Peptic ulcer

Introduction
Stomach ulcer a.k.a. peptic ulcer is small erosion in the GIT. Common type, duodenal, occurs in the first 12 inches of small intestine beyond the stomach. Ulcers that form in the stomach are called gastric ulcers. Ulcers that form in the duodenum are called duodenal ulcers. An ulcer is not contagious or cancerous. Duodenal ulcers are almost always benign, while stomach ulcers may become malignant. The size of a stomach ulcer can

range between 1/8 of an inch to 3/4 of an inch.

Cause
The direct cause of peptic ulcers is the destruction of the gastric or intestinal mucosal lining of the stomach by HCl, an acid normally present in the digestive juices of the stomach. Other causes of ulcer are:

Helicobacter pylori Smoking Caffeine Alcohol

Stress Nonsteroidal antiinflammatory drugs (NSAIDs)

Nausea vomiting.

and

copious

Loss of appetite and weight loss. Hematemesis blood. Melena feces. vomiting foul-smell

Signs and symptoms

Symptoms of a peptic ulcer can be:

tarry,

Abdominal pain. Bloating and fullness.

abdominal

Waterbrash rush of saliva after an episode of regurgitation to dilute the acid in esophagus.

Complications
People with ulcers may experience serious complications

if they do not get treatment. The most common problems include:

Gastrointestinal bleeding. Perforation often leads to catastrophic consequences. Penetration is when the ulcer continues into adjacent organs such as the liver and pancreas. Gastric outlet obstruction is when scarring and swelling due to ulcers causes narrowing in the duodenum. Pyloric stenosis.

Diagnosis
Diagnosing a stomach ulcer is

done using a range of methods, including: Endoscopy - a thin flexible tube is threaded down the esophagus into the stomach under light anesthesia. The endoscope is fitted with a small camera so the physician can see if there is an ulcer. Barium meal - a chalky liquid is drunk and an x-ray is performed, showing the stomach lining. These tests are less common nowadays, but may be useful where endoscopy is unavailable.

Biopsy - a small tissue sample is taken during an

endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found.

C14 breathe test - to check for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon (C14) and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.

Treatment Special diets are now known to have very little impact on the prevention or treatment of stomach ulcers. Treatment options can include: Medications including antibiotics, to destroy the H. pylori colony, and drugs to help speed the healing process. Different drugs need to be used in combination; some of the side effects can include diarrhea and rashes. Resistance to some of these antibiotics is becoming more common.

Subsequent breath tests used to make sure the H. pylori infection has been treated successfully. Changes to existing medications - the doses of arthritis medications, aspirin or other anti-inflammatory drugs can be altered slightly to reduce their contributing effects on the stomach ulcer. Reducing acid - tablets are available to reduce the acid content in the gastric juices. Lifestyle modifications such as quitting cigarettes, since smoking reduces the natural defenses in the

stomach and impairs healing process.

the