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Peptic ulcer disease (duodenal ulcer, gastric ulcer): Treatment, symptoms, advice and help

About peptic ulcer disease (duodenal ulcer, gastric ulcer)

The occurrence of peptic ulcer disease is a common problem of the digestive system. A peptic ulcer is a sore which arises from the erosion of mucosal membrane lining the interior of the stomach. Several factors may play a role in causing damage to the inner lining of stomach which results in ulcer formation. Peptic ulcer in the stomach is termed as ‘gastric ulcer’ whereas a ‘duodenal ulcer’ is a peptic ulcer in duodenum, which is a part of the small intestine.

Peptic ulcer disease (duodenal ulcer, gastric ulcer): Incidence, age and sex

Peptic ulcer disease is a commonly encountered digestive disorder in the general population. It mainly occurs in older adults, though it can be seen in any age group. Its incidence is almost similar in both men and women.

Signs and symptoms of peptic ulcer disease (duodenal ulcer, gastric ulcer): Diagnosis

The predominant symptom of peptic ulcer is stomach discomfort or pain, which is felt in the centre of upper abdomen. The pain is typically experienced at night and may be burning or gnawing in quality. Some individuals may also complain of bloating sensation. In some individuals, the gastric ulcer may bleed which is manifested by black, tarry stools and detection of anaemia in blood test.

A detailed history and comprehensive physical examination usually point towards the diagnosis which can be corroborated with detection of anaemia in the blood test and presence of occult blood in the stool. However upper gastro-intestinal endoscopy is the investigation of choice wherein a flexible tube is passed through mouth into the digestive tract to view the interior of stomach and duodenum. A specimen of the ulcer tissue can also be taken to study it microscopically.

Causes and prevention of peptic ulcer disease (duodenal ulcer, gastric ulcer)

Peptic ulcer usually occurs due to disruption between the aggressive and defensive factors in the gastro-intestinal system, which results in the corrosion of the gut lining. One of the commonest causes of damage to the gastric lining is its infection with bacteria named Helicobacter pylori. Moreover, the digestive juices may also cause damage to the already weakened gut wall. Additionally persistent use of NSAID medications is a significant factor in causation of peptic ulcer. Other risk factors include smoking, alcohol consumption, increased intake of caffeine and emotional stress.

The occurrence of peptic ulcer disease can be prevented by certain lifestyle modifications which include cessation of smoking and alcohol, reducing emotional and work stress, reduced intake of caffeine and improving eating habits.

Peptic ulcer disease (duodenal ulcer, gastric ulcer): Complications

The most common complication of peptic ulcer, especially duodenal ulcer is bleeding which results in anaemia. Longstanding gastric ulcer which has been neglected, may progress to complete perforation of wall of the stomach. This is a surgical emergency which requires immediate management.

Peptic ulcer disease (duodenal ulcer, gastric ulcer): Treatment

The treatment of peptic ulcer disease is quite varied and is usually tailor-made according to the individual’s needs. Infection with H. pylori is effectively treated with a course of triple regime which includes drugs like metronidazole, tetracycline and bismuth. Further medications which reduce the production of the digestive juices are also prescribed. Such medications include ranitidine, omeprazole and lansoprazole. Sometimes, mucosal protective drugs may be considered which form a protective lining over the wall of the stomach. Perforation of peptic ulcer is an emergency and needs to be managed immediately with surgical repair.