Stomach Ulcers - truth media ct


                       Stomach ulcers
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Stomach ulcers, which are also known as gastric ulcers, are painful sores in the stomach lining. Stomach ulcers are a type of peptic ulcers disease. Peptic ulcers are any ulcers that affect both the stomach and small intestines.
Stmach ulcers occur when the thick layer of mucus that protects your stomach from digestive juices is reduced. This allows the digestive acids to eat away at the tissues that line the stomach, causing an ulcer.
Stomach ulcers may be easily cured, but they can become severe without proper treatment.
Peptic ulcer disease, commonly called ulcers, is very common and affects more than 4 million people each year in the U.S. Ulcers are sores or eroded areas that form in the lining of the stomach or duodenum (small bowel). Left untreated, ulcers can cause significant problems, including significant pain and severe bleeding. Fortunately, most people who develop ulcers can be easily treated.
Cause for ulcers 

Most ulcers are caused by a bacterium known as Helicobacter pylori or the use of aspirin or nonsteroidal anti — inflammatory drugs. Helicobacter is mostly acquired in childhood and much less common in developed nations than in those with less well — developed sanitary conditions. Baby aspirin alone does not cause ulcers but higher doses and many other over — the — counter pain relievers can lead to ulcers, particularly at high doses and if used daily. Ulcers can affect appetite and cause nausea, vomiting, or bleeding into the digestive tract,

    Peptic ulcer disease, commonly called ulcers, is very common and affects more than 4 million people each year in the U.S. Ulcers are sores or eroded areas that form in the lining of the stomach or duodenum (small bowel). Left untreated, ulcers can cause significant problems, including significant pain and severe bleeding. Fortunately, most people who develop ulcers can be easily treated.
       People with ulcers can have a wide variety of symptoms. Some people may experience no symptoms at all, or in rare instances can develop life — threatening complications, such as bleeding. Some of the more common symptoms may include abdominal pain, burning, nausea, bloating, fatigue, or black stools.The two most common causes of ulcers are Helicobacter pylori (H. pylori) and non steroidal anti — inflammatory drugs (NSAIDS).

H. pylori is a bacteria which causes ulcers by disrupting the protective mucous layer that lines the intestines. When the mucus layer is disrupted, it triggers the release of certain enzymes and toxins that injure the cells of the stomach or duodenum causing small sores. Once a small sore develops, the tissue becomes more vulnerable to damage from digestive juices and has the potential to develop into an ulcer.
The most common NSAIDS are ibuprofen and aspirin. These types of drugs are taken to decrease inflammation. Inflammation is caused by a natural chemical in the body called prostaglandins . NSAIDS work by inhibiting the body's production of prostaglandins. However, certain prostaglandins are important in protecting the stomach lining from the corrosive effects of stomach acid, as well as playing a role in maintaining the natural, healthy condition of the stomach lining. By disrupting the production of prostaglandins in the stomach, NSAIDs can cause ulcers and bleeding.
The majority of peptic ulcers are caused by a bacterial infection of the stomach called Helicobacter pylori. This infection is often asymptomatic and can be acquired in childhood. The other cause of ulcers is the regular use of aspirin and anti — inflammatory medicines. There is no evidence that stress causes ulcers. Symptoms of ulcers can include upper abdominal pain, nausea and vomiting, and black, tarry stools . 

Anatomy

      Sufferers describe an ulcer as a burning, cramping, gnawing, or aching in the abdomen that comes in waves, for three to four days at a time, but may subside completely for weeks or months. Pain is worst before meals and at bedtime when the stomach is usually empty. The ulcer itself is an open sore in the lining of the stomach (gastric ulcer) or in the upper part of the small intestine, or duodenum (duodenal ulcer). Both types are also called peptic ulcers.







But some stomach ulcers aren't painful and are only noticed when a complicationsdevelops, such as bleeding from the ulcer.

Tummy pain

The pain caused by a stomach ulcer can travel out from the middle of your tummy up to your neck, down to your belly button, or through to your back.
It can last from a few minutes to a few hours, and often starts within a few hours of eating. You may also wake up in pain during the night.
Taking indecision medicinmay relieve the pain temporarily, but it'll keep coming back if the ulcer isn't treated.

Other symptoms

Less common symptoms of a stomach ulcer can include:
  • Indigestion
  • Heartburn
  • loss of appetite
  • feeling and being sick
  • weight loss
Some people also find they burp or become bloated after eating fatty foods.

Diagnosis


In order to detect an ulcer, your doctor may first take a medical history and perform a physical exam. You then may need to undergo diagnostic tests, such as:
  • Laboratory tests for H. pylori. Your doctor may recommend tests to determine whether the bacterium H. pylori is present in your body. He or she may look for H. pylori using a blood, stool or breath test. The breath test is the most accurate. Blood tests are generally inaccurate and should not be routinely used
    • For the breath test, you drink or eat something that contains radioactive carbon. H. pylori breaks down the substance in your stomach. Later, you blow into a bag, which is then sealed. If you're infected with H. pylori, your breath sample will contain the radioactive carbon in the form of carbon dioxide.
      If you are taking an antacid prior to the testing for H pylori, make sure to let your doctor know. Depending on which test is used, you may need to discontinue the medication for a period of time because antacids can lead to false-negative results.
    • Endoscopy. Your doctor may use a scope to examine your upper digestive system (endoscopy). During endoscopy, your doctor passes a hollow tube equipped with a lens (endoscope) down your throat and into your esophagus, stomach and small intestine. Using the endoscope, your doctor looks for ulcers.
      If your doctor detects an ulcer, small tissue samples (biopsy) may be removed for examination in a lab. A biopsy can also identify whether H. pylori is in your stomach lining.
      Your doctor is more likely to recommend endoscopy if you are older, have signs of bleeding, or have experienced recent weight loss or difficulty eating and swallowing. If the endoscopy shows an ulcer in your stomach, a follow-up endoscopy should be performed after treatment to show that it has healed, even if your symptoms improve.
    • Upper gastrointestinal series.Sometimes called a barium swallow, this series of X-rays of your upper digestive system creates images of your esophagus, stomach and small intestine. During the X-ray, you swallow a white liquid (containing barium) that coats your digestive tract and makes an ulcer more visible.

    Treatment

    Treatment for peptic ulcers depends on the cause. Usually treatment will involve killing the H. pylori bacterium, if present, eliminating or reducing use of NSAIDs, if possible, and helping your ulcer to heal with medication.
    Medications can include:
    • Antibiotic medications to kill H. pylori. If H. pylori is found in your digestive tract, your doctor may recommend a combination of antibiotics to kill the bacterium. These may include amoxicillin (Amoxil), clarithromycin (Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline (Tetracycline HCL) and levofloxacin (Levaquin).
      The antibiotics used will be determined by where you live and current antibiotic resistance rates. You'll likely need to take antibiotics for two weeks, as well as additional medications to reduce stomach acid, including a proton pump inhibitor and possibly bismuth subsalicylate (Pepto-Bismol).
    • Medications that block acid production and promote healing.Proton pump inhibitors — also called PPIs — reduce stomach acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium) and pantoprazole (Protonix).
      Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist and spine fracture. Ask your doctor whether a calcium supplement may reduce this risk.
    • Medications to reduce acid production. Acid blockers — also called histamine (H-2) blockers — reduce the amount of stomach acid released into your digestive tract, which relieves ulcer pain and encourages healing.
      Available by prescription or over-the-counter, acid blockers include the medications ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine (Axid AR).
    • Antacids that neutralize stomach acid. Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients.
      Antacids can provide symptom relief, but generally aren't used to heal your ulcer.
    • Medications that protect the lining of your stomach and small intestine. In some cases, your doctor may prescribe medications called cytoprotective agents that help protect the tissues that line your stomach and small intestine.
      Options include the prescription medications sucralfate (Carafate) and misoprostol (Cytotec).

    Follow-up after initial treatment

    Treatment for peptic ulcers is often successful, leading to ulcer healing. But if your symptoms are severe or if they continue despite treatment, your doctor may recommend endoscopy to rule out other possible causes for your symptoms.
    If an ulcer is detected during endoscopy, your doctor may recommend another endoscopy after your treatment to make sure your ulcer has healed. Ask your doctor whether you should undergo follow-up tests after your treatment.

    Ulcers that fail to heal

    Peptic ulcers that don't heal with treatment are called refractory ulcers. There are many reasons why an ulcer may fail to heal, including:
    • Not taking medications according to directions
    • The fact that some types of H. pylori are resistant to antibiotics
    • Regular use of tobacco
    • Regular use of pain relievers — NSAIDs and aspirin — that increase the risk of ulcers
    Less often, refractory ulcers may be a result of:
    • Extreme overproduction of stomach acid, such as occurs in Zollinger-Ellison syndrome
    • An infection other than H. pylori
    • Stomach cancer
    • Other diseases that may cause ulcer-like sores in the stomach and small intestine, such as Crohn's disease
    Treatment for refractory ulcers generally involves eliminating factors that may interfere with healing, along with using different antibiotics.
    If you have a serious complication from an ulcer, such as acute bleeding or a perforation, you may require surgery. However, surgery is needed far less often than previously because of the many effective medications now available.

Lifestyle and home remedies

You may find relief from the pain of a stomach ulcer if you:
  • Choose a healthy diet. Choose a healthy diet full of fruits, especially with vitamins A and C, vegetables, and whole grains. Not eating vitamin-rich foods may make it difficult for your body to heal your ulcer.
  • Consider foods containing probiotics. These include yogurt, aged cheeses, miso, and sauerkraut.
  • Consider eliminating milk.Sometimes drinking milk will make your ulcer pain better, but then later cause excess acid, which increases pain. Talk to your doctor about drinking milk.
  • Consider switching pain relievers. If you use pain relievers regularly, ask your doctor whether acetaminophen (Tylenol, others) may be an option for you.
  • Control stress. Stress may worsen the signs and symptoms of a peptic ulcer. Consider the sources of your stress and do what you can to address the causes. Some stress is unavoidable, but you can learn to cope with stress with exercise, spending time with friends or writing in a journal.
  • Don't smoke. Smoking may interfere with the protective lining of the stomach, making your stomach more susceptible to the development of an ulcer. Smoking also increases stomach acid.
  • Limit or avoid alcohol. Excessive use of alcohol can irritate and erode the mucous lining in your stomach and intestines, causing inflammation and bleeding.
  • Try to get enough sleep. Sleep can help your immune system, and therefore counter stress. Also, avoid eating shortly before bedtime.

Alternative medicine

Over-the-counter medications that contain calcium carbonate (Tums, Rolaids), may help treat peptic ulcers but should not be used as the primary treatment. There is also some evidence that zinc can help heal ulcers.
Among botanicals recommended to treat peptic ulcers are turmeric, mastic, cabbage, deglycyrrhizinated licorice, and neem bark extract.
While over-the-counter and alternative medications may be helpful, evidence on effectiveness is lacking. Therefore they are not recommended as the primary treatment for peptic ulcers.



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