1.What is peptic ulcer?
Peptic ulcer is a common disease of the digestive system, mainly refers to chronic ulcers occurring in the stomach and duodenum. Its formation is related to the digestive action of gastric acid-pepsin.
2.What are the causes of peptic ulcers?
(1) H. pylori infection: Some data show that the detection rate of Hp in gastric ulcers is 70% to 90%, and in duodenal ulcers the detection rate of Hp is as high as 95% to 100%.
(2) Drug abuse: mainly refers to non-steroidal anti-inflammatory drugs and corticosteroids. Such as aspirin, anti-inflammatory pain, POTUS, prednisone, dexamethasone, etc., of which aspirin is particularly important.
(3) mental factors: emotional distress, mental tension can increase the secretion of gastric acid through the neuroendocrine system, and affect the blood nutrient supply of the gastrointestinal mucosa, and cause ulcer disease. For example, clinically, we often encounter some young people in overworked, stressed out all day when the peptic ulcer or even bleeding.
(4) dietary factors: overeating, irregular meals, strong tea, coffee, strong alcohol, spicy seasonings, kimchi and other foods as well as partial food, eating too fast, too cold, hot, can affect the secretion of gastric acid, affect the digestive function of the stomach, weaken the barrier role of the gastric mucosa, leading to ulcer disease and can affect the repair of the mucosa.
(5) smoking: tobacco contains nicotine components have the effect of damage to the gastric mucosa, long-term smoking can also make excessive secretion of gastric acid, is an important causative factor of peptic ulcer.
(6) drinking alcohol: alcohol can stimulate gastric acid secretion, the gastric mucosa also has a direct damage effect. Alcohol addiction and frequent smoking or long-term use of aspirin and other drugs, more prone to ulcer disease.
(7) Heredity: the risk of recurrence in families with ulcer disease is high; the chance of monozygotic twins having ulcers at the same time is more than 50%; blood type O is more common than other blood types in patients with duodenal ulcers. Some data show that in patients with type O, the duodenal bulb is 1.4 times higher than in other blood types, and patients with this disease often have a family history, and those with a family history are three times higher than others.
(8) Geography and climate: the incidence of ulcer disease varies in different geographical areas, and according to the data on gastroscopy, the geographical characteristics of peptic ulcer in China are higher in the south than in the north, and higher in urban than in rural areas. Climate change is also one of the factors triggering ulcer disease, and the turn of autumn and winter is the high incidence of peptic ulcer.
(9) the impact of other chronic diseases: patients suffering from emphysema, duodenal ulcer incidence is 3 times higher than normal; coronary heart disease, arteriosclerosis can cause poor blood supply to the gastric mucosa, which can affect the healing of ulcers; peptic ulcer incidence in patients with liver cirrhosis is 2 to 3 times that of the general population, patients with hepatitis B disease with positive surface antigen, the incidence of gastric ulcers up to 33%.
3.What are the symptoms of peptic ulcer?
(1) The symptoms are diverse, and some patients may be asymptomatic or have bleeding, perforation and other complications as the first symptoms.
(2) Most patients have chronic and recurrent epigastric pain, often after exertion or weather changes and other triggers, and abdominal pain in patients with duodenal ulcer can appear on an empty stomach and at night and can be relieved after eating.
(3) Some patients have symptoms such as abdominal distension, anorexia, belching, acid reflux, etc. or only.
4.What are the differences between duodenal ulcer and gastric ulcer in terms of symptoms?
Clinically, duodenal ulcers are more common than gastric ulcers, with the recent statistics being 1.56:1. Duodenal ulcers are more common in young adults, while gastric ulcers are more common in middle-aged and elderly people. Gastric ulcers are generally larger than duodenal ulcers. Both gastric and duodenal ulcers are often accompanied by chronic gastritis, and the incidence is higher in the case of gastric ulcers.
The most common symptom of gastric ulcer is abdominal pain or abdominal discomfort, typically located in the upper abdomen under the glabella, sometimes to the left, lacking the typical rhythm, and appearing early after meals.
Most of the abdominal pain in duodenal ulcers is rhythmic, periodic and prolonged, with limited epigastric pain often occurring at the time of gastric emptying, especially at 10-11 am, 3-4 pm and around 10-11 pm, and at 1-2 am in the morning. The rhythmical nature of the pain is prominent and can be clearly described by the patient to the physician; the site of the pain is mostly to the right of the subxiphoid process. Periodic attacks and remissions are the prominent manifestations of duodenal ulcers. The duration of each attack varies, with about half of them lasting 2-4 weeks, while the rest can be as short as a few days and as long as 8-10 weeks. The remission period between episodes also varies in length, with some lasting 1-3 months, some shorter, and some longer, and occasionally up to 10 years after an episode. During the remission period, the patient can eat at will without pain. In many cases, these periodic attacks are seasonal, often occurring in the spring and fall, and remitting in the summer and winter, correlating with changes in climate.
In addition gastric ulcers can be partially cancerous, while duodenal ulcers have a very low cancer rate
5.What are the complications of peptic ulcer?
(1) Upper gastrointestinal bleeding: Patients may have tar-like or sesame-like stools, or even vomit coffee-like material, pale
(1) Upper gastrointestinal bleeding: Patients may have tarry or sesame-like stools, or even vomit coffee-like material, pale face, dizziness, panic, or faint in severe cases.
(2) Ulcer perforation: Acute perforation can appear severe abdominal pain, turning and coughing aggravate abdominal pain patients often can not move because of severe pain, abdominal muscle tension, abdominal pain.
(2) Ulcer perforation: acute perforation can be severe abdominal pain, turning and coughing can aggravate abdominal pain, and patients often cannot move due to severe pain, abdominal muscle tension, irritability, pallor, wet and cold extremities, panic and heartbeat, which can be life-threatening.
(3) Pyloric obstruction: The main manifestation is vomiting, which occurs 30-60 minutes after meals, once every 1-2 days, and one vomiting
The amount of vomiting can be more than 1 liter, containing fermented food.
(4) Cancer: Cancer can occur in patients with gastric ulcer, generally no more than 2-3% according to research.
6.How can we clarify whether there is peptic ulcer or not?
(1) X-ray barium meal examination (indirect method)
(2) Fiber gastroscopy (direct method)
7.How to prevent and control peptic ulcer?
(1) Regulate life: keep emotionally optimistic, regular work and rest, and smoke.
(2) Pay attention to diet: chew slowly, avoid swallowing sharply, and complete the diet regularly; it is appropriate to eat less and more meals during the acute activity period.
When the symptoms are under control, 3 meals a day are normal; avoid empty meals between meals, do not eat before bedtime, avoid strong, spicy and stimulating food and acidic food during the acute period; the diet should not be too full.
(3) Regular drug therapy: For patients with Hp infection, Hp eradication therapy should be carried out first, the course of treatment is usually 1 week, followed by anti-ulcer therapy, the total course of treatment for duodenal ulcer is about 4 weeks, the total course of treatment for gastric ulcer is about 6-8 weeks, and whether Hp has been eradicated should be reviewed according to the situation; for patients without Hp infection, direct anti-ulcer therapy should be carried out, the course of treatment for duodenal ulcer is about 4 weeks, the course of treatment for gastric ulcer is about 6-8 weeks. For patients without Hp infection, the course of direct anti-ulcer therapy is about 4 weeks for duodenal ulcer and 6-8 weeks for gastric ulcer. In addition, because of the potential risk of cancer in gastric ulcers, gastroscopic review is required after the completion of the treatment course; for duodenal ulcers, gastroscopic review or simple Hp review is performed according to the situation.
8, finally, the introduction of eight kinds of eating methods harmful to stomach health.
(l) eat too fast: wolf swallowing, swallowing dates, food is not fully chewed, insufficient secretion of digestive juices, food is difficult to fully digest, and over time, prone to gastric disease.
(2) eat too much: overeating, not only make the stomach’s digestive capacity is difficult to bear, resulting in indigestion, and sometimes can lead to acute gastric dilatation, gastric perforation and other serious illnesses.
(3) read (play) while eating: some people like to read the newspaper while eating and drinking, or play while eating. Thus, due to reading or playing a lot of blood for the brain, for gastrointestinal digestion and absorption of blood relatively reduced, affecting digestion and absorption, long-term, prone to chronic gastric disease.
(4) often snack: often snacking, will destroy the normal rules of gastric digestive enzyme secretion, so that the stomach often “fight unprepared”, do not get a normal and reasonable rest, easy to “accumulate labor into disease”.
(5) squatting to eat: some rural areas in China, especially in the northern countryside, many people have the habit of squatting to eat. This way of eating, so that the abdomen and the digestive tract blood vessels are squeezed, not conducive to blood supply; and when eating, just need a lot of blood people stomach for digestion. Investigation shows: these areas have a high incidence of gastric disease, and this bad eating posture.
(6) eat more cold food: some people prefer cold food, especially in the summer while drinking cold drinks while eating, so the stomach can not be harmless? More cold food will reduce the temperature of the stomach, so that the stomach’s ability to fight disease; general cold food pathogenic microbial content also tends to be more, so more cold food can easily lead to gastric disease.
(7) Excessive smoking and alcohol: smoking can increase the incidence of ulcer disease and gastric cancer. Excessive alcohol consumption can damage the gastric mucosa, causing gastric bleeding, gastric perforation, etc.; often drink a lot of alcohol, can affect the secretion of gastric juice, reduce the activity of gastric acid, so that people’s appetite decreased.
(8) Food is too spicy: frequent consumption of spicy food can stimulate gastric mucosa congestion, which, over time, can lead to peptic ulcers.