Peptic Ulcers; all you need to know about it.

Overview

Open sores on the inside lining of your stomach and the upper region of your small intestine are known as peptic ulcers. Stomach discomfort is the most prevalent sign of a peptic ulcer.

The following are types of peptic ulcers:

• Gastric ulcers; the ulcers on the inside of the stomach.
• Duodenal ulcers; ulcers that form on the interior of your small intestine’s upper part (duodenum)

The bacteria Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen and naproxen sodium are the most common causes of peptic ulcers . Peptic ulcers are not caused by stress or spicy foods. They can, however, exacerbate your symptoms.

Symptoms

• Stomach discomfort that is burning
• Intolerance to fatty foods
• fullness
• bloating, or belching
• Heartburn
• Nausea

The most frequent sign of a peptic ulcer is burning stomach discomfort. Stomach acid, as well as having an empty stomach, aggravates the pain. Eat some meals that buffer stomach acid or take an acid-reducing medication to alleviate the pain, but it may return. It’s possible that the discomfort will be worse between meals and at night.

Many persons with peptic ulcers have no symptoms at all.

Ulcers can also generate severe signs and symptoms, such as:

• Vomiting or vomiting blood (which can be red or black in color)
• Stools with dark blood, or stools that are black or tarry
• Breathing problems
• Dizziness.
• Vomiting or nausea
• Weight loss that isn’t explained
• Appetite shifts

When should you see a doctor?

If you have any of the above-mentioned serious signs or symptoms, you should see a doctor. Consult your physician as well.

Causes

Acid in the digestive tract eats away at the inner surface of the stomach or small intestine, causing peptic ulcers. The acid might cause an open sore that is uncomfortable and may bleed.

A mucous layer coats your digestive tract, which generally protects it from acid. However, if the amount of acid produced increases or the amount of mucus produced decreases, an ulcer may form.

Among the most common causes are:

• A bacterium. Helicobacter pylori bacteria are typically found in the mucous layer that covers and protects the stomach and small intestine tissues. The H. pylori bacterium usually causes no problems, but it can create ulcers by inflaming the stomach’s inner layer. The exact mechanism by which H. pylori infection spreads is unknown. It can be passed from one person to the next through close contact, such as kissing. H. pylori can also be contracted by food and water.
• Use of some pain medicines on a regular basis. Nonsteroidal anti-inflammatory drugs (NSAIDs), which include aspirin and other over-the-counter and prescription pain relievers, can irritate or inflame the lining of your stomach and small intestine. Ibuprofen (Advil, Motrin IB, and others), naproxen sodium (Aleve, Anaprox DS, and others), ketoprofen, and other drugs are among them. They don’t include acetaminophen (Tylenol, others).
• Other drugs . Other drugs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate, and risedronate (Actonel), can dramatically enhance the risk of ulcers when combined with NSAIDs.

Risk factors

In addition to the hazards associated with using NSAIDs, you may be at a higher risk of developing peptic ulcers if you:

• Smoking. In patients infected with H. pylori, smoking may increase the risk of peptic ulcers.
• Consuming alcoholic beverages. Alcohol can irritate and dissolve your stomach’s mucous lining, as well as increase the amount of stomach acid produced.
• Having stress that is not being addressed.
• Consuming spicy meals.

These variables do not create ulcers on their own, but they can aggravate them and make them more difficult to heal.

Complications

Peptic ulcers, if left untreated, can lead to:

• There is intestinal bleeding. Bleeding can occur as slow blood loss that leads to anemia or as significant blood loss that may necessitate hospitalization or a blood transfusion. Severe blood loss might result in black or bloody vomit or bloody feces.
• Perforation. Peptic ulcers can eat a hole in the wall of your stomach or small intestine, putting you at risk of developing a dangerous intestinal infection (peritonitis).
• Obstruction. Peptic ulcers can prevent food from passing through the digestive tract, leading you to feel bloated, vomit, and lose weight due to swelling from inflammation or scarring.
• Gastric cancer is a disease that affects the stomach. H. pylori infection has been linked to an increased risk of stomach cancer in studies.

Prevention
If you use the same procedures that are advised for treating ulcers at home, you may lower your risk of developing a peptic ulcer. It may also be beneficial to:

• Defend yourself against infections. Although it’s unclear how H. pylori spreads, there’s evidence that it can be passed from person to person or by food and water. You can protect yourself from illnesses like H. pylori by washing your hands frequently with soap and water and eating foods that have been fully cooked.
• When it comes to pain medicines, be cautious. Take actions to limit your risk of stomach troubles if you regularly use pain medicines that increase your chance of peptic ulcer. Take your medication with food, for example.
• Work with your doctor to determine the smallest amount that will still provide pain relief. When taking your prescription, avoid consuming alcohol because the two can raise your risk of stomach discomfort.
• If you need to take an NSAID, you may also need to take an antacid, a proton pump inhibitor, an acid blocker, or a cytoprotective drug. COX-2 inhibitors are a type of NSAID that may reduce the risk of peptic ulcers but may raise the risk of heart attack.

Diagnosis

Your doctor may start by taking a medical history and performing a physical check to see if you have an ulcer. Following that, you may be required to undertake diagnostic tests such as:

• H. pylori tests in the lab. Tests to see if the bacteria H. pylori is present in your body may be recommended by your doctor. He or she may use a blood, stool, or breath test to look for H. pylori. The most accurate test is the breath test. You drink or eat anything containing radioactive carbon for the breath test. H. pylori is a bacteria that breaks down the contents of your stomach. You then blow into a bag that is then sealed. Your breath sample will contain radioactive carbon in the form of carbon dioxide if you have H. pylori infection.
• If you’re taking an antacid before your H. pylori test, make sure to tell your doctor. Because antacids might generate false-negative findings, depending on which test is utilized, you may need to stop taking the drug for a while.
• Endoscopy. A scope may be used by your doctor to inspect your upper digestive tract (endoscopy). A hollow tube with a lens (endoscope) is passed down your neck and into your esophagus, stomach, and small intestine during endoscopy. Your doctor uses an endoscope to check for ulcers.  If your doctor suspects an ulcer, a small sample of tissue (biopsy) may be taken for testing at a lab. A biopsy can also reveal whether H. pylori is present in the lining of your stomach.
• If you’re older, have indications of bleeding, or have recently lost weight or had difficulty eating or swallowing, your doctor is more likely to recommend an endoscope. Even if your symptoms improve, if an endoscope reveals an ulcer in your stomach, a follow-up endoscopy should be conducted following treatment to ensure that it has healed.
• Barium series of the upper gastrointestinal tract. This set of X-rays of the upper digestive system, also known as a barium swallow, produces images of your esophagus, stomach, and small intestine. You consume a white liquid containing barium during the X-ray, which coats your digestive track and makes an ulcer more noticeable.

Treatment

Peptic ulcer treatment is determined by the cause of the ulcer. Typically, treatment involves destroying the H. pylori bacterium if it is present, lowering or eliminating the use of NSAIDs if possible, and aiding the healing of your ulcer using medication.

The following are examples of medications:

To kill H. pylori, antibiotics are used. If H. pylori is discovered in your digestive tract, your doctor may prescribe a cocktail of medications to eradicate the bacteria. Amoxicillin, clarithromycin, metronidazole, tinidazole, tetracycline, and levofloxacin are some of the antibiotics that can be used.

Where you live and current antibiotic resistance rates will dictate which antibiotics are utilized. Antibiotics and other medications to lower stomach acid, such as a proton pump inhibitor and maybe bismuth subsalicylate, will almost certainly be required for two weeks.

Medications that inhibit acid formation and aid in the healing process. PPIs (proton pump inhibitors) lower stomach acid by preventing the action of the acid-producing portions of cells. The pharmaceuticals omeprazole, lansoprazole , rabeprazole , esomeprazole , and pantoprazole.

Long-term use of proton pump inhibitors, especially at high doses, raises the risk of hip, wrist, and spine fractures. Consult your doctor to see if taking a calcium supplement will help lower your risk.

Medications that reduce the generation of acid. Acid blockers, also known as histamine (H-2) blockers, work by lowering the amount of stomach acid released into the digestive tract, reducing ulcer discomfort and promoting healing.

Acid blockers include famotidine , cimetidine , and nizatidine, which are available via prescription or over the counter.

Antacids are stomach acid neutralizers. Your doctor may prescribe an antacid as part of your treatment plan. Antacids neutralize stomach acid and can provide pain relief quickly. Depending on the principal constituents, side effects may include constipation or diarrhea.

Antacids can help with symptom alleviation, but they aren’t usually used to treat ulcers.

Medications that protect the stomach and small intestine lining. Your doctor may prescribe cytoprotective medicines, which assist protect the tissues that lining your stomach and small intestine in specific circumstances. among which are Sucralfate and misoprostol

After the initial therapy, there is a need for follow-up.

Peptic ulcer treatment is frequently effective, resulting in ulcer healing. However, if your symptoms are severe or persist despite treatment, your doctor may suggest an endoscopy to rule out other possible causes.

If an ulcer is discovered during an endoscopy, your doctor may recommend a follow-up endoscopy to ensure the ulcer has healed. Inquire with your doctor about if you should have any tests done after your treatment.

Ulcers that aren’t healing

Refractory ulcers are peptic ulcers that do not cure despite treatment. An ulcer might fail to heal for a variety of causes, including:

• Not taking my meds as prescribed.
• The fact that some strains of H. pylori are antibiotic-resistant
• Tobacco consumption on a regular basis
• The use of pain medicines, such as NSAIDs, on a regular basis increases the risk of ulcers.

Refractory ulcers are more commonly caused by:

• Zollinger-Ellison syndrome is characterized by excessive stomach acid production.
• Stomach cancer caused by an infection other than H. pylori
• Other disorders, such as Crohn’s disease, can create ulcer-like lesions in the stomach and small intestine.

Treatment for refractory ulcers usually entails removing elements that may obstruct healing as well as the use of various antibiotics.

You may need surgery if you have a major ulcer complication, such as intense bleeding or a perforation. However, due of the many powerful drugs available today, surgery is no longer required as frequently as it formerly was.

Home remedies and a healthy lifestyle

If you do the following, you may find relief from the agony of a stomach ulcer:

• Switching pain medicines is a good idea. If you take pain medicines on a regular basis, check with your doctor to see if acetaminophen (Tylenol, etc.) is a choice for you.
• Reduce your stress levels. The signs and symptoms of a peptic ulcer might be made worse by stress. Consider the reasons of your stress and do everything you can to eliminate them. Although some stress is inescapable, you may learn to manage with it by exercising, socializing, or writing in a journal.
• Please don’t smoke. Smoking can harm the stomach’s protective lining, making it more vulnerable to the development of an ulcer. Smoking raises stomach acid levels as well.
• Alcohol should be consumed in moderation or avoided entirely. Alcohol abuse can irritate and destroy the mucous lining of your stomach and intestines, resulting in inflammation and bleeding.