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Ulcers

What is the symptoms of ulcer?

What is the symptoms of ulcer?

The symptoms of an ulcer include: Burning upper abdominal pain, particularly between meals, early in the morning, or after drinking orange juice, coffee, or alcohol, or taking aspirin; discomfort is usually relieved after taking antacids. Tarry, black, or bloody stools. Bloating.

Ulcers

A gastric ulcer is an ulcer in the mucous membrane of the stomach .

As in a duodenal ulcer, gastric ulcer is a form of peptic ulcer disease . The prevalence of gastric ulcers in Western society is less than the prevalence of duodenal ulcers. It generally appears at a more advanced age, and its prevalence is greater at the age of 50-60 years.

Stomach ulcer symptoms

Symptoms of stomach ulcers are numerous and the main symptom of the disease is abdominal pain.

Abdominal pain can appear in many forms and is not characteristic of stomach ulcers only.

It is possible for pain to appear when eating, after a certain time, and it may even awaken a stomach ulcer patient from his sleep.

In contrast to a duodenal ulcer, the pain does not subside after eating.

Additional symptoms of stomach ulcers

  • Nausea, with or without vomiting
  • and low weight.

Sometimes the ulcer is discovered after the onset of symptoms without being preceded by a complaint of abdominal pain.

Bloody vomiting and black faeces are among the symptoms that require investigation to ensure that there is no peptic ulcer.

Causes and risk factors for stomach ulcers

As in  the twelve ulcers  (Duodenal ulcer), as well as gastric ulcer is a form of disease  peptic ulcer  (Peptic Ulcer), and like him also, Vegrahh stomach occur as a result of the imbalance between the harmful factors such as the bacterium  Helicobacter pylori  (Helicobacter pylori) and mechanisms to defend membrane The gastric mucosa, on the other hand.

pylori infection appears in 70% of gastric ulcer cases, and unlike patients with duodenal ulcer, the degree of acid secretion in the stomach in patients with stomach ulcers is more low, compared to healthy people. That is, the injury to the defense mechanism of the gastric mucosa, it seems, is the main reason for the development of gastric ulcers.

Another important cause of stomach ulcers is the abuse of  aspirin  and non-steroidal anti-inflammatory drugs (NAIDs). These medications, intended to treat joint pain and inflammation, block the enzyme cyclooxygenase-1 and impair the production of prostaglandins, which are vital to protect the gastric mucosa.

The widespread treatment of these drugs, in recent years, especially among the elderly, has led to a significant increase in the percentage of patients with gastric ulcers and their complications, such as severe bleeding.

Stomach ulcer diagnosis

  • Endoscopy : The most accurate examination for diagnosing stomach ulcers is  endoscopy of the upper digestive tract.

To perform this examination, a flexible tube with a very small video camera is inserted into the esophagus, stomach and duodenum.

This examination allows a close view of the gastric mucosa, and a tissue sample (biopsy) is taken at the edges of the ulcer for the purpose of pathological examination to confirm or deny the presence of H. pylori. In order to spare the patient the uncomfortable feeling during the examination, it is performed under local anesthesia for the pharynx, or by introducing sedative materials intravenously, before starting the examination.

  • X-ray : Another test for diagnosing stomach ulcers is an X-ray of the stomach and duodenum  , after swallowing a contrast material (barium).

This test is not accurate, and it is not possible to take a sample (biopsy) for a microscopic examination or to detect the presence of Helicobacter pylori. Although there are typical signs that distinguish a benign ulcer from a malignant ulcer, it is preferable in all cases to perform an endoscopic examination for the purpose of biopsy and to rule out the presence of malignant tumors.

stomach ulcer treatment

Stomach ulcer treatment is divided into two main cases:

1- The presence of confirmed infection with H. pylori bacteria

  • Antibiotics are the answer to the complete eradication of H. pylori. This is what is known today as the triple treatment consisting of the three antibiotics: metronidazole, amoxicillin, and clarithromycin, for two weeks.
  • Treatment with antisecretory drugs, which help the ulcer heal better. It is worth noting that taking this type of medicine for this category of patients (ulcers caused by infection with H. pylori) depends on whether the ulcer is large and complex in terms of its data or not.
  • In people who are taking NSAIDs such as aspirin and other NSAIDs, the attending physician must decide whether there is a need to stop using these drugs, depending on several factors such as the time that the patient has used them, the size and complexity of the wound, and the risk versus benefit. As a result of the patient stopping the use of this type of medicine.

2- Absence of confirmed H. pylori contamination:

  • First of all, the doctor must make sure that there is no infection with this germ with more than one examination. A single negative test for MRSA is not enough for actual confirmation.
  • Treatment with antisecretory drugs, which help the ulcer heal better. There are three main classes of these drugs:

    • Proton pump inhibitors: The medications available on the market for this type are (omeprazole, esomeprazole, lansoprazole, dexlansoprazole, pantoprazole, rabeprazole,).
    • Histamine-type (H2) receptor blockers : The drugs available in the market for this type are (cimetidine, ranitidine, famotidine, and nizatidine).
    • Medicines that contain synthetic prostaglandins, such as: Misoprostol.

giant ulcer

In this case, in addition to all the treatment options previously mentioned. In this type, treatment with a proton pump inhibitor (PPI) for a long period of time over 12 weeks is recommended.

In addition to the necessity of conducting an endoscopy to review the location of the ulcer, due to the increased risk in these types of ulcers to be a malignant tumor.

Also, it is recommended to resort to surgical treatment of stomach ulcers in the event that malignant tumors are confirmed or when malignant tumors are suspected, after the failure of appropriate and continuous treatment to heal the ulcer.

Follow-up of patients after the treatment process:

  • Patients with duodenal ulcer: Usually there is no need for follow-up and endoscopic examination to check on the healing process of the ulcer and its healing. Except in the case of the return of the initial symptoms that the patient was experiencing before taking the treatment.
  • Patients with stomach ulcers: There are several medical opinions that deal with the follow-up of patients in this category, due to the danger of the presence of a malignant disease in the ulcer area. Therefore, some doctors recommend an endoscopy after a period of 6 weeks of taking the treatment.

Usually patients who are required to be re-examined are those who have the following characteristics of ulcers:

  • a stomach ulcer without recent use of an NSAID,
  • Presence of Helicobacter pylori
  • A patient over 50 years old
  • Large ulcer larger than 2-3 cm
  • Certain ethnic groups are at risk for stomach cancer

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