What causes are associated with gastric and duodenal ulcers?
- Acid hypersecretion: The loss of acid balance of the stomach by excessive production of hydrochloric acid (acid necessary to help digestion) can cause peptic ulcer.
- Non-steroidal anti-inflammatory drugs (NSAIDs): the excessive and prolonged use of anti-inflammatory drugs to relieve pain, inflammation and fever such as ibuprofen potentiates the risk of digestive hemorrhage and ulcerative disease.
- Stress, tobacco and alcohol: favor the appearance of peptic ulcer.
On the other hand, it is now known that there is a direct relationship between gastric or duodenal ulcer and bacterial infection Helicobacter pylori. The characteristic spiral morphology of this bacterium facilitates its penetration into the gastric mucosa, adhering to it and producing toxins that will cause inflammation and the appearance of the lesion.
It is estimated that approximately 50% of the world's population may be infected by H. pylori, Although only 15% of people infected with this microorganism will develop a gastric or duodenal ulcer throughout their life.
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What are the symptoms?
The most common symptoms related to gastric and duodenal ulcers They are the following:
- Abdominal pain: main symptom that is referred to as a burning or burning sensation in the pit of the stomach. It is usually calm when you eat food or after the administration of antacids. In the case of gastric ulcer pain is more characteristic immediately after meals.
- Heartburn or burning sensation in the esophagus.
- Nausea and vomiting.
- Changes in intestinal transit and absomial distension or bloating.
It may be the case of asymptomatic ulcer, where the discomforts are not so characteristic and their diagnosis takes place when there are more serious complications such as:
- Digestive hemorrhage: hematemesis (the patient vomits blood) and melena (black stools due to the presence of blood in the stool).
- Drilling: the ulcer is getting deeper and deeper until it reaches the gastroduodenal mucosa.
- Pyloric stenosis: occurs when the area between the stomach and the duodenum narrows and the patient has a feeling of fullness without having ingested food.
How is it diagnosed?
Test of Helicobacter pylori for diagnosis of gastric ulcer.
The diagnosis of gastric and duodenal ulcer is done based on the patient's medical history, of the characteristic symptoms that present and of the physical examination and complementary tests that are considered opportune.
The diagnostic methods are usually focused on the visualization of the ulcer and the detection of the bacterium Helicobacter pylori.
- Methods focused on the visualization of the ulcer
- Oral digestive endoscopy: is done by introducing a tube with a small camera through the mouth and esophagus. This allows the visualization of the complete digestive tract and the detection of alterations. In case of detection of ulcerative lesion tissue sample (biopsy) is taken for analysis.
- Methods focused on the detection of Helicobacter pylori
- Serological tests for the detection of antibodies against this microorganism.
- Detection of helicobacter in stool samples.
- The breath test: consists first of the intake of a liquid with urea marked with carbon and then in blowing a tube to determine if the exhaled CO2 contains marked carbon, which would indicate if the bacterium has metabolized it and therefore the confirmation of its presence.
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What is your treatment?
The treatment is focused on relieving symptoms and pain relief with pharmacological treatment.
Antacid drugs and gastric protectors
- Proton-pump inhibitor: as for example, the well-known omeprazole, responsible for blocking the acid secretion of the stomach.
- H2 receptor antagonists: an example is ranitidine.
Drugs indicated in the treatment of Helicobacter pylori
The treatment to eradicate this microorganism consists in the use of a proton pump inhibitor to reduce acid secretion in combination with antibiotics that eliminate the bacteria.
It is administered for a few days and after the treatment the breath test is repeated, which will confirm that the infection has disappeared.
The treatment of complications of peptic ulcer such as Bleeding or perforation require localization of the ulcer Bleeding through endoscopy and cauterization of bleeding. In the case of perforation, surgical intervention is required urgently.
Prevent gastric ulcers
The prevention of ulcerative diseases is in our hands. Do not abuse non-steroidal anti-inflammatories, of drinks rich in caffeine, avoiding tobacco and eating a healthy diet reduce the risk of gastroduodenal ulcer.