Peptic Ulcer

admin   September 23, 2011   4 Comments on Peptic Ulcer

WHAT IS IT?
The entire digestive tract is lined internally by a layer called the mucosa. The mucosa located in the stomach and duodenum has a special resistance due to contact with highly corrosive substances such as:
Acid,
Pepsin,
Pancreatic Enzymes,
Bile;

Responsible for breaking down ingested food into its basic principles that can be absorbed by the blood and used as nutrients by various tissues of our body.
When one or other circumstance this mucosa is injured, we speak of peptic ulcer disease, according affecting the stomach or duodenum, respectively referred to as gastric or duodenal ulcer.

This ulcer is a more or less large wound that produces a discontinuity of the mucosa. Sometimes it does occur but a real wound that appears superficial erosion is accompanied by inflammation, then we are faced with a gastritis or duodenitis, depending on your location.

CAUSES
The recent demonstration of the relationship of peptic ulcer with gastric infection by flagellated bacteria called Helicobacter pylori has revolutionized the concept of the disease, its diagnosis and treatment, although not all peptic ulcers are due to the infection (not all infected by this bacterium have peptic ulcers).

Under normal conditions there is a balance between aggressive factors (acid, pepsin) and the resistance of the mucosa to protect itself, through the secretion of gastric mucus of its irritant action. This balance can be changed for the following reasons:

A weakening of the mucosa or defenders, due to certain substances such as alcohol, anti-inflammatory drugs, aspirin, or retrograde passage of duodenal contents into the stomach.
An increase in acid secretion or pepsin. The former tends to cause stomach ulcers and duodenal second.

SYMPTOMS
Classically, symptoms are seasonal, worsening in autumn and especially in spring to eased or disappear in summer and winter.

Usually, when the ulcer has been established, the subject has a pain that is located in the upper abdomen and keeping a rhythm associated with food (typically, though not infallible, it was said that the stomach ulcer pain with it empty and quiet while eating, while duodenal ulcer has an inverse relationship).
It is an annoying pain and usually changes the patient’s mood worsens while the states of anxiety.
This pain is accompanied by nausea and burning.
Sometimes causes bleeding of varying intensity that stain black stool or expel the vomit.
However, although pain is a common symptom, may be due to other diseases or develop an ulcer in people who do not experience pain.
The latter occurs in the elderly and in ulcers associated with intake of painkillers that mask.

RISK FACTORS
Heavy or spicy food.
Untreated gastritis.
Smoking.
Stress and worry.
Serious diseases that produce a significant physiological stress, such as blood infections or extensive burns.
Disorders of intestinal activity.
Drugs that damage the gastric mucosa, especially anti-inflammatory drugs, both drugs (aspirin, diclofenac, oxicam, etc..) And steroids (cortisone and derivatives.)

PREVENTION
Avoid eating foods that cause symptoms and too heavy meals.
Avoid taking anti-inflammatory drugs, or protect the stomach if they are essential, especially in susceptible persons.

DIAGNOSIS AND TREATMENT
DIAGNOSIS
The diagnosis will be issued by the physician and will be made through gastroduodenal study. Thus, the patient swallows a slurry with a contrast that will be visible on x-ray the stomach and duodenum, providing a template in the image that will be the ulcer.
It is now used primarily for gastroscopy: is inserted through the mouth tube (fiber optic) the thickness of a finger, which gives us a direct image of the state of the mucosa, stomach and duodenum.
It has the advantage of being more reliable and allows us to sample the lesion and see if it is gastritis, or cancer (which has similar radiographic images). In addition to confirm or rule out infection with Helicobacter pylori, face major treatment.

TREATMENT
The treatment of choice depends on the existence of Helcobacter pylori infection or not.

If an infection, treatment is aimed at eliminating, by the administration during two weeks of a combination of antibiotics and gastric antisecretory drugs.
Once completed, shall be verified by a simple breath test (test that can not be used for the initial diagnosis, not being too precise), which has eradicated the bacteria:

If this is achieved, most ulcers heal completely.
If this fails, you should try another course of treatment, perhaps with a different combination of antibiotics.
If no infection, treatment of possible causal factors (decision-inflammatory, physiological or psychological stress management ,…) and antisecretory drugs often control symptoms in a few weeks, although in this case we can not ensure permanent cure .
Sometimes the ulcer can cause more serious paintings and complications that we will resort to surgery.
Currently used

POSSIBLE COMPLICATIONS
The two most serious complications of the ulcer arising from his character of injury:
If it reaches a blood vessel can bleed, sometimes very significantly, putting even their lives in danger.
If it does pass through the stomach, the contents of the can spread into the abdominal cavity, very serious situation, or digesting organs with which contact, causing pancreatitis, pancreatic pseudocyst, fistula gastrocolic (communication between the stomach and large intestine). ..
Perforated ulcer can lead to death if nothing is done surgically on time.
FORECAST
If successful eradication of Helicobacter pylori, you can ensure definitive cure in most cases.
In cases that are not due to the infection, the treatment described above allows a very effective control of the disease.

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