peptic ulcer
What is peptic ulcer disease?
A peptic ulcer is a sore on the lining of the stomach or duodenum, which is the beginning of the small intestine. Peptic ulcers are common: One in 10 Americans develops an ulcer at some time in his or her life. One cause of peptic ulcer is bacterial infection, but some ulcers are caused by long-term use of nonsteroidal anti-inflammatory agents (NSAIDs), like aspirin and ibuprofen. In a few cases, cancerous tumors in the stomach or pancreas can cause ulcers. Peptic ulcers are not caused by stress or eating spicy food, but these can make ulcers worse.
Helicobacter pylori (H. pylori) are a type of bacteria responsible for majority of peptic ulcers. Most infected people, however, do not develop ulcers. Why H. pylori do not cause ulcers in every infected person is not known. Most likely, infection depends on characteristics of the infected person, the type of H. pylori, and other factors yet to be discovered. Researchers are not certain how people contract H. pylori, but they think it may be through food or water. Researchers have found H. pylori in the saliva of some infected people, so the bacteria may also spread through mouth-to-mouth contact such as kissing.
H. pylori weaken the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause a sore, or ulcer. H. pylori are able to survive in stomach acid because it secretes enzymes that neutralize the acid. This mechanism allows H. pylori to make its way to the “safe” area—the protective mucous lining. Once there, the bacterium’s spiral shape helps it burrow through the lining.
What are the symptoms of an ulcer?
Abdominal discomfort is the most common symptom. This discomfort usually
- is a dull, gnawing ache
- comes and goes for several days or weeks
- occurs 2 to 3 hours after a meal
- occurs in the middle of the night—when the stomach is empty
- is relieved by eating
- is relieved by antacid medications
Other symptoms include
- weight loss
- poor appetite
- bloating
- burping
- nausea
- vomiting
Some people experience only very mild symptoms or none at all.
Diagnosing an Ulcer
To see whether symptoms are caused by an ulcer, the doctor may do an upper gastrointestinal (GI) series or an endoscopy. An upper GI series is an x ray of the esophagus, stomach, and duodenum. The patient drinks chalky liquid called barium to make these organs and any ulcers show up more clearly on the x ray.
An endoscopy is an exam that uses an endoscope, a thin, lighted tube with a tiny camera on the end. The patient is lightly sedated, and the doctor carefully eases the endoscope into the mouth and down the throat to the stomach and duodenum. This allows the doctor to see the lining of the esophagus, stomach, and duodenum. The doctor can use the endoscope to take photos of ulcers or remove a tiny piece of tissue to view under a microscope. This procedure is called a biopsy. If an ulcer is bleeding, the doctor can use the endoscope to inject drugs that promote clotting or to guide a heat probe that cauterizes the ulcer.
H. pylori are diagnosed through blood, breath, stool, and tissue tests. Blood tests are most common. They detect antibodies to H. pylori bacteria. Urea breath tests are an effective diagnostic method for H. pylori. They are also used after treatment to see whether it worked. In the doctor’s office, the patient drinks a urea solution that contains a special carbon atom. If H. pylori are present, it breaks down the urea, releasing the carbon. The blood carries the carbon to the lungs, where the patient exhales it. The breath test is 96 percent to 98 percent accurate. Stool tests may be used to detect H. pylori infection in the patient’s fecal matter. Studies have shown that this test, called the Helicobacter pylori stool antigen (HpSA) test, is accurate for diagnosing H. pylori. Tissue tests are usually done using the biopsy sample that is removed with the endoscope. There are three types:
The rapid urease test detects the enzyme urease, which is produced by H. pylori.
A histology test allows the doctor to find and examine the actual bacteria.
A culture test involves allowing H. pylori to grow in the tissue sample.
In diagnosing H. pylori, blood, breath, and stool tests are often done before tissue tests because they are less invasive. However, blood tests are not used to detect H. pylori following treatment because a patient’s blood can show positive results even after H. pylori have been eliminated.
Drugs Used to Treat H. pylori Peptic Ulcers:
Antibiotics: metronidazole, tetracycline, clarithromycin, amoxicillin
H2 blockers: cimetidine, ranitidine, famotidine, nizatidine
Proton pump inhibitors: omeprazole, lansoprazole, rabeprazole, esomeprazole, pantoprozole
Stomach-lining protector: bismuth subsalicylate
Points to Remember
A peptic ulcer is a sore in the lining of the stomach or duodenum.
The majority of peptic ulcers are caused by the H. pylori bacterium. Many of the other cases are caused by NSAIDs. None are caused by spicy food or stress.
H. pylori can be transmitted from person to person through close contact and exposure to vomit.
Always wash your hands after using the bathroom and before eating.
A combination of antibiotics and other drugs is the most effective treatment for H. pylori peptic ulcers.
Pathophysiology
<!–[if !supportLists]–>· <!–[endif]–>H. pylori infection is thought to be responsible for the majority of peptic ulcers.
<!–[if !supportLists]–>· <!–[endif]–>Not all individuals infected with H. pylori eventually develop ulcers.
<!–[if !supportLists]–>· <!–[endif]–>H. pylori weaken the protective mucous coating of the stomach and duodenum, resulting in acid penetration into the underlying sensitive lining.
<!–[if !supportLists]–>· <!–[endif]–>Interestingly, H. pylori secrete enzymes that neutralize stomach acid, hence prolonging its survival.
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even thou were not complete we always celebrate our team’s monthsary,this is the only time that we can bond together and release our negative emotions through the help of each other and of course by the help of our beloved console and with the help of a little bit of liquor,,hehe..here is our picture….