complication of peptic ulcer disease. Gastric ulcers may be either functional or non-functional.

1) Functional gastric ulcers are a type of self-limited lesion that heals without intervention. Clinical symptoms resolve as the lesion heals and no longer causes symptoms. The pathophysiology is related to Helicobacter pylori infection which causes acid secretion in the stomach, resulting in damage to epithelial cells and inflammation. Antibiotics do not affect the course of this disease, but other measures such as Helicobacter pylori eradication therapy may improve symptoms.

2) Non-functional gastric ulcers Non-functional gastric ulcers are nonhealing lesions that do not cause clinical symptoms. They may progress to cancer and require treatment for this reason.

Signs and Symptoms of Peptic Ulcer Disease

There are a variety of signs and symptoms that can be associated with peptic ulcer disease, including;

·        Nausea, vomiting, and/or abdominal pain

·        Heartburn or acid regurgitation

·        Mucus in the stool or blood in the stool (hemoccult)

·        Numbness in your hands and feet (paresthesia)

·        Feeling tired all the time (fatigue)

Causes of Peptic Ulcer Disease

There are several causes of peptic ulcer disease.

These include:

1) Habitually eating or drinking too fast. You may only notice heartburn when you eat or drink quickly.

2) Heartburn is more likely to occur when you eat and drink too fast because the stomach cannot empty as fast as your stomach needs to empty.

3) Eating or drinking spicy, acidic, or fatty foods or drinks.

4) Heartburn is more common after eating a meal high in fat, protein, or carbohydrates and has been linked with overeating.

5) Skipping meals and poor dieting habits can lead to a lack of nutrients which can trigger symptoms of heartburn.

6) A low-fat diet may be beneficial for people with peptic ulcer disease because it helps reduce acids in the stomach that trigger symptoms such as heartburn, nausea, and vomiting.

Peptic ulcer disease (PUD) is a chronic condition that can cause irritation, inflammation, and bleeding in your digestive system.

Causes of peptic ulcer include

H. pylori infection. H. pylori is the most common cause of gastric cancer worldwide, according to the World Health Organization (WHO). Stress or anxiety.

Stress can cause an increased risk of PUD symptoms, such as heartburn, nausea, or vomiting.

A diet high in red meat and processed foods. A diet high in red meat and processed foods may increase your risk of developing peptic ulcers.

Injury to the stomach (perforation) or other areas of the digestive system. Some types of surgeries, such as gastric bypass surgery or a laparoscopic procedure called fundoplication, may increase the risk of developing PUD symptoms.

Treatment of Peptic Ulcer Disease

Treatment of Peptic Ulcer Disease

Medications: Pain relievers like ibuprofen (Motrin) or naproxen sodium (Aleve) can help relieve the pain associated with peptic ulcers. They may also be used to treat chronic gastritis and reflux disease.

Antacids:

Antacids can be used to relieve symptoms of acid-related conditions, including dyspepsia (indigestion), heartburn, and peptic ulcer disease. Examples include calcium carbonate, bismuth subsalicylate (Pepto-Bismol), and sodium bicarbonate.

Antacids are not recommended for people who have a history of kidney stones or gallbladder problems because they might decrease the amount of potassium in the body's blood. 

Antisecretory drugs:

Tolinase (Tolinat) and omeprazole are antisecretory medications that may be prescribed for the treatment of peptic ulcer disease if other medications do not work sufficiently well. However, these drugs do not completely cure peptic ulcers.

Risk Factors of Peptic Ulcer Disease

Risk factors for Peptic Ulcer Disease include:

·        -Smoking

·        -Steroid use (e.g., cortisone)

·        -Age over 50

·        -Infection with helicobacter pylori bacteria, a known risk factor for Peptic Ulcer Disease.

Peptic ulcer disease (PUD) is a term used to describe any ulcer in the stomach or intestine, but peptic ulcers that occur in the stomach are more common than those that occur in the small intestine.

Peptic ulcers can result from a number of conditions. For example, some people develop them as a side effect of taking certain medications, such as NSAIDs (nonsteroidal anti-inflammatory drugs), aspirin, and other blood thinners. Others may develop them as a side effect of alcohol abuse or chronic stress.

Other risk factors for developing PUD include

Age: Peptic ulcers are most common in people over age 50, but they can occur at any age. However, the older you are, the more likely you are to have symptoms such as persistent heartburn or epigastric pain.

Menopause: Women who go through menopause often develop peptic ulcers due to changes in their hormone levels. Hormone replacement therapy can help reduce this risk.

Family history: If your mother or father had peptic ulcers before age 50, you may be at increased risk of developing this condition yourself later on in life. Smoking: Smokers who quit smoking before age 35 may see.

Complications of Peptic Ulcer

Most peptic ulcers do not cause complications. However, they can develop into more serious conditions, including

Stomach cancer. Stomach cancer is rare and occurs in less than 1 percent of people with peptic ulcers. It's most common in people who have had their stomach removed or who have had their appendix removed.

Cancer develops from the lining of the stomach and usually affects older men who are heavy smokers or alcoholics. Cancer of the esophagus (esophageal cancer). Esophageal cancer is rare in people with bleeding gastric ulcers, but it may occur at any age and is more common in men than women.

Esophageal cancer develops from cells lining the esophagus, which is the tube that carries food from your mouth to your stomach. When you eat food, acid from your stomach mixes with food particles and causes them to stick together into a bolus that passes down into your esophagus. The sticky mucus covering this bolus then irritates cells lining your esophagus and causes them to grow rapidly without proper blood supply or oxygen delivery from your lungs (metastasis).

Prevention of Peptic Ulcer

In order to prevent peptic ulcer disease, it is important to avoid stress and nutritional deficiencies. Stress can lead to acid reflux, which can damage the stomach lining and cause an ulcer. Some people are genetically prone to developing peptic ulcers, whereas others are not. The best way to prevent peptic ulcer disease is through proper diet and nutrition, including fresh fruits and vegetables, whole grains, and lean protein sources such as fish or chicken. As with any disease, though, there are some things that may aggravate the symptoms of peptic ulcers.

These include:

- Chronic stress - Stress can worsen existing symptoms of gastric disorders and make them more difficult to treat.

- Poor diet - A poor diet can aggravate any underlying conditions that cause chronic stress and lead to poor digestion.

- Smoking - Smoking can cause damage to the stomach lining by directly damaging cells in the area or indirectly by increasing acid production in the stomach (which promotes intestinal bacterial growth).

When to see a doctor for Peptic Ulcer disease

If you have a mild or moderate attack, you can usually treat it yourself.

If the pain is severe, you should see a doctor immediately.

When to see a doctor in Peptic Ulcer disease:

If you have signs of bleeding such as blood in your stool or dark blood in your vomit.

If you have vomiting blood or blood in your vomit that has not been passed within 6 hours of eating.

If you feel pain in your belly area when you eat (gastric reflux).

If you are vomiting small amounts of blood that may get larger with time.

If the pain lasts more than several days or if it worsens after eating food.

 

Conclusions:

In this article, we have seen that Peptic Ulcer Disease can be caused by an increase in the number of HCl secretions and a decrease in Pepsinogens. There are many causes for ulcers, but these two are the main reason for ulcers, and in this article, we have learned about causes the rise of HCl secretion or decline of pepsinogens levels. This is why if you have ever suffered from peptic ulcer disease then you know the kind of pain it can give you and how dangerous it can be if left untreated.

If you suspect that you or someone you know may have symptoms of Peptic Ulcer Disease, seek medical treatment as soon as possible. Only a doctor can properly diagnose the condition with the necessary tests. After diagnosis and proper treatment, patients should be able to enjoy a higher quality of life than before.