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Peptic Ulcer


Peptic ulcer is a common disease. It is a painful condition in which the stomach pain always comes and goes. Complications may develop in some cases, such as internal bleeding or perforated peptic ulcer. The term ‘peptic ulcer’ is a collective name that actually refers to gastric ulcer or duodenal ulcer. However, the common symptom of all these forms of stomach ulcer is stomach pain. They also have similar causes.

Causes of Peptic Ulcer
Peptic ulcer can be caused by a variety of factors. The primary cause is believed to be an imbalance between stomach acid and protective mucosal coating.

  1. An increasing stomach acid production will certainly result in a peptic ulcer. Other causes are stress, anxiety, high caffeine consumption, and poor eating habits.
  2. Infection with a type of bacteria called Helicobacter Pylori or H. Pylori is considered the primary cause of a peptic ulcer. H. Pylori is transmitted from person to person through saliva. The bacteria lives in the mucous layer that covers and protects the tissues that line the stomach causing inflammation which develops into an ulcer.
  3. Gastric mucosal damage can be caused from the consumption of aspirin, bone and joint pain relievers, alcohol and spicy food.

Symptoms of Peptic Ulcer

  1. Stomach pain is the most common symptom. Patients experience abdominal distension or burning sensation that occur below the xiphoid or upper abdomen. It usually occurs when hungry or when the stomach is empty. The pain is not constant but comes and goes.
  2. Abdominal distension, bloating, rumbling sounds in the stomach, gas in stomach, nausea, and vomiting are all symptoms of peptic ulcer.
  3. Complications include vomiting blood, black stool as a result of bleeding in the stomach, and severe abdominal pain due to the development of a perforated peptic ulcer.

Diagnosis of Peptic Ulcer

  1. Barium X-ray (Upper GI Study) is easy, and inexpensive. However, with this technique, tissue samples cannot be taken to a lab for examination.
  2. Esophagogastroduodenoscopy is a diagnostic procedure used to examine the lining of the esophagus, stomach, and first part of small intestine. It can examine the stomach thoroughly and remove tissue samples for examination in a lab. This procedure has been used widely and safely. In some cases, patients may be given a light anesthetic to make them sleep during the procedure.

Diagnostic tests to determine Helicobacter Pylori infection
The following tests can be applied:

  1. Blood test for immunity
  2. Urea breath test
  3. Endoscopic biopsy through 3 methods:
    – Rapid urease test
    – Microscopic examination
    – Culture test
  4. Stool test for H. Pylori antigen

Peptic Ulcer Treatments

  1. Medications that block acid production and promote healing for 6-8 weeks
  2. Antibiotic medications that kill Helicobacter Pylori (H. Pylori)
  3. Lifestyle and home remedies:
    – Develop good eating habits.
    – Eat foods that are easily digested and bland.
    – Avoid spicy foods, preserved foods and soft drinks.
    – Do not smoke and drink.
    – Stop taking aspirin and NSAID for pain relief
    – Avoid stress and anxiety.
    Then you can stay free from peptic ulcer.

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Nathavut Sirimontaporn, M.D. Summary: Internal Medicine Internal Medicine