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Friday, September 16, 2016

What is Peptic Ulcer ?



Introduction - 

Peptic ulcer disease refers to presence of painful sores on the linings of stomach, duodenum (first part of small intestine) and occasionally lower part of oesophagus. According to site ulcer is called as Gastric ulcer or Duodenal ulcer or Esophageal ulcer. Most common symptom is upper abdominal pain early in the morning.


Meaning of peptic means acid related problems. Again some people believe that peptic word may be derived from pepsin, a n enzyme produced at stomach that helps digestion.

History - 


In ancient days people thought it to be a life-style disease, may be related to spicy food and living stressful life with personnel and emotional issues. In 1958 Greek practitioner John  Lykoudis started treating peptic ulcer patients with antibiotics. He assumed that bacteria may be the latent cause for producing peptic ulcer.
In 1982 two Australian scientists, Robin Warren and Barry J. Marshall identified a bacteria named Helicobacter pylori and they claimed in their research paper that this the bacteria responsible for gastritis and gastric ulcer. In 2005 these two scientists has been awarded Nobel Prize for their discovery.
There after some believed that mastic tree (Pistacia lentiscus) gum, a tree resin extract, is successful in eliminating the H. pylori bacteria. It was used as traditional medicine in Middle East. Mastic contains antioxidants and it has antibacterial and antifungal properties. A Nottingham University study published in the New England Journal of Medicine claims that mastic can cure peptic ulcers by killing Helicobacter pylori bacteria.

Other risk factors for development of Peptic ulcer :

·         Non-steroidal anti inflammatory drugs viz. Aspitin, Naproxen, Ibuprofen.
·         Alchol.
·         Smoking
·         Serious illness.
·         Stress.
·         Diet – coffee, spices.
Symptoms of peptic ulcer
·         Burning pain on epigastric regionof upper abdomen.
·         Nauses and vomiting.
·         Bloating.
·         Heartburn.
In severe cases
Hematmesis and Mealena
Weight loss
Anaemis

Complications of Peptic ulcer : –
Gastro intestinal bleeding
Gastric outlet obstruction /pyloric stenosis
Perforation leading to peritonitis.

Diagnosis :                                                        

Clinical history and physical examination.
Upper GI endoscopy also known as GED (Gastro- esophageo-duodenoscopy).
Blood test for H.Pylori antibody and anaemia.
Breath test for Urease (enzyme produced by H.Pylori).
Stool for occult blood and H, Pylori.
Barium meal X ray study.

Treatment –
(1)   Medical  management - Antibiotics to destroy H.Pylori, Protein Pump Inhibitors, H2 Antagonist, Sucralafate.
(2)   Surgical management.
(3)   Endoscope may be used for cotorizing any bleeding point in the stomach. By endoscope photograph can be taken and sample may be collected for biopsy.


Dr. Bhupen Saikia
16-09-2016


1 comment:

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