Peptic ulcer is a very dangerous pathology that people face, regardless of gender and age. The disease is accompanied by damage to the gastric mucosa, the formation of ulcers and serious digestive disorders. If untreated, the pathology leads to dangerous complications up to a violation of the integrity of the walls of the digestive tract.
Of course, many people are looking for additional information about pathology. Why do ulcers appear? What symptoms should I look for? What treatments can modern therapy offer? Is surgery necessary for gastric ulcer? The answers to these questions are interesting to many readers.
General information about the disease
Stomach ulcer is a pathology that is accompanied by a violation of the trophism of the organ mucosa and the further formation of small ulcers. At first, the damage covers only the superficial layers, but then the pathological process extends to deeper tissues - in the absence of treatment, the disease can result in massive bleeding and perforation of the stomach.
According to statistics, 70% of patients are men aged 20 to 50 years. Less commonly, the disease manifests itself in old age. Of course, women are not immune from such a pathology.
It is worth noting that peptic ulcer disease is a chronic process that usually worsens in the autumn and spring.
The main causes of the development of pathology
According to statistics, in 75% of cases, gastric ulcer is the result of penetration of Helicobacter pylori into the body. This is a spiral-shaped bacterium that is resistant to the aggressive environment of the stomach and is able to neutralize the effects of hydrochloric acid. The activity of this pathogenic microorganism leads to damage to the cells of the gastric mucosa, and subsequently to the formation of ulcers. The transmission of infection occurs through contact with the carrier, as well as through food, water, tableware, medical instruments, etc.
In addition, there are other causes of gastric ulcer.
- First of all, it is worth mentioning the intake of medicines. Potentially dangerous drugs include non-steroidal anti-inflammatory drugs, cytostatics, antihypertensive agents and potassium preparations. Of course, in this case we are talking about the long-term use of large doses of these medications. The risk of ulcers increases if the patient is older than 65 years.
- Peptic ulcer may be the result of other pathologies. For example, an ailment often develops against the background of diabetes mellitus, pancreatitis, hepatitis, tuberculosis, cirrhosis of the liver, syphilis.
- The list of causes includes various stomach injuries, burns or frostbite of large body surfaces, shock conditions.
- There is a genetic inheritance.
- It is proved that the likelihood of developing such an ailment is much higher in patients with the first blood group.
For one reason or another, the protective mechanisms of the stomach are weakened, as a result of which the gastric mucosa lends itself to the aggressive effects of gastric juice.
In the process of diagnosis, it is extremely important to determine what exactly caused the development of the disease - in many respects, the success of therapy depends on this.
Peptic ulcer: risk factors
Doctors also highlight risk factors, the impact of which increases the likelihood of damage to the mucous membranes of the digestive tract.
- First of all, it is worth mentioning smoking. By the way, not only regular cigarettes are potentially dangerous, but also cigars and mixes for hookahs.
- Alcohol also irritates the mucous membrane of the stomach - alcohol abuse is dangerous.
- Risk factors also include the abuse of soda and drinks, which contain caffeine (this is not only coffee, but also various energy).
- Irregular nutrition, the structure of the diet, the use of too hot or, conversely, cold food, cakes, rolls, sweets - all this negatively affects the inner walls of the stomach.
- Risk factors include frequent stresses, depressive states, as all this affects the functioning of the endocrine glands.
The main symptoms of pathology
Symptoms of gastric ulcer directly depend on the stage of development. There are several very characteristic signs of the disease.
- In most cases, the first symptom of gastric ulcer is pain. It is usually localized in the upper abdomen. Pain can be aggravated during exercise, as well as after drinking alcohol, eating spicy foods, or on an empty stomach.
- To the list of symptoms include heartburn. It is associated with the ingestion of gastric juice into the lumen of the esophagus. As a rule, an unpleasant burning sensation appears 1-2 hours after a meal.
- Due to the formation of ulcers, the digestion process is disturbed, as well as gastric motility. That is why patients are concerned about nausea, which occurs several hours after a meal. Often, an attack of nausea results in vomiting - this greatly facilitates the condition of a person, so patients often independently cause vomiting.
- The list of symptoms also includes a decrease in appetite and belching, which is accompanied by the appearance of a sour taste or bitterness in the mouth.
- When eating, a feeling of fullness quickly comes. After eating, patients note a feeling of heaviness in the abdomen.
- Patients also suffer from constant constipation and increased gas formation.
The appearance of such violations is an occasion to consult a doctor. Symptoms cannot be ignored, as the ulcerative process is constantly progressing.
Stages of the development of the disease
In modern medicine, several stages of gastric ulcer are distinguished, each of which is characterized by a certain set of symptoms.
- The first stage is considered a kind of pre-ulcerated condition. Small areas of erosion appear on the mucous membrane, but patients feel relatively normal. Symptoms of peptic ulcer are very mild. Relapses occur every 2-7 years.
- The second stage - here we are talking about a moderate and severe form of peptic ulcer.
- In the third stage, complications already occur, including bleeding and perforation.
- The fourth stage is spoken if the patient has relapsed after the correct surgical procedure.
Complications of the disease
Complications of gastric ulcer can be extremely dangerous.
- Sometimes, against the background of the disease, penetration develops. Gradually, the wall of the stomach is destroyed, resulting in the bottom of the ulcer becomes a nearby organ, for example, the gall bladder, pancreas, small omentum. Gastric juice destroys organ tissues. For example, if we are talking about the pancreas, then patients develop destructive pancreatitis.
- If the ulcerative process extends to deeper layers, then perforation of the stomach may occur. As a result, the entire contents of the organ is poured into the abdominal cavity.
- Gastric bleeding is considered a very common complication - approximately 20% of patients with this diagnosis are accompanied by blood loss. Pathology is accompanied by sharp abdominal pain. Vomit looks like coffee grounds. Traces of blood are also present in the feces. In the absence of timely assistance, this condition ends with the death of the patient.
- There is a possibility of malignant degeneration of tissues against a background of ulcerative lesions. According to statistics, this disease ends with stomach cancer in 3% of cases.
- Among the dangerous complications include pyloric stenosis. This pathology is accompanied by a narrowing of the pyloric stomach, as a result of which food cannot move into the intestines.
That is why it is so important to consult a doctor when the first symptoms appear. Complications of gastric ulcer require emergency care.
Diagnostic measures
Diagnosis of gastric ulcer involves several basic steps. It is extremely important to determine the cause of the development of the disease, the area of damage to the mucous membrane, the presence of complications.
- First of all, the patient submits blood and urine samples for analysis. Feces are also examined for traces of occult blood.
- Mandatory is fibrogastroduodenoscopy. Using special optical equipment, the doctor carefully examines the mucous membrane of the esophagus, stomach, and duodenum. If necessary, a tissue biopsy is performed during the procedure - samples are subsequently sent for laboratory analysis.
- An ultrasound of the stomach, liver, gall bladder and pancreas is also performed.
- Informative is radiography using a contrast medium.
- Sometimes, additional monitoring of the pH of the gastric juice is carried out. This is a rather painful study, which, nevertheless, helps to assess the acidity of the gastric juice and the change in this indicator during the day.
- In addition, samples of feces and gastric mucosa (taken during a biopsy) are checked for Helicobacter. A laboratory blood test is also performed to determine the presence of antibodies to this bacterium.
Standards for the treatment of gastric ulcer
Depending on the data obtained during the diagnosis, the doctor will draw up a treatment regimen. To date, a variety of drugs are used. With gastric ulcer, it is necessary to eliminate the infection, restore the structure of the mucous membrane, eliminate the causes of the development of the disease.
- First of all, antibiotic therapy is carried out to help get rid of Helicobacter pylori. In most cases, antibiotics of the penicillin group (Amoxicillin), macrolides (Clarithromycin), tetracyclines, as well as nitromidazole derivatives are used.
- Treatment of gastric ulcer necessarily includes the protection of the inner surface of the organ. Preparations such as De-Nol and Sucralfate help create a special protective film on the surface of the mucous membrane.
- Also, patients are prescribed Enprostil, Biogastron, Ventroxol. These funds stimulate the regeneration of mucous membranes, accelerate tissue healing.
- Treatment of gastric ulcer necessarily includes the use of antisecretory drugs. The proton pump blockers are introduced into the treatment regimen, in particular, “Rabelok”, “Nexium” and “Omez”. These drugs inhibit the secretion of hydrochloric acid.
- Antacids, in particular Antareyt, Almagel, help to neutralize the effect of acid, have enveloping and anti-inflammatory properties.
- Tools such as Cytotec and Misoprostol reduce the secretion of hydrochloric acid, as well as increase the amount of mucus produced to protect the inner membranes of the stomach.
- Patients are also recommended to take prokinetics - such drugs activate the motility of the digestive tract. Such drugs as Domperidone and Multilium are considered effective.
- Antispasmodics, such as Drotaverin and No-shpa, help relieve spasm of the gastric wall and cope with pain.
- Probiotics are also used to help restore the normal microflora of the digestive tract.
- If necessary, patients are additionally prescribed taking mild sedatives and antidepressants.
The course of therapy lasts from 14 days to 1.5-2 months, depending on the presence of certain symptoms, the degree of damage to the stomach.
Diet as part of therapy
Diet for gastric ulcer is very important. The body needs to be saturated with useful substances and energy substrates, while avoiding additional irritation of the mucous membrane of the digestive tract.
First, it’s worth mentioning some basic rules. Fractional nutrition is recommended for patients - eat at least 5 times a day, but in small portions (this way you can avoid stretching the stomach). Food should not be cold or hot. Products are best boiled or steamed. Diet for gastric ulcer involves the use of the following products:
- scrambled eggs;
- mucous soups of rice, oats, cereals;
- liquid cereals (mashed);
- lean meats (chopped);
- jelly;
- cottage cheese and cream of low fat content.
The following products should be completely excluded from the diet:
- fried and fatty dishes, smoked meats;
- products containing dyes and preservatives;
- sauces, spices, hot seasonings;
- rich meat soups, broths;
- bread, bakery products;
- fruits and vegetables that irritate the stomach, in particular, legumes, tomatoes, gooseberries, citrus fruits, legumes, dates, radish.
When is surgery necessary?
Unfortunately, sometimes drug treatment of gastric ulcer does not give the desired effect. Moreover, the ailment sometimes leads to the development of dangerous complications that require emergency surgical intervention. Indications for the operation are as follows:
- gastric bleeding;
- perforation of the gastric wall;
- severe stenosis;
- malignant degeneration of tissues (onset of cancer);
- penetration process;
- the presence of ulcers that do not heal for a long time even after undergoing therapy;
- frequent relapses of the disease;
- scarring on the walls of the stomach with further deformation of the organ;
- the effect of drugs is absent even after 2-3 years of drug therapy.
There are many methods of surgical treatment of this disease. For example, sometimes it is necessary to close the site of perforation of the stomach, and sometimes a complete or partial resection of the organ is necessary. In some cases, it is advisable to conduct a vagotomy - the essence of the procedure is to intersect the vagus nerve trunk or its individual branches.
Preventive actions
There are a huge number of pathologies, the development of which can lead to peptic ulcer of the stomach. Bleeding, perforation of the walls of the digestive tract - all these are dangerous complications. It is much easier to try to prevent the development of such a disease. Prevention in this case is quite simple.
- It is worth trying to avoid the penetration of Helicobacter pylori into the body. To this end, people are advised to use personal dishes and cutlery, follow the rules of personal hygiene.
- It is important to exclude the impact of risk factors, in particular, give up alcohol, quit smoking.
- Doctors recommend eating right. It is better to eat in small portions, abandon spices, spicy, fatty and fried foods.
- Do not arbitrarily take medications that contribute to the appearance of erosion and ulcers on the mucous membrane of the stomach and intestines (for example, non-steroidal anti-inflammatory drugs). If there is still a need to use the drug, then only the attending physician should determine the dosage and schedule of administration.
- Stitching, physical activity, outdoor recreation - all this helps to strengthen the immune system.
- Doctors also recommend avoiding stress, as they are accompanied by hormonal disruptions, which sometimes leads to damage to the mucous membrane.
- Do not forget about quality rest, the right mode of work, a full sleep.
- All diseases that, in theory, can lead to the development of gastritis and peptic ulcer disease, should yield to timely therapy - they should not be ignored in any case.
If the patient has already suffered from peptic ulcer, then he needs to regularly visit a doctor, undergo examinations and take tests - so you can detect a relapse in time. Of course, you need to adhere to an appropriate diet and abandon bad habits. About remission is said if the exacerbation of the disease was not observed in the patient for three years.
Forecasts in most cases are favorable, especially if the patient promptly consulted a doctor for help.