Peptic ulcer is a common gastrointestinal disorder, usually a benign ulcer that occurs in the stomach and duodenum. The disease is called peptic ulcer because it occurs in association with stomach acid and pepsin.
Some experts have studied that about lo% of people have had a gastric or duodenal ulcer at some time in their lives, and that there are more duodenal ulcers than gastric ulcers.
Ulcer lesions are based on erosion of the mucosal layer extending down to the submucosal layer and the muscular layer, and severe ulcers even penetrate the outer plasma membrane layer of the stomach and intestinal wall, causing perforation of the stomach or duodenal wall.
Who is prone to peptic ulcer?
Genetic factors People who have peptic ulcers in their close relatives are three times more likely to get peptic ulcers. In other words, relatives of peptic ulcer patients are more likely to get peptic ulcers.
H. pylori infection People infected with H. pylori are more likely to get peptic ulcers. In China, 70% to 90% of patients with gastric ulcers not mouth duodenal ulcers have H. pylori infection.
Mental factors People in a bad mental state, often in anxiety, sadness, resentment, tension and fear are prone to peptic ulcers, because poor emotions can cause gastrointestinal dysfunction.
Drug factors People who take antipyretic and analgesic drugs and certain anti-cancer drugs for a long time are prone to peptic ulcers because these drugs tend to destroy the gastric mucosa.
Tobacco and alcohol Smokers and drinkers of strong alcohol are prone to peptic ulcers because alcohol can cause serious damage to the gastric mucosa; smoking can aggravate the reflux of duodenal fluid and stimulate the gastric mucosa.
In addition, the incidence of peptic ulcers is much higher in men than in women. Most duodenal ulcer patients are young adults, while gastric ulcer patients are most often adults aged 45 to 55.
What are the characteristics of abdominal pain caused by peptic ulcer?
Abdominal pain is the most common and important symptom of peptic ulcer. Abdominal pain caused by peptic ulcer has obvious patterns and characteristics.
Most of the pain sites are in the middle and upper abdomen, and the pain of gastric ulcer is mostly in the heart fossa or to the left; the pain of duodenal ulcer is mostly located above the navel or slightly to the right.
The abdominal pain is clearly related to eating. The abdominal pain of gastric ulcer appears 0.5 to 1 hour after eating, and l to 2 hours after eating again, the abdominal pain reappears, obviously showing the pattern of “eating an abdominal pain and relief”. The abdominal pain of duodenal ulcer mostly appears 2 to 4 hours after eating, that is, after the basic emptying of food in the stomach, if you eat something or drink a few mouthfuls of boiled water this pain will be reduced or disappear, obviously showing the pattern of “abdominal pain a feeding a relief”, so this pain is also known as “hunger pain This pain is also called “hunger pain”.
The abdominal pain rarely occurs in the early morning, but the abdominal pain often wakes up at night.
The abdominal pain is recurrent and periodic, a feature that is more prominent in patients with duodenal ulcers. A painful period of several weeks or more of recurrent abdominal pain is usually followed by a painless period of remission. In the early stage of ulcer, the pain period is short and the remission period is long; as the disease progresses, the pain period gradually lengthens while the remission period becomes shorter and shorter. Recurrences tend to occur in late fall and early winter, and most abdominal pain does not occur in summer.
The degree of abdominal pain is usually tolerated by patients.
The abdominal pain can be relieved after pressing the painful part of the abdomen with a hand fist or after vomiting.
The abdominal pain can be reduced after oral administration of drugs such as baking soda.
Why do some peptic ulcer patients feel no abdominal pain?
In 30% of peptic ulcer patients, there is hardly any abdominal pain or other discomfort in general, and some patients have not experienced abdominal pain even when the stomach or duodenal wall is perforated due to peptic ulcer.
There are two types of peptic ulcer patients who are less prone to abdominal pain: the elderly, who are no longer very sensitive to pain; and those who take high doses of antipyretic and analgesic drugs such as aspirin and fen-phen, which have their own analgesic effect and make the patient less prone to pain.
The occurrence of peptic ulcers without abdominal pain sensation is very dangerous, because these patients often come to the hospital only when they suddenly vomit blood, and if resuscitation is not timely, it may even be life-threatening. So if you usually once you find a black stool, you should go to the hospital in time to see a doctor.
In addition to abdominal pain, peptic ulcer patients are also said to be able to appear what manifestations?
Warm breath Peptic ulcer patients will often belch constantly.
Acid reflux Patients with peptic ulcers tend to vomit acid, especially after eating sweet or indigestible foods.
Bleeding Some patients with peptic ulcers may suddenly develop black stools or vomit blood.
Why should older people be more alert to peptic ulcers?
Older people are less sensitive to pain and often have peptic ulcers without abdominal pain, and even if they have abdominal pain, the abdominal pain characteristic of peptic ulcers is not obvious, so the condition is not easily detected. Moreover, older patients with large ulcer surfaces and a high percentage of bleeding are more likely to have gastric perforation and recurrence.
In view of the above, elderly people should be more alert to the occurrence of peptic ulcers. Although older people with peptic ulcers are less likely to have abdominal pain, they may have difficulty swallowing and pain when swallowing, or they may experience pain in the back or chest, so it is important to see a doctor promptly when these manifestations occur.
Can children also get peptic ulcers?
Although peptic ulcers are most common in adults, they are not uncommon in children and usually occur in school-age children. Duodenal ulcers are more common in children and are more common in boys than girls.
Parents and schools should be aware of the possibility of peptic ulcers in children when the following conditions occur and take the child to the hospital promptly
Recurrent vomiting related to eating.
Poor appetite.
Pain around the navel often occurs when hungry, and pressure on their abdomen with the hand will reveal pressure pain at the heart fossa.
Body wasting or poor growth.
Peptic ulcers in children are less severe than in adults and can be cured quickly if treated promptly.
What tests are needed to diagnose peptic ulcer?
Depending on the condition, the doctor may choose to use upper gastrointestinal barium angiography or gastroscopy for the patient.
Why is it important to treat peptic ulcers promptly?
Peptic ulcers must be treated promptly, otherwise they can have serious consequences. Peptic ulcers can cause several serious consequences as follows.
Bleeding Peptic ulcers can cause bleeding in the gastrointestinal tract when they are severe, which can occur as black stools or vomiting of blood. The occurrence of vomiting blood indicates rapid bleeding, with a bleeding volume of 250 ml or more. When the amount of bleeding exceeds 500 ml, the patient may feel dizzy, panic and experience a decrease in blood pressure. Prolonged black stool, although not as large as the bleeding volume of vomiting blood, can also lead to anemia, and the patient may show general weakness, dizziness, and pallor. Once this happens, the patient should be taken to the hospital immediately for emergency treatment or call the emergency number.
Perforation In severe cases of peptic ulcers, the mucosal erosion can penetrate the outermost plasma membrane layer of the stomach or duodenal wall, resulting in perforation of the stomach or duodenal ulcer. When perforation occurs, the contents of the stomach and intestines enter the abdominal cavity, and the patient will suddenly experience severe, persistent pain in the upper middle or right abdomen, accompanied by nausea and vomiting. If this happens, the patient should be taken to the hospital immediately for emergency treatment or call an emergency number.
Pyloric obstruction In severe cases of duodenal ulcers, the pylorus can become spastic and obstructed, preventing food from entering the duodenum from the stomach. The patient will vomit after a meal (30-60 minutes) and the vomit will be large, with a putrid smell of residual food. If this happens, take the patient to the hospital immediately for emergency treatment or call the emergency number.
Gastric ulcers have the potential to become cancerous, but no cases of cancerous duodenal ulcers have been found.
The consequences are very serious, such as bleeding, perforation and pyloric obstruction, which are not only painful but also life-threatening if not rescued in time. Although gastric cancer is not an emergency, it will eventually bring pain and life threatening to patients. Therefore, peptic ulcer must be treated in time.
Which drugs are said to treat peptic ulcer?
Drugs to reduce gastric acid Reduce the irritation of gastric mucosa and relieve the patient’s pain. Commonly used are calcium carbonate, magnesium oxide, gastropin, aluminum hydroxide gel cimetidine (Tegretol, mecamylate), ranitidine (Sinogastride), famotidine (Cinfadin), omeprazole (Loxac), esomeprazole (Nexium), rabeprazole (Polite), etc.
Drugs to protect the gastric mucosa Commonly used are aluminum thioglycollate (gastric ulcer), sodium glycopyrrolate (gastrodinone), gastrobid, Schweser, and Hylococcus, etc.
Drugs for H. pylori eradication The most commonly used drug is omeprazole (or esomeprazole, rabeprazole) plus two antibacterial drugs (such as amoxicillin and cloride) to form a triple therapy regimen for H. pylori eradication.
Can Chinese medicine treat peptic ulcer?
Many Chinese herbs can be used to treat peptic ulcers, and they also have good efficacy. Chinese herbs not only have the effect of adjusting the function of the gastrointestinal tract, but also enhance the self-protective ability of the gastrointestinal mucosa and also inhibit the growth of H. pylori. However, each patient’s condition is different, and the doctor needs to give different drugs according to the specific situation of each patient. Therefore, you should not buy some Chinese medicine at the pharmacy and take it casually, not to mention replace the regular drug treatment.
What should peptic ulcer patients pay attention to when taking medication?
1. Use the medication according to the doctor’s requirements
For example, the best time to take calcium carbonate, aluminum hydroxide gel, etc. is 60 to 90 minutes after meals, 5-10 minutes after taking the drug, but the maintenance of antacid effect is short, only 2-3 hours; ranitidine, famotidine, etc. should be taken in the morning and evening before meals; Loxac, Nexium Proton pump inhibitors such as lorcet, nexium, and polite need to be taken at once before breakfast. In addition, the method of taking different drugs may also be different, for example, cover the gastric flat, gastric must be treated, such as magnesium aluminum carbonate requirements chewed.
2, do not frequently change the drug
Some patients are eager to cure, see no significant improvement in symptoms, a drug only a few times (a day or two), and soon change another drug treatment. This is a very wrong approach. It is important to know that any drug does not play a therapeutic role immediately after entering the body, but only after taking it for a certain period of time and reaching a sufficient concentration in the body can the drug play a therapeutic role, and it needs to be maintained for a period of time before the therapeutic effect is consolidated. It is difficult to obtain satisfactory results by changing the drugs around. If you need to change the medication, it must be arranged by the doctor.
3.Adhere to the course of medication
Inadequate course of medication is a major taboo for patients with gastric and duodenal ulcers, and is also the main cause of recurrence of the disease. Remember, the elimination of symptoms does not mean that the peptic ulcer is cured. The general course of medication for peptic ulcers is shown in Figure 8-7.
To eradicate H. pylori treatment, you need to adhere to the standard medication for l to 2 weeks; thick broth, sour vinegar, etc.; avoid being too hungry and too full; avoid food that is too cold, too hot and rough; chew more during meals.
Drugs Be careful with drugs that damage the gastric mucosa. Such drugs include aspirin, pautazone, anti-inflammatory pain, ibuprofen, fenpropathrin, prednisone, etc. The blood pressure lowering drug reserpine should also be used sparingly or not. If you have to take the above drugs because of a certain disease, you should take them at the same time with gastric mucosal protection drugs under the guidance of your doctor.
Can peptic ulcer be cured?
After 4 to 8 weeks of standardized anti-ulcer treatment, the majority of peptic ulcer patients can have their ulcers completely healed and their symptoms relieved. However, the biggest problem in the treatment of peptic ulcer patients is the recurrence of ulcers. The key to reducing and avoiding recurrence is firstly to adhere to a large course of regular anti-ulcer therapy and secondly to successfully eradicate H. pylori in peptic ulcer patients who are positive for H. pylori.