PEPTIC ULCER DISEASE: CAUSES, SYMPTOMS AND SIGNS

PEPTIC ULCER DISEASE

En-comprises both Gastric and Duodenal Ulcers, depending on location of ulcer; Gastric Ulcer found on Stomach while Duodenal Ulcer found in first part of small intestine known as Duodenum. Peptic Ulcers are referred as breaks / erosion in the mucosal surface (about 5 mm in size) with depth to the submucosal of Stomach and Duodenum.

Gastric Ulcer

CAUSES OF PEPTIC ULCER.

The most important cause of Peptic Ulcers is Infection with Helicobacter Pylori and long term use of group of medications such as Nonsteroidal Anti-Inflammatory Drugs (NSAIDs);

• Helicobacter Pylori (H. Pylori).

H. Pylori is the bacterium (Gram Negative micro-aerophilic rod) found in most common in the deeper portion of the mucosa gel coating Stomach mucosa or between the mucosa layer and the gastric epithelium. People who are infected with H. pylori are at higher risk of developing Peptic Ulcers. It confirmed in laboratory by number of tests depend on the situation. Treatment of Helicobacter Pylori consisting of taking three to four drugs. 

• Nonsteroidal Anti-Inflammatory Drugs (NSAIDs).

NSAIDS represent a group of the most commonly used medications worldwide for the management of Pain. There are many drugs such as Aspirin, Ibuprofen, Naproxen, Ketoralac and Oxaprozin. Also NSAIDs includes combination of some medications such as BC Powder, Goody’s Powder and Alka-seltzer. 
NSAIDs cause Peptic Ulcer by  interrupt the natural ability of the stomach and duodenum to protect themselves from Stomach Secretions products such as Gastric Acid and Pepsin, can also Interfere with blood clot which is obvious important when Ulcers bleed.

Individuals who take NSAIDs for a long time a\or at higher doses are at risk of developing Peptic Ulcer. These indivinduals should discuss various options for preventing ulcer with their Doctors. Acetaminophen is not an NSAIDs drug and is therefore the preferred non prescription treatment for the pain in patient at risk of Peptic Ulcer Disease.

PREDISPOSING FACTORS FOR PEPTIC ULCER.

• Cigarette smoking – not only smoker have been found to have Peptic Ulcers but more frequent than nonsmokers. Also it reduce Ulcer healing rate and increase Ulcer related complications.

• Psychological stress – has been thought to play role in Peptic Ulcer Disease.
• Genetic Predisposition – may also play role in Ulcer development. people with Blood Group O are at genetic risk for Peptic diathesis but the role of genetic predisposition in common Peptic Ulcer has not been established yet.
• Diet – Also has been thought to play role in Peptic Ulcer Disease, certain food and drinks cause Dyspepsia ( indigestion). Alcohol And Caffeine drinks has been thought to contribute on indigestion.

alcohol drinks  

SINGS AND SYMPTOMS OF PEPTIC ULCERS

Abdominal pain

The most common Symptoms of Peptic Ulcer is Abdominal pain in both Gastric and Duodenum Ulcers. The pain is often in Upper Part of Abdomen known as Epigastric Pain described as burning sensation or gnawing discomfort, The discomfort described as Ill-defined, aching sensation or as hunger pain. Patient with NSAIDs induced Peptic Ulcer Disease can present with serious medical complications such as:

• penetration,
• Perforation,
• Bleeding and
• Obstruction

Variation in intensity and distribution of Abdominal pain as well as associated symptoms such as nausea and vomiting, feeling bloating or full may be indicative of the complications;

• Dyspepsia (indigestion) that is no longer relieved by food or antacids and radiate to the back may indicate a Penetrating Ulcer.
• sudden onset of severe generalized Abdominal pain and Vomiting of undigested eaten food suggest Gastric Outlet Obstruction.
• Tally stool or coffee ground emesis (vomiting) indicated bleeding which may lead to anemia and can be life threatening.

Epigastric tenderness – pain on touch at Upper Abdomen is most frequent sign/finding in patient with Gastric Ulcer and Duodenal Ulcer.

Pain on palpation at upper Abdomen