Peptic ulcer:- The term peptic ulcer is used to describe any localised erosion of the mucosal lining of those portions of alimentary tract that comes in contact with gastric juices. the majority of the ulcers are found in the duodenum, although also occur in stomach oesophagus or jejunum.
1. Bacterial infection: Helicobacter pylori is the chief cause of ulcer.
2. Genetic factors: People who are 1st degree relatives of patients with duodenal ulcer have an increased risk of developing an ulcer.
3. Sex: Men are effected 2-3 times more frequently than woman.
4. Age: The incidence is high between 20 – 40 years. During these years careers and personal strivings are at a peak.
5. Stress: People who are highly nervous who worry fear and feel anxiety are particularly susceptible. The emotional and nervous factors in turn may lead to hyper secretion& hyper motility of the stomach.
6. Potentially irritant substances: Caffeine, ethanol, aspirin and nicotine may delay healing. Chillies, pepper, ginger, strong tea and coffee, meat soups, protein rich foods increases secretion of HCL and aggregate the condition.
7. Emergency injuries: Stress ulcers occur in relation to emergency injuries such as burns.
1. Epigastric pain, heart burn etc.
2. Discomfort and flatulence in upper part of abdomen.
3. Pain is also associated with hyper motility of the stomach following ingestion of large amount of foods or liquids.
4. Weight loss and iron deficiency are common.
5. Bleeding ulcers can result in vomiting known as Haematemesis (dark brown in colour)
1. Radiographic examination with barium metal: This technique though simple carries a fairly substantial risk of missing the problem.
2. Endoscopy: A flexible tube made of fiber is introduced into the stomach and the endoscopist inspects the food pipe in stomach and detects any break in the lining membrane. It takes 15 – 20 mins. Cancer can also be detected by endoscopy.
3. Biopsy: Biopsy of lining tissue is examined.
4. Acid secretion of the stomach: In this acid, output after stimulation is measured. Acid output is higher than normal in duodenal ulcer and low or absent in patients with carcinoma of stomach.
1. Drugs: It is important to neutralise the excess acid produced.
a. Antacids were the earliest and logical method of providing relief.
b. H2 Blockers: Group of chemicals that block certain vital steps in acid production by the stomach. They are effective, devoid of side effects and are given once or twice in a day.
2. Dietary Management:
A bland diet is suggested for peptic ulcer patients. a dyed which is mechanically chemically and thermally non irritating full stop mechanical a irritating foods include those with and digestible carbohydrates such as whole grains raw fruits and vegetables. chemically irritating foods include those foods which have stimulatory effect on gastric secretion like caffeine meet extract alcohol and spicy foods. thermally irritating foods include those foods served at extreme temperatures such as very hot or iced liquid this diet full stop this diet prevents irritation to the mucosa avoids increased in acidity, and aids in in control of pain.