is a defect in the gastric mucosa. It occurs as a result of the action of bile, acid, pepsin. This defect causes trophic disorders.
Duodenal ulcer is formed by the action of pepsin and acid on the mucous membrane of the organ. First of all, it occurs in people with increased sensitivity.
Statistics say that about a tenth of the world’s population suffers from a peptic ulcer. It is interesting that men are more likely to develop this disease than women.
Ulcers of the duodenum are much more common than ulcers of the stomach. If there are ulcers in the duodenum and in the stomach, they are called combined.
Peptic ulcer is a chronic process.
Peptic ulcer disease lasts for a long time, its manifestations depend on many factors: the stage of the disease, the age and sex of the patient, the season and some other factors.
For a peptic ulcer there is a recurrent course.
This means that periods of exacerbation (from one week to two months) alternate with periods of remission. During the period of remission, a person is able to feel completely healthy and not have any complaints. Exacerbations of peptic ulcer often occur in the spring or autumn, that is, we can talk about the seasonally expressed nature of peptic ulcer. Distinction of peptic ulcer from erosion (in erosion, the defect of the mucosa is superficial, it also consists of the scar remaining after healing of the ulcer.) Ulcerous lesions are determined by infection with Helicobacteria
More than 80% of ulcerative lesions of the stomach and duodenum are associated with infection with this microorganism. But only 20% of people infected with Helicobacter pylori develop peptic ulcer of these organs.The reason for this, according to doctors, is the general state of immunity in humans, mucosal properties and acidity
If there is a duodenal ulcer, a gastric ulcer is guaranteed.
This common statement is far from true.á Indeed, such combined ulcers are sometimes found, but, as medicine proves, they occur only in less than 10% of patients with peptic ulcer
The peptic ulcer is characterized by the presence of a pre-ulcer period
Its manifestations: pain after an hour and a half after eating, night pains in the epigastric region, hunger pains. The disease itself begins acutely. The term pre-ulcer state is not always used recently. Patients who complain of these symptoms are at increased risk for developing this disease.
Pain is the main symptom of peptic ulcer of the stomach and duodenum.
Pain in the epigastric region accompanies the primary formation of the ulcer. Pain can be: early, late, hungry or nocturnal. With the ulcer of the upper parts of the stomach, early pain occurs-they appear half an hour and a half after eating. They tend to increase. This is due to the increase in the stomach concentration of hydrochloric acid. Another hour or two the pains become less strong. This fact is explained by the fact that food from the stomach enters the duodenum. Late pains are observed after a longer period of time after eating – after about two hours. This kind of pain is inherent in chronic pancreatitis. Hungry pains appear after a considerable time after eating – in five to six hours – they tend to decrease after a regular meal. The hunger pains are like night pains. Hungry and nocturnal pains are characteristic of ulcers of the duodenum.
The localization of pain in the ulcer of the stomach and duodenum is different.
Peptic ulcer is characterized by pain on the left side, in the upper abdomen or along its median line. For peptic ulcer of the duodenum, the pain to the right of the median line is characteristic. Also, pain can be given in the back or be retrosternal.The character of the pain itself is diverse: most patients with this diagnosis have blunt or aching, stitching or drilling; in a third of patients, the pain is very strong.
Heartburn – a frequent phenomenon with peptic ulcer.
A person feels a burning sensation in the neck or behind the sternum. The most common cause of heartburn is that the contents of the stomach get into it through the lower orifice of the esophagus. Often, cases where heartburn is the only sign of ulcers. Another fairly common sign of peptic ulcer is an eructation, which mainly has a sour taste. The reason for this is the high acidity of the contents of the stomach.
Nausea is a characteristic sign of a peptic ulcer during its exacerbation.
With duodenal ulcers, nausea appears quite often. With stomach ulcer, nausea occurs much less frequently. As for vomiting, it takes place only at the height of pain; after vomiting the patient feels better.
Weight loss is a process characteristic of peptic ulcer disease.
Not a true statement. The fact that the patient can lose weight during the period of exacerbation of the disease. All the rest of the time (except exacerbations) the patient has a normal appetite or even increased (but obesity in patients is extremely rare).
Constipation is not uncommon in peptic ulcer disease.
About half of all patients have complaints of constipation. Their cause may be a violation of the motor function of the intestine. Constipation can also be caused by the use of antacids.
многие Many studies are needed to diagnose a peptic ulcer.
Obligatory are fluoroscopy of the stomach and intestines. Fibrogastroduodenoscopy is also necessary and consists in taking pieces of mucosa along the edge of the ulcer. Pieces of the mucosa are examined for the purpose of determining the presence of Helicobacter pylori. In addition, the patient is examined the general functional state of the organs on which an ulcer (stomach and duodenum) can be found. The feces are analyzed (for the presence of hidden blood), a biochemical blood test and a general blood test.
Treatment of peptic ulcer is based on a number of components.
Firstly, with peptic ulcer, rest and elimination of all possible stressful situations is necessary. Hospitalization can be performed during a period of exacerbation of the disease. Secondly, and this is an important component, a diet is recommended. In this regard, the food used by the patient must contain many proteins. This is necessary due to the fact that protein food contributes to the healing of ulcers. Basically, it’s meat, eggs, fish. Eggs, as well as milk, bind hydrochloric acid. As a result, the acidity of the gastric contents is reduced The patient with peptic ulcer must be familiar with the principles of the gastric mucosa. Mechanical shoeing includes the exclusion from the diet of dry and coarse food, as well as cooking products for a couple. Thermal shaking involves the reception of warm food. The exclusion from the diet of various spices, smoked products and acidic products form the basis of chemical shading of the mucous membrane of the stomach and duodenum. Based on the data of the ongoing studies, the doctor appoints the patient treatment, which includes an antibiotic, an antimicrobial drug, a proton pump inhibitor – according to this scheme the patient is treated for one to two weeks. The course of treatment is aimed at the destruction of Helicobacter pylori. The treatment is designed to ensure that the patient fully adheres to the prescription of the doctor, because the unauthorized interruption of the course of treatment can lead to Helicobacteria becoming resistant to the prescribed medications.
Peptic ulcer disease requires fractional nutrition.
Take food five to six times a day in small portions. In case of peptic ulcer, overeating and drinking are unacceptable. It is recommended that smokers be given this harmful habit or at least reduce smoking,It is known that smoking in no way contributes to the healing of ulcers.
Complications of peptic ulcer occur suddenly.
This refers to the complications of the first group. These complications threaten the life of the patient (perforation of the ulcer, bleeding). Therefore, urgent intervention is necessary. The second group includes complications that occur chronically. This, for example, stenosis of the pylorus and duodenum, malignancy of the ulcer, pancreatitis and hepatitis (which are associated with ulcers).
A perforated ulcer is a serious complication of an acute or chronic ulcer.
If it is an exacerbation of a chronic peptic ulcer, then perforation of the ulcer occurs most often during the period of exacerbations. The perforated ulcer (perforation of the ulcer) occurs if a through defect appears in the wall of the stomach or duodenum. The latter usually opens into the retroperitoneal space or abdominal cavity. The consequence of perforation of the ulcer is gastroduodenal contents entering the abdominal cavity. It acts on the abdominal covering irritant, develops peritonitis. This complication, like perforation of the ulcer, occurs in 10% of gastric and duodenal ulcers. A perforated ulcer is more common in men than in women. Probing is possible at the age of 20 to 40 years.
For “perforation of the ulcer,” dagger “pain is characteristic.
Before the perforation in about four days, patients complain of a sharp exacerbation of the peptic ulcer, and then there is a strong “dagger” pain in the abdominal region, which tends to increase. There are three stages of the disease. The first – a reflex, lasts up to six hours. The second – imaginary well-being, lasts for six to twelve hours. It is characterized by a reduction in pain and an improvement in the general condition of the patient. However, due to the fact that peritonitis is progressing, the general condition of the patient worsens. In connection with this, the third stage of the disease is distinguished – the progression of peritonitis, lasting more than twelve hours. There are several known signs on the basis of which the doctor can correctly determine the disease. These include a peptic anamnesis, which occurs in 80-90% of cases, “dagger” pain, a hard abdomen, and the presence of tachycardia at normal body temperature.
Perforation of the ulcer requires surgical treatment.
Premedication with antibiotics is performed before the operation (in order to prepare the body for the operation). With diffuse purulent peritonitis, the perforation is sutured. The stomach ulcer gives a basis for its resection.
Penetration (penetration) of stomach and duodenum ulcers is a complication of peptic ulcer.
In case a chronic ulcer destroys the wall of the stomach or duodenum, it is possible to penetrate the ulcer into other organs and tissues. Ulcers of the stomach often penetrate (penetrate) into the small omentum, less often into the abdominal wall. In this case, a constant sign is a constant pain. Ulcers of the duodenum often penetrate the pancreas. To diagnose the penetrating ulcer, the following studies should be carried out. This is fibrogastroscopy and X-ray examination. Penetrating ulcer can lead to perforation of the ulcer, inflammation of the organs, into which the ulcer penetrates and some other complications.
Treatment of penetrating ulcer is surgical.
Not at all necessary. The decision on an operative measure is applied only in the event that conservative therapy has not given results.
Stenosis of the gatekeeper is a complication of peptic ulcer.
This disease occurs due to the scarring of ulcers that are in the initial section of the duodenum or pyloric canal. Complaints of patients in this case are associated with discomfort in the stomach. The characteristic manifestations of stenosis of the pylorus are eructations and vomiting.