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Ulcer pain in the morning: 13 Stomach Ulcer Symptoms, Treatment, Diet, Causes & Surgery


8 Signs You May Have A Stomach Ulcer

We have absolutely warned our patients about the dangers of untreated ulcers in the past. However, we consider this to be an extremely important matter and therefore, we will continue to try to educate the people of Los Angeles, as well as those elsewhere on the most common symptoms of stomach ulcers. If you know the signs, you can see your doctor sooner rather than later when things have gotten especially bad. Continue reading below to get familiar with what these symptoms are.

Signs You May Have A Stomach Ulcer 

Burning Pain In Your Abdomen

This may seem like a no-brainer but the most common sign that people experience when they have a stomach ulcer is a persistent burning pain in their abdomen. This sensation occurs when juices in the stomach used for digestion come into contact with the open sore. For the most part, the pain is felt from the breastbone to navel and is often worse at night than during the day. On the other hand, if you are someone who frequently skips meals, you may find that you experience this pain much throughout the daytime.


Another common clue that you are suffering from a stomach ulcer is vomiting blood. Seeing as how this is an extremely scary thing to go through, you should go directly to the hospital. While you might expect to see a bright red color to the blood, most often ulcers cause for your vomit to look similar to coffee grinds, meaning they it will likely be dark brown in color.

Feeling Nauseous

Clearly if you are vomiting than chances are you are were have already been feeling nauseous for a while. Most often this nausea occurs early in the morning, it will most likely subside once the vomiting episodes begin.

Black or Dark Colored Stool

If you think you may have an ulcer, a good way to tell is to look at your stool. If you notice that when you use the restroom your stool is extremely dark in color, or even black, chances are you are right about what is ailing you. If this is the case, you should absolutely go to the hospital immediately.

Losing Weight

Another sign that you may have a stomach ulcer is a complete loss of appetite which will likely lead to weight loss. When your stomach lining is damaged, scar tissue forms, causing blockage of the food passageway, as well as potential swelling in the small intestines. This will make you feel as though you are full, even though you haven’t eaten anything. Even if you feel this way, it’s important that you eat as your body needs nutrients so that it can function properly.


Having a lot of scar tissue in your stomach can also lead to significant bloating. Since your food cannot move through your stomach opening the way it should, gas builds up quite easily in your intestines.


Many people have anemia and do not have an ulcer at all. On the other hand, if you have already been diagnosed with a stomach ulcer, and you are experiencing fatigue, dizziness or paleness, this could be because you are now also suffering from anemia on top of your ulcer. This has occurred because you have lost significant amount of blood from the bleeding your ulcer is doing.

Acid Reflux

When the lower esophageal sphincter is not able to close all the way or opens too frequently, stomach acid is able to move up into the esophagus. This is known as acid reflux and it is known to cause severe heartburn and regurgitation in those who suffer from it.

What Does A Stomach Ulcer Feels Like

Stomach ulcer pain usually begins in the upper middle part of the abdomen, above the belly button and below the breastbone. The pain may feel like burning or gnawing that may go through to the back. The onset of the pain may occur several hours after a meal when the stomach is empty. Patients have reported paint to be worse at night as opposed to the morning. Pain duration may vary from a few minutes to several hours. Pain may be relieved by foods, antacids or vomiting.

Do You Have A Stomach Ulcer?

If you suspect that you have a stomach ulcer, it is beyond important that you seek medical attention as soon as possible. As you can tell from the symptoms listed above, things can only get worse if your ulcer goes untreated. Call the experts at West Gastroenterology in Los Angeles today and make an appointment!

Ulcers | Cedars-Sinai

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An ulcer occurs when part of the lining of the stomach or intestines becomes deeply eroded. This typically happens in the stomach (gastric ulcer) or the in the duodenum (duodenal ulcer), which is located at the lower end of the stomach and the beginning of the small intestine. Ulcers range from quite small to an inch or more in size.


Symptoms vary depending on where the ulcer is and how old the patient is. Many patients, especially older ones, may have no symptoms. When symptoms do occur, they tend to come back again and again.

Stomach (or peptic) ulcers may produce few or no symptoms, or they may cause burning, gnawing pain in the upper middle part of the abdomen that is relieved by eating or taking an antacid. Stomach ulcers often are not consistent. For example, eating sometimes will make the pain worse rather than better with certain types of ulcers, such as pyloric channel ulcers, which are often associated with bloating, nausea and vomiting, symptoms of a blockage caused by swelling (edema) and scarring.

Duodenal ulcers tend to cause consistent pain. A patient may feel no pain when he or she awakens, but by midmorning it is present. The pain can be relieved by eating, but it usually returns two to three hours later. Pain that wakes a patient at night is common for duodenal ulcers.

Causes and Risk Factors 

At one time ulcers were believed to be the result of too much stomach acid. It is now known that the main factors that lead to ulcers are the bacteria H. pylori and non-steroidal anti-inflammatory drugs (NSAIDS). These disturb the normal defense and repair processes of the mucosal linings, making them more vulnerable to attack from stomach acid.

How H. pylori causes ulcers is not entirely clear. One theory is that the organism causes ammonia to be created so that it can survive in the stomach’s acid. The ammonia may then erode the mucous barrier that protects the cells of the digestive tract. Other poisons and enzymes from the bacteria may also be a cause, and proteins produced by the body in response to inflammation may play a role.

NSAIDs tend to cause inflammation of the GI tract lining. Weak acids themselves, NSAIDS cause a number of changes within the stomach, including reduced flow of blood to the stomach, less mucus production, and less cell repair and reproduction. All of these tend to break down the process of defense and repair that keeps the mucosa healthy.


A doctor usually bases a diagnosis of peptic ulcer on the patient’s history. A physician will want to rule out the presence of stomach cancer, which can have similar symptoms. This is especially true in patients who are older, have lost weight, have severe symptoms or do not respond to treatment.

The diagnosis can be confirmed through a variety of studies, such as:

  • Endoscopy, which uses a camera attached to the end of a flexible tube to allow the doctor to see inside the body. This can reliably detect swelling and irritation (inflammation) of the esophagus and esophageal ulcers as well as H. pylori infection.
  • Barium swallow
  • Cytology (examination under a microscope of cells from the affected area)
  • Multiple biopsies
  • X-rays or CT scans to identify ulcers that have caused holes in the stomach or intestines


In the past, ulcers were treated by trying to neutralize or decrease the amount of acid in the stomach. Current treatment focuses on eliminating H. pylori through antibiotics. Antibiotic treatment should be given to all ulcer patients who have been diagnosed with H. pylori, even if they have no symptoms or are being treated to reduce stomach acid. Antibiotic treatment is especially important for patients who have had complications in the past. Antibiotics to treat H. pylori are evolving, and a combination of antibiotics is usually prescribed.

The symptoms of an ulcer can be relieved by taking antacids, which can also help prevent the symptoms from coming back and help promote healing of the ulcer. Antacids must be taken five to seven times a day and can interfere with the body’s ability to absorb other drugs. The two general types of antacids are:

  • Ones that the body can absorb, such as baking soda. These are quick and effective but may have side effects when taken on a regular basis
  • Ones that interact with stomach acid to create salts that are not absorbed by the body and are excreted

While there is currently no evidence that changing the diet helps an ulcer heal faster or prevents its return, a doctor may suggest that any food that causes distress be eliminated. These may include fruit juices, spicy foods and fatty foods.

Alcohol tends to increase the acid in the stomach, and ulcer patients are usually advised to restrict their drinking of alcohol. Persons who smoke are at a higher risk of developing ulcers and complications. Smoking also slows the healing process and makes the return of ulcers more likely.

Although surgical treatment is being prescribed less often, surgery may be necessary if complications do not respond to medical therapy, symptoms are severe or there is a suspicion that the ulcer may be cancerous.

More than 60% of people have a return of their ulcers a year after traditional treatment has ended. Fewer than 10% of people have a recurrence of ulcers after anti-H. pylori therapy. The use of non-steroidal anti-inflammatory drugs might also affect recurrence of ulcers.


Certain complications can also result from peptic ulcers, including:

  • Bleeding
  • A hole in the wall of the stomach or duodenum. This causes intense, ongoing pain that may be felt in locations other than the abdomen. The pain may change with shifts in body position.
  • A hole into the peritoneal cavity, which surrounds the organs of the abdomen. This causes sudden, intense pain that spreads quickly throughout the abdomen and is worse with movement.
  • A blockage. The outlet of the stomach may become blocked as a result of scarring, muscle spasms or inflammation related to an ulcer. This causes repeated, high volume vomiting, usually at the end of the day. There may also be a feeling of bloating after eating and a loss of appetite. Dehydration and weight loss are risks if vomiting continues.

Treatment of complications varies. For example:

  • Bleeding may be stopped using a variety of minimally invasive techniques.
  • Acid-suppressing drugs may be given intravenously and continued until the condition stabilizes.
  • Emergency surgery may be necessary if the patient gets worse even with treatment and blood transfusions and if their pulse rate and blood pressure are not stable.

Persons who have H. pylori-related ulcers may be at higher risk for certain forms of cancer and lymphoma.

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Gastric and duodenal ulcers: Differences, causes, and treatments

In April 2020, the Food and Drug Administration (FDA) requested that all forms of prescription and over-the-counter (OTC) ranitidine (Zantac) be removed from the U.S. market. They made this recommendation because unacceptable levels of NDMA, a probable carcinogen (or cancer-causing chemical), were present in some ranitidine products. People taking prescription ranitidine should talk with their doctor about safe alternative options before stopping the drug. People taking OTC ranitidine should stop taking the drug and talk with their healthcare provider about alternative options. Instead of taking unused ranitidine products to a drug take-back site, a person should dispose of them according to the product’s instructions or by following the FDA’s guidance.

Gastric and duodenal ulcers are types of peptic ulcer. The main distinction is that they affect different parts of the digestive tract. A person could have both at the same time. Some causes of peptic ulcers include an excess of stomach acid, bacterial infection, and certain medications.

In this article, we look at what gastric and duodenal ulcers are and how a doctor diagnoses them. We also explore their causes and treatments, along with associated symptoms and risk factors.

Share on PinterestGastric and duodenal ulcers are open sores in the lining of the digestive tract.

Gastric and duodenal ulcers are peptic ulcers, which are open sores in the lining of the digestive tract.

Gastric ulcers form in the lining of the stomach.

Duodenal ulcers develop in the lining of the duodenum, which is the upper part of the small intestine.

Many people with peptic ulcers rely on medical treatment to relieve their symptoms. Peptic ulcers sometimes heal on their own, but they can recur if a person does not receive treatment.

Symptoms of gastric and duodenal ulcers are generally similar. The most common complaint is a burning pain in the stomach.

Duodenal ulcers may also cause abdominal pain a few hours after eating.

This pain tends to respond well to medications or foods that reduce stomach acid, but as the effects of these wear off, the pain usually returns.

Abdominal pain from a duodenal ulcer may be worse when the stomach is empty, for example, between meals, at night, or first thing in the morning.

Other common symptoms of peptic ulcers include:

Some people with these ulcers develop intolerances for specific foods. These foods may make a person feel sick, or they may make ulcer-related symptoms worse.

Less common and more severe symptoms include:

  • feeling lightheaded
  • weight loss
  • blood in the stool
  • vomiting
  • vomiting blood
  • trouble breathing

Some people with peptic ulcers have no symptoms. A doctor may only discover the ulcer when checking for a different digestive disorder.

Anyone with symptoms of peptic ulcers should see a doctor. If symptoms are severe, seek urgent medical attention.

Share on PinterestAn overgrowth of H. pylori bacteria in the digestive tract may cause a peptic ulcer.

Peptic ulcers result from damage or erosion to the protective lining of the digestive tract.

The following issues can play a role:

  • having too much acid in the stomach or digestive tract
  • digestive imbalances
  • problems with the lining that makes it more susceptible to damage

Bacterial infections and certain medications can also lead to peptic ulcers.

A person has a higher risk of developing a peptic ulcer if they have an overgrowth of Helicobacter pylori (H. pylori) bacteria in the digestive tract. This type of bacterial infection is common.

While an H. pylori infection does not cause symptoms in most people, it sometimes irritates the lining of the digestive tract, which can lead to peptic ulcers.

Long-term use of certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) can also damage or irritate the lining and increase the risk of peptic ulcers.

NSAIDS include many other-the-counter pain relievers, such as ibuprofen (Advil), naproxen (Aleve), and aspirin.

A person’s genetics and lifestyle can also increase the risk of developing a peptic ulcer.

If close family members have peptic ulcers, a person may be more likely to develop them. Smoking tobacco products can also increase a person’s risk.

Other risk factors include:

  • being over the age of 70
  • having a history of gastric or duodenal ulcers
  • recently experiencing serious physical trauma

Beyond NSAIDs, other medications can also increase a person’s risk of developing peptic ulcers, including:

  • anticoagulants
  • steroids
  • selective serotonin reuptake inhibitors, or SSRIs

Doctors no longer think that alcohol, spicy foods, or rich foods cause ulcers. However, consuming them may make symptoms worse or slow the healing process.

The role of stress in the development of ulcers is uncertain. Some doctors believe that stress is a direct risk factor, while others do not.

In one small study, psychological stress increased the risk of developing peptic ulcers. However, the researchers believed that the link was partly indirect, that stress led to other risk behaviors, such as taking NSAIDs and smoking.

Symptoms of peptic ulcers can be similar to those of other conditions, such as gallstones or gastroesophageal reflux disease, which is commonly called GERD. Receiving a correct diagnosis is essential.

A doctor may begin by asking about a person’s medical history and current medications. They will also ask about symptoms and the location of any pain.

A variety of tests can help confirm a diagnosis. The doctor may test the blood, stool, or breath to check for signs of H. pylori infection.

The doctor may also perform an endoscopy to look for ulcers. This involves inserting a thin tube with an attached camera down a person’s throat and into the stomach and upper small intestine.

In some cases, a doctor may also recommend a barium swallow test. This involves swallowing a liquid that contains barium. The barium helps the doctor see the intestinal tract more clearly on an X-ray of the abdomen.

For most people, treatment will involve taking medications that either reduce the amount of acid in the stomach or protect the lining of the stomach and duodenum.

These medications may fall into the following categories:

  • proton pump inhibitors (PPIs), including omeprazole, pantoprazole, and lansoprazole
  • h3-receptor antagonists, including famotidine, and cimetidine
  • protectants, such as sucralfate
  • antacids, such as calcium carbonate and sodium bicarbonate

If an H. pylori infection is responsible for the ulcers, a doctor may prescribe antibiotics to kill the bacteria. They may also prescribe medications that help suppress excess stomach acid, such as PPIs.

If other medications, such as NSAIDs, have caused the ulcers, the doctor may prescribe a PPI or review the need for the drug.

Some doctors also recommend reducing or better managing levels of stress.

Untreated ulcers can cause complications.

Rarely, peptic ulcers can lead to a perforation, or hole, in the wall of the stomach or intestine.

A perforation can put a person at serious risk of infection in the abdominal cavity. The medical name for this infection is peritonitis.

If a person with peptic ulcers experiences sudden abdominal pain that grows worse, they should see a doctor immediately.

Also, inflammation from ulcers can block a portion of the digestive tract. This obstruction can cause a person to:

  • feel full after eating little or no food
  • regularly vomit
  • lose weight or become malnourished

In addition, ulcers can cause internal bleeding. If this bleeding develops slowly, it can lead to anemia. Symptoms of anemia can include fatigue, pale skin, and shortness of breath.

If the bleeding is severe, a person may see blood in vomit or stools. Anyone with symptoms of severe internal bleeding should seek immediate medical attention.

It may not be possible to prevent a peptic ulcer. However, reducing risk, for example by quitting tobacco use and eating a healthful diet, may help.

People who use NSAIDs or other medications that can cause peptic ulcers should talk to a doctor about managing their ulcer-related risk.

A doctor may recommend taking:

  • medications with meals
  • lower dosages
  • an alternate medication
  • acid-reducing drugs

The medical community is not entirely certain how H. Pylori spreads. People should protect themselves by cooking foods thoroughly and frequently washing the hands with soap and water.

Gastric and duodenal ulcers are both types of peptic ulcer. They can cause pain and other symptoms in the digestive tract.

Treatment usually involves addressing the underlying cause and taking appropriate medication, including medicine to reduce stomach acid.

If left untreated, these ulcers can cause serious complications.

Stomach Ulcer Pain Worse In Morning

How to treat ulcers (with pictures) wikihow. How to treat ulcers. Ulcers are sores or lesions in your stomach or the upper part of your small intestines. Ulcers develop when the acids that digest foods damage. 10 common ulcer signs. Stomach ulcer pain. Find results. Explore our easytoread articles. Stomach pain every morning stomach, ulcers, gastric. · stomach pain every morning. I have lower abdomen pain (lower front left area) every single morning. It pretty much hurts every morning without fail. The. Ulcers symptoms bloating, heartburn, nausea, pain, & more. Early in the morning, or after you have symptoms of an ulcer and develop severe back pain; your ulcer may be perforating peptic ulcer disease; more. Peptic ulcer medlineplus national library of medicine. · dull and burning stomach pain are common symptoms of a a peptic ulcer is a sore in the lining of your peptic ulcers will get worse if not. Identifying the symptoms of stomach ulcers ulcer. How to recognize the symptoms of stomach ulcers. An ulcer is a lesion if your stomach pain is both stress and acidic foods are known to make ulcers worse. Stomach pain at night (digestive nighttime pain). Over 25 million americans will suffer from an ulcer at some point or ulcers feel worse depending on is a burning pain in the stomach,

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Stomach ulcer – Symptoms – NHS

The most common symptom of a stomach ulcer is a burning or gnawing pain that develops in your abdomen (tummy).

But some stomach ulcers aren’t painful and are only noticed when a complication of a stomach ulcer develops, such as bleeding from the ulcer.

Tummy pain

The pain caused by a stomach ulcer can travel out from the middle of your tummy up to your neck, down to your belly button, or through to your back.

It can last from a few minutes to a few hours, and often starts within a few hours of eating. You may also wake up in pain during the night.

Taking indigestion medication (antacids) may relieve the pain temporarily, but it’ll keep coming back if the ulcer isn’t treated.

Other symptoms

Less common symptoms of a stomach ulcer can include:

Some people also find they burp or become bloated after eating fatty foods.

When to seek medical advice

Visit your GP if you experience persistent symptoms of a stomach ulcer.

Contact your GP or NHS 111 immediately, or go to your nearest accident and emergency (A&E) department, if you develop signs of a serious complication.

These include:

  • vomiting blood – the blood can appear bright red or have a dark brown, grainy appearance, similar to coffee grounds
  • passing dark, sticky, tar-like stools
  • a sudden, sharp pain in your tummy that gets steadily worse

If you’re not sure that you have a stomach ulcer, see other causes of stomach pain.

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Peptic ulcers – MyDr.


What is a peptic ulcer?

A peptic ulcer is a lesion or sore on the protective lining of the stomach (where it is called a gastric ulcer) or duodenum. Doctors often define it as a mucosal break greater than 3-5 mm in the stomach or duodenum, with a visible depth.

Peptic ulcers are a common condition – they used to affect men more than women, but now their occurrence is similar in men and women.


Peptic ulcers do not always cause signs or symptoms, but some of the symptoms of peptic ulcer are:

  • Upper abdominal pain. The usual symptom of an ulcer is pain in the upper part of the abdomen just below the breast bone. It is often a burning or ‘knife-like’ pain which goes through to the back. The pain generally occurs when the stomach is empty (a few hours after meals) and will often wake the sufferer at 2 or 3 o’clock in the morning. The pain is often relieved by food or antacid medication.
  • Heartburn may occur, although this is more often a symptom of gastro-oesophageal reflux
  • Indigestion.
  • Nausea (feeling sick).
  • Loss of appetite.
  • Unexplained weightloss.
  • Anaemia may occur due to blood loss, which may happen slowly. Symptoms of anaemia include tiredness, shortness of breath with exercise, and pale skin colour.
  • Vomiting blood. This is a more serious symptom that happens if the ulcer bleeds.
  • Passing blood in the bowel motions. Also a serious symptom as a result of the ulcer bleeding. If this happens the motions have a black, ‘tar-like’ appearance.
  • Perforation. On rare occasions an ulcer will perforate (form a hole) through the stomach or duodenal wall. This is a major emergency requiring surgery and may be life-threatening.

Risk factors for peptic ulcer

Ulcers are areas of damage to the lining of the stomach (gastric ulcer), or the upper part of the intestine (duodenal ulcer).

The 2 most common risk factors for peptic ulcer are Helicobacter pylori (a bacterium that lives in the stomach), and long term use of NSAIDs (non-steroidal anti-inflammatory drugs).

Helicobacter pylori

Many people with ulcers have an infection in the stomach with a bacterium known as Helicobacter pylori. H. pylori infection is particularly important in the development of duodenal ulcers. The bacteria cause ongoing inflammation of the stomach lining.

It is estimated that up to 4 of every 10 adults in the world are infected with Helicobacter pylori, but not every one of them will go on to develop an ulcer. Thirty per cent of Australians are estimated to be infected, but infection rates are greater for Indigenous Australian communities. It’s not clear why some people with H. pylori seem to be resistant to developing ulcers.

H. pylori is more common in older age groups. It is often acquired in childhood and the increased incidence in older people may reflect living conditions in earlier years, more than it does age.


Long-term use of NSAIDs (non-steroidal anti-inflammatory drugs), such as aspirin, ibuprofen and naproxen, is linked to an increased risk of peptic ulcer. This is because most NSAIDs are associated with an increased risk of damage to the gastrointestinal mucosa.

Other factors

Other factors which additionally may increase the risk for peptic ulcers, and make them more difficult to treat, include smoking, alcohol and stress.

Tests and diagnosis

Your GP may refer you to a gastroenterologist for tests and treatments, depending on your symptoms, age and medical history.

Peptic ulcers can be diagnosed by endoscopy, where a flexible telescopic tube is passed through your mouth down into the stomach and duodenum, allowing the doctor to examine the tissues. If they find an ulcer, they may take a small sample (biopsy) to test for H. pylori bacteria.

The doctor will probably also want to test you for H. pylori – usually by a breath test. H. pylori can also be tested for by a blood test or a stool test.


Your doctor will probably suggest you take H. pylori eradication therapy. Eradication of H. pylori greatly reduces the likelihood of ulcers recurring and the need for long-term acid suppression therapy. Most ulcers respond well to this therapy.

Eradication of H. pylori takes the form of triple therapy – a proton pump inhibitor (esomeprazole) and the 2 antibiotics amoxicillin and clarithromycin – taken for a week. Examples of brand names of triple therapy are Esomeprazole Sandoz Hp7 and Nexium Hp7.

The proton-pump inhibitor suppresses acid production in the stomach and allows healing to take place.

There are alternative medicines for people allergic to penicillin.

Triple therapy will heal most active peptic ulcers and eradicate H. pylori in 70-80 per cent of cases. Some more complicated ulcers will also need a short maintenance course of a proton-pump inhibitor until the ulcer is confirmed to be healed.

People with NSAID-induced ulcers should ideally stop taking the NSAIDs (on their doctor’s advice). If this is not possible, they may need to take a proton-pump inhibitor also for a prolonged time to suppress excess acid production in the stomach.

People whose ulcers are linked to H. pylori should also stop taking NSAIDs if they can. But always check with your doctor.

Very rarely, peptic ulcers cause complications, and surgery is necessary to stop bleeding.

What should you do if you have ulcer symptoms?

If you have symptoms suggestive of a peptic ulcer, see the doctor.

This common condition is easily managed and serious complications are usually preventable.

1. Therapeutic Guidelines (eTG). Helicobacter pylori and peptic ulcer disease. . In: Gastroenterology Guidelines [updated 2006, Sep; accessed 2009, Oct 2]. Available from: http://www.etg.hcn.net.au/

2. Ford A, McNulty C, Delaney B, Moayyedi P. Helicobacter pylori infection. BMJ Clinical Evidence 2007; 06:406

Peptic Ulcer Disease – Causes, Symptoms, Treatment, Diagnosis

A peptic ulcer is an erosion or sore in the lining of the stomach or intestine that occurs when the protective mucus layer wears away in certain areas, allowing damage to occur from the natural acids of the stomach.

Around 10% of people will have peptic ulcer disease (PUD) at some point in their life. The majority of peptic ulcers are caused by bacteria called Helicobacter pylori (H. pylori) or by taking ASA (acetylsalicylic acid) or nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen*, ketoprofen, naproxen).

  • Gastric ulcers are sores in the lining of the stomach.
  • Duodenal ulcers are those in the first part of the small intestine, called the duodenum. This is an area where food is digested after passing through the stomach.

  • Causes

    Although stress and spicy foods might make the symptoms of peptic ulcer worse, they aren’t the cause of the condition as was once thought.

    A bacterium called H. pylori causes the majority of ulcers. The bacteria can spread into the mucus lining that usually protects the stomach and small intestine from digestive acids, damaging it in the process. By 60 years of age, up to 50% of people are infected with this bacteria, but only 10% to 20% of these people will actually develop stomach problems.

    The other major cause of PUD is the use of ASA (acetylsalicylic acid) and other NSAIDs such as ibuprofen or naproxen. NSAIDs can penetrate the lining of the stomach and release substances that damage cells. NSAIDs also block natural chemicals called prostaglandins that can help to protect and repair those cells. People more at risk of ulcers caused by NSAIDs include those who:

    • are seniors
    • have a history of a peptic ulcer
    • have a family history of peptic ulcer disease
    • are also taking glucocorticoids (e.g., prednisone, dexamethasone)
    • are taking high doses of NSAIDs or ASA
    • have several medical conditions
    • are taking more than one NSAID or ASA

    Excessive alcohol use can put people at higher risk for PUD, but it isn’t a true cause.

    Symptoms and Complications

    The most common symptom of peptic ulcers (both duodenal and gastric) is a gnawing or burning pain in the abdomen between the breastbone and the navel, sometimes passed off as “heartburn.” An ulcer can also feel like a dull ache or strong hunger pangs. Yet some people, especially the elderly, may not feel any pain at all from an ulcer. Ulcer pain can come or go and can be aggravated by eating or an empty stomach. Ulcers can also cause belching and bloating.

    The most common complication of stomach and duodenal ulcers is bleeding. Although the blood loss is usually too slow to be noticed, it might be enough to make you tired, pale, and weak.

    If bleeding from the peptic ulcer is heavier, blood may show up in the stool or vomit. Stools that have blood in them may look tarry, black, or red. If you notice any of these signs, see a doctor right away. If a bleeding ulcer is severe, it can be fatal if left untreated. Keep in mind also that, since NSAIDs are such strong painkillers, they can mask the pain of bleeding ulcers.

    Very rarely, ulcers can make a hole, called a perforation, in the stomach or intestine. This can cause sudden and severe pain. Sometimes an ulcer can create a blockage out of the stomach or in the duodenum. This may cause bloating, feeling full after eating, vomiting, and weight loss.

    If an ulcer causes scarring, spasm, or inflammation, it is considered a gastric outlet obstruction and may lead to weight loss and dehydration. It may cause loss of appetite with fullness after eating, or it may cause large-volume vomiting up to 6 hours after a meal.

    Making the Diagnosis

    If you have the typical symptoms of PUD, your doctor will perform a physical exam and may order one or more of the following tests:

    A breath test (drinking a fluid and exhaling into a tube), blood test, or stool test may be used to check for H. pylori infection. If you have H. pylori, treatment may be given to cure the infection without the need for more invasive tests.

    A series of GI (gastrointestinal) X-rays may be done. These are X-rays of your stomach, duodenum, and esophagus (the swallowing tube). To make the ulcer easier for the doctor to see, you’ll first need to swallow a chalky liquid called barium.

    Endoscopy is another test used to detect ulcers. After numbing the throat, the doctor carefully guides a thin tube with a tiny camera on its end into the mouth and down the throat to get close-up pictures of the esophagus, stomach, and duodenum.

    If ulcers are detected by these tests, then appropriate treatment will be prescribed.

    Finally, all people older than 50 years who, for the first time, show symptoms suggestive of a stomach acid-related disorder, and anyone of any age with “alarm” features such as vomiting, bleeding, anemia, an abdominal mass, unexplained weight loss, or trouble swallowing should have an endoscopy to identify the cause quickly and to rule out cancer.

    Treatment and Prevention

    Medical treatment focuses on eliminating the H. pylori bacteria in people where it has been detected. The majority of peptic ulcers caused by H. pylori can be cured with a combination of antibiotics and acid-reducing medications called proton pump inhibitors (PPIs; e. g., omeprazole, lansoprazole, esomeprazole, pantoprazole, rabeprazole) plus two antibiotics (clarithromycin plus amoxicillin or metronidazole), all taken twice a day for 2 weeks.

    Other combinations of acid-reducing medications and antibiotics may also be used, including ones that use a total of four medications. For some people, several courses of treatment may be needed to get rid of H. pylori. Once the treatment for H. pylori is complete, the acid-suppressing medication should be continued for a total of 4 to 6 weeks.

    When an ulcer is not associated with H. pylori or is caused by NSAIDs, treatment with a PPI is prescribed for 2 to 4 weeks. Some people may need to continue treatment for longer periods of time. Another type of acid reducer, h3-antagonists (e.g., ranitidine, nizatidine), may also be used.

    If the peptic ulcer was caused by NSAIDs, such as ASA, your doctor will most often recommend that you stop taking them if possible. Some people are more susceptible to peptic ulcers caused by NSAIDs, including those who:

    • are seniors
    • have a history of a peptic ulcer
    • are also taking glucocorticoids (e.g., prednisone, dexamethasone)
    • are taking high doses of NSAIDs or ASA
    • have several medical conditions
    • are taking more than one NSAID or ASA

    If you’re taking a NSAID and have one of these risk factors, your doctor may prescribe a protective medication to take along with it. Acid-suppressing medications (e.g., PPIs) or misoprostol may be used for this. Misoprostol encourages the stomach to produce its protective mucus coating and improves blood flow.

    It’s important for people with PUD to quit smoking. Smoking can delay healing and can cause ulcers to return.

    Very rarely, surgical treatment may be needed for PUD and its complications.

    All material copyright MediResource Inc. 1996 – 2021. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Peptic-Ulcer-Disease

    90,000 Diseases of the stomach and duodenum

    The most common chronic diseases of the stomach and duodenum are gastritis, duodenitis and peptic ulcer . In chronic gastritis, inflammation of the gastric mucosa is noted, with duodenitis, the duodenal mucosa. Peptic ulcer disease is manifested by the formation of a defect (ulcer) in the mucous membrane of the stomach or duodenum.
    The most common symptom of these diseases is pain in the epigastric region. Attention is drawn to the relationship of pain syndrome with food intake. Moreover, depending on the localization of the pathological process, pain can be early, late, hungry. With an ulcer of the antrum of the stomach and duodenal bulb, pain can occur at night, forcing the patient to wake up and eat. The nature of the pain can be different – dull aching, cutting, stabbing, cramping, of varying intensity.Less often, patients complain of belching, heaviness in the stomach, stomach overflow after eating, nausea, vomiting, bringing relief, loss of appetite, body weight. Such manifestations can be alarming signs of pyloric stenosis (complications of peptic ulcer disease), as well as stomach cancer.

    The reasons for the development of chronic gastritis and peptic ulcer are similar. The bacterium Helicobacter pylori plays an important role. In 1994, WHO experts classified H. pylori as a carcinogen of the first risk group.When it enters the stomach, it can persist in it for a long time, multiply and damage the gastric mucosa, causing chronic inflammation, the appearance of erosions and ulcers, contributing to oncological pathology in a certain contingent of patients with a hereditary predisposition, high acidity of gastric juice, disorders of local immunity, blood supply mucous membrane of the stomach and duodenum, impaired gastric motility.

    Treatment of diseases of the esophagus, stomach and duodenum can be carried out by conservative (therapeutic) and surgical methods.The tactics of treatment and its duration should be determined by the attending physician.

    Late treatment of diseases of the esophagus, stomach, duodenum, especially erosive gastritis, duodenitis, as well as peptic ulcer disease, and especially self-medication, can lead to the ineffectiveness of conservative therapy, the development of formidable complications of the disease, which often requires urgent surgical treatment.

    Peptic ulcer of the stomach and duodenum

    Peptic ulcer of the stomach and duodenum (Duodenal ulcer) is the most common disease of the gastrointestinal tract.Up to 10% of the adult population suffers from this disease. People in large cities and people whose work is associated with neuropsychic stress and irregular nutrition are more often sick.

    Peptic ulcer and duodenal ulcer is a chronic recurrent disease of the gastrointestinal tract, the main manifestation of which is the formation of an ulcer defect in the wall of the stomach or duodenum. Exacerbations of the disease usually occur in spring and autumn. The ulcer either heals with the formation of a scar, then during an exacerbation it “opens” again.

    The main cause of gastric ulcer and duodenal ulcer is a violation of the neuro-immuno-endocrine regulation of the digestive system, as a result of which blood circulation and trophism of the mucous membranes, secretory and motor functions of the stomach and duodenum are impaired. A peptic ulcer is not a local disease of the mucous membrane, it is a disease of the whole organism.

    Ulcerative defect of the mucous membrane develops when the balance between the aggressive properties of gastric juice and the protective properties of the mucous membrane is disturbed. Normally, gastric juice ceases to be produced 2 hours after eating. In a healthy, well-fed person, as well as at night, the stomach “rests” and practically does not produce gastric juice. With a peptic ulcer, the stomach works constantly, even at night when it is empty, and its acidity, as a rule, is increased. At the same time, the mucous membrane loses its ability to defend itself against aggressive gastric juice, because with this disease the amount of gastric mucus decreases and its quality deteriorates, as well as local blood circulation and control of the immune system for the restoration of mucosal cells deteriorate.Disturbances in the immune system also contribute to infection with Helicobacter pylori bacteria, which prevent the healing of ulcerative defects and provoke exacerbations of the disease.

    No other disease has been offered as many treatments as peptic ulcer disease. Their very abundance speaks of the absence of ideal means of therapy for this disease. Drug therapy does not eliminate the main cause of the disease (violation of the neuro-immuno-endocrine regulation of the digestive system), but only temporarily eliminates or reduces the manifestation of the symptoms of the disease.

    In our Clinic for the treatment of this disease, the method of computer reflexology is used, which, without the use of drug therapy, gives a pronounced and stable clinical effect. Computer reflexology eliminates the main cause of the disease: it restores neuro-immuno-endocrine regulation, as well as local mechanisms of self-regulation of the digestive system. This helps to eliminate the symptoms of the disease, ensures active healing of the ulcer without side effects, and also prevents the development of a relapse of the disease.At the same time, if medications are used, then in a minimum amount.

    The treatment of peptic ulcer disease by our doctors begins with the diagnosis of the whole organism, the search for the causes of imbalance, and ends with a significant improvement in the quality of life, gaining health and knowledge about preserving youth for many years.

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    Video about treatment in the clinic

    Examples of treatment of various diseases

    Esophagogastroduodenoscopy (EGDS, gastroscopy) in the diagnosis of diseases of the esophagus, stomach and duodenum

    Esophagogastroduodenoscopy (EGDS, gastroscopy) is an examination of the esophagus, stomach and duodenum for which it is easy to prepare.

    Endoscopy is a fairly young branch of medicine. At the same time, its rapid development over the past decade has made it possible to diagnose diseases of the gastrointestinal tract (GIT) in the early stages, when even the most formidable diagnosis is treatable, using, among other things, the minimally invasive endoscopic method.

    The purpose of the procedure is to examine the mucous membranes of the gastrointestinal tract and, if indicated, the study is supplemented by biopsy and other methods.

    Each doctor of our department, when performing gastroscopy, first of all, is guided by the main principle of medicine – do no harm. Therefore, a personal approach to each patient is used.

    Conversation starts first:

    • Collection of anamnesis (history) of the disease (if any). At the same time, it is very important to provide the doctor with the medical documentation you have (take extracts and protocols of previous endoscopic examinations with you).
    • Collecting information on allergic reactions to medications (in particular lidocaine).

    Then, in the absence of allergies, the patient’s throat is irrigated with a special solution of local anesthetic to suppress the gag reflex, because the procedure itself is painless. After that, the patient is placed on the left side and the gastroscope is inserted, alternately, into the esophagus, stomach and the initial sections of the small intestine. At the same time, the doctor assesses the condition of the mucous membrane, which makes it possible to identify diseases such as:

    Gastroesophageal reflux disease (GERD) is a chronic recurrent multisymptomatic disease caused by spontaneous, regularly recurring discharge of gastric and / or duodenal contents into the esophagus, leading to damage to the lower esophagus.

    There are two forms of GERD: Endoscopic-negative reflux disease, or non-erosive reflux disease (NERD). It accounts for about 70% of cases of the disease. Reflux esophagitis (RE) – about 30% of cases.

    GERD is manifested primarily by heartburn, sour belching, which more often occur after eating, when the trunk is tilted forward or at night. The second most frequent manifestation of this disease is chest pain, which radiates to the interscapular region, neck, lower jaw, and left half of the chest.

    The extraesophageal manifestations of the disease include pulmonary symptoms (cough, shortness of breath, which often occur when lying down), otolaryngological symptoms (hoarseness, dry throat), and gastric symptoms (rapid satiety, bloating, nausea, vomiting).

    Barrett’s esophagus is a condition of the esophagus in which the squamous stratified epithelium of the lower part of the esophageal mucosa is replaced by a columnar epithelium. Doctors call this metaplasia.This replacement is usually caused by chronic damage to the esophageal mucosa by acid discharged from the stomach, i.e. is a complication of esophagitis or gastroesophageal reflux disease. Barrett’s esophagus is found in about 1% of the population. Barrett’s esophagus is considered a precancerous condition and often leads to the development of esophageal cancer.

    Gastritis is a term used to designate inflammatory and dystrophic changes in the gastric mucosa (GLC), different in origin and course.There are two main forms of gastritis – acute and chronic.

    The clinical manifestations of gastritis can differ significantly from each other. This is primarily due to differences in the level of hydrochloric acid, pepsin, and gastric motor activity. The nature of changes in the gastric mucosa is of decisive importance – the presence of erosions, atrophy, the presence of an infectious agent, etc.

    Usually gastritis is manifested by pain syndrome and dyspeptic digestive disorders.

    Pain syndrome. Pain with gastritis is usually localized in the epigastric region and appears 1.5 to 2 hours after eating. Often there are “hungry pains” (in the morning, on an empty stomach). Sometimes pains appear immediately after eating. The pain is often spastic in nature and can be acute, intense, cramping. In other cases, there are non-intense dull pressing pains in the epigastrium.

    Dyspeptic digestive disorders are observed in most patients. Characterized by the appearance of heartburn and sour eructation, which indicates the appearance of gastroesophageal reflux (reflux of acidic stomach contents into the esophagus).Sometimes there is a feeling of discomfort in the epigastrium, a feeling of fullness. With an exacerbation, nausea and vomiting may bring relief.

    Stomach ulcer – a chronic recurrent disease that occurs with periods of exacerbation and remission. Its main feature is the formation of a defect (ulcer) in the stomach wall. Other organs of the digestive system can also be involved in the pathological process with the development of complications that threaten the patient’s life.

    Duodenal ulcer (Duodenal ulcer) – a chronic recurrent disease that occurs with periods of exacerbation and remission.The main symptom of a duodenal ulcer is the formation of a defect (ulcer) in its wall. Often, ulcers affect not only the duodenum, but also the stomach (stomach ulcer), and other organs of the digestive system with the development of dangerous complications.

    The main symptom of exacerbation of stomach ulcers and duodenal ulcers is pain in the upper abdomen, which, depending on the location of the ulcer, can radiate to the left half of the chest, scapula, thoracic and lumbar spine, left and right hypochondrium, various parts of the abdomen.The time of onset of pain also depends on the location of the ulcer.

    Symptoms of a stomach ulcer. With an ulcer of the cardiac part of the stomach, i.e. the upper part of it, pain occurs immediately after eating, with ulcers of the body of the stomach, i.e. in its middle part, – 1 – 1.5 hours after eating. Symptoms of an ulcer of the pyloric canal, that is, of the lower part of the stomach, and ulcers of the duodenal bulb are characterized by the appearance of pain 2-3 hours after eating, “hungry” pains that occur “on an empty stomach” and decrease or completely disappear after a meal, as well as at night. pain.

    In addition to pain, during exacerbation of peptic ulcer disease, dyspeptic symptoms are noted – heartburn, sour belching, nausea, vomiting at the height of pain, bringing relief, a tendency to constipation. Peptic ulcer disease is characterized by a spring-autumn exacerbation.

    Complications of the disease may include gastric bleeding of varying intensity, perforation (perforation) of the stomach, cancerous degeneration, etc.

    It is possible to detect small neoplasms (polyps), early forms of cancer and remove them in a timely manner only with the help of gastroscopy.

    Modern gastroscopes of the Japanese company “Olympus”, which are at our department, represent a flexible, elastic tube with a controllable end, where the video camera, light guides are located, the water / air channel and the channel for instruments are located. The presence of an instrumental channel in the endoscope enables additional manipulations such as:

    • Biopsy – using special forceps, a piece of mucous membrane is taken for morphological examination, which allows a diagnosis to be made with high accuracy.This manipulation is absolutely painless.
    • Express diagnostics of H. pylori – also using a biopsy, but a fragment of the mucous membrane is placed in a special medium, which changes its color in the presence of a microbe.
    • pH-metry is performed by touching the mucous membrane with a special probe that reacts to the acidity of the medium.

    Thus, to summarize the above, gastroscopy is performed for:

    1. Diagnosis
    2. Confirmation of the diagnosis (visual and morphological)
    3. Process localization refinements
    4. Determining the prevalence of the process
    5. Study of secretory topography of the stomach
    6. definition Nr
    7. evaluation of the effectiveness of conservative and surgical treatment
    8. carrying out medical manipulations through an endoscope.

    The reason for the gastroscopy may be:

    1. pain and heaviness in the abdomen after eating or on an empty stomach
    2. heartburn
    3. burp
    4. weight loss or lack of appetite
    5. nausea and vomiting

    Contraindications to gastroscopy are:

    1. acute myocardial infarction
    2. acute stroke
    3. cardiovascular and cardiopulmonary insufficiency of the 3rd degree.
    4. disorders of the blood coagulation system
    5. stricture of the upper third of the esophagus
    6. extremely serious condition of the patient

    Special preparation for gastroscopy is not required – it is enough not to have breakfast and not to have a hearty supper or too late.

    As mentioned above, gastroscopy, even with the use of additional techniques, is a painless procedure that requires patience from the patient and strict observance of the instructions of the endoscopist.However, in some patients, it causes, which does not allow to decide on the study, even with acute abdominal pain.

    In this case, we recommend performing gastroscopy under conditions of medication sedation or “in sleep”. Experienced anesthesiologists of our clinic provide anesthesia support during the study, after which the patient is in the wake-up room under medical supervision.

    Gastritis and peptic ulcer of the stomach and duodenum | Publications

    Gastritis and peptic ulcer of the stomach and duodenum are diseases of the gastrointestinal tract, characterized by exacerbations in the autumn-spring period.

    Gastritis is a fairly common disease characterized by inflammation of the gastric mucosa. The most common cause of gastritis is the bacterium Helicobacter pylori , however, malnutrition, constant stress, smoking, alcoholism can contribute to the development of gastritis.

    Very often the cause of gastritis is the wrong diet, hasty food and poorly chewed food or food “dry” injure the mucous membrane mechanically.Eating food that is too hot or too cold causes gastritis due to thermal damage to the stomach lining. Eating spicy and salty foods irritates the stomach lining, similar to the action of caustic chemicals.

    From the point of view of the course of the disease, gastritis can be acute and chronic.

    Acute gastritis most often develops in a matter of hours or days and is the result of massive infection with Helicobacter pylori, or other bacteria (food poisoning), as well as the intake of chemicals that have a damaging effect on the gastric mucosa (acids, alkalis, alcohols).Such aggressive substances, in the end, can even lead to ulcers and perforation of the stomach.

    Chronic gastritis develops as a consequence of acute gastritis or as an independent disease. Chronic gastritis may be asymptomatic for a long time. In chronic gastritis, the gastric mucosa is affected much deeper and more extensively than in acute gastritis. In the development of the disease, as a rule, there are periods of exacerbation and remission. During periods of exacerbation of chronic gastritis, short-term attacks of pain, discomfort, a feeling of heaviness, nausea after eating, heartburn may appear, which indicates a dysfunction of the natural “valves” of the stomach and the throwing of acidic stomach contents into the esophagus.Signs of impaired digestion of food in the intestines may also appear: episodes of constipation or diarrhea, bloating (flatulence).

    Helicobacter pylori infection, parasitizing in the stomach, disrupts the processes of renewal of the mucous membrane; thus, when old cells die, new ones cannot be formed. This leads to a gradual degradation of the gastric mucosa with loss of function of the glands that produce gastric juice.

    Often, the above-described disorders of the digestive process lead to weight loss, severe weakness, drowsiness, and irritability.
    As already mentioned, chronic gastritis occurs with periodic exacerbations and remissions. During remission, the symptoms of the disease practically disappear, but they reappear during the period of exacerbation of the disease. An exacerbation of chronic gastritis can be seasonal (for example, in spring and autumn), and can also be provoked by a violation of the diet, smoking, alcohol, and the use of certain medications.

    Sooner or later, gastritis gives rise to dangerous complications: gastric ulcer and duodenal ulcer, stomach cancer.

    Diagnosis is based on data from anamnesis, clinical picture, examination results, laboratory and instrumental studies.
    Currently, the main method for diagnosing gastritis is fibrogastroduodenoendoscopy (FGDS) – examination of the gastric mucosa by means of a probe.

    Treatment of gastritis is aimed at eliminating factors that provoke the development or exacerbation of the disease (infection, unhealthy diet), stimulation of recovery processes in the gastric mucosa and prevention of new episodes of the disease (exacerbations).The treatment regimen for gastritis depends on the form of the disease. In general, the treatment of gastritis includes the following components: diet, medication, measures to prevent exacerbations.
    Nutrition for gastritis depends on the form and course of the disease. In acute gastritis and exacerbation of chronic, a strict diet is shown; in the remission phase of chronic gastritis, the diet can be expanded.

    What can you eat with gastritis?

    Boiled lean meats: chicken, rabbit.It is recommended to pass the meat through a meat grinder several times or chew thoroughly and slowly.

    Low-fat types of fish: cod, hake, pink salmon.

    Vegetable purees, mashed vegetables: potatoes, carrots, beets, young peas, fruit purees, jelly, compotes, porridge, well-boiled in water (semolina, oatmeal, rice), milk, fresh low-fat cottage cheese. Food intake is carried out in small portions at regular intervals (5-6 times a day).

    Medical nutrition is observed for another 2-3 months after an exacerbation.The patient should be in a calm environment with conditions for good rest and sleep. It is recommended to take vitamin and mineral preparations.

    ULCER – a chronic recurrent disease, the main symptom of which is the formation of a defect (ulcer) in the wall of the stomach or duodenum.

    Duodenal ulcers are much more common than stomach ulcers. Young people and especially men are most susceptible to peptic ulcer disease.As a rule, their work is associated with neuropsychic stress in combination with irregular nutrition.

    Do not forget about hereditary factors.

    Long-term use of drugs that adversely affect the mucous membrane of the stomach and duodenum can provoke the development of peptic ulcer disease.

    The leading symptom of peptic ulcer disease is pain, often radiating to the left half of the chest, thoracic or lumbar spine.Pain is usually clearly associated with food intake. So, with ulcers of the body of the stomach, they appear, as a rule, 30 – 60 minutes after eating, as well as on an empty stomach.

    Peptic ulcer disease usually occurs with alternation of exacerbations and remissions. Exacerbations are often seasonal, occurring mainly in spring and autumn; their duration is from 3 – 4 to 6 – 8 weeks or more. Remissions can last from several months to several years.

    Diagnosis is based on data from anamnesis, clinical picture, examination results, laboratory and instrumental studies.

    Endoscopic examination plays a leading role in the diagnosis of peptic ulcer disease and its complications. It allows you to confirm or reject the diagnosis, to accurately determine the localization, shape, depth and size of the ulcer.

    Patients with uncomplicated peptic ulcer disease in most cases are treated with conservative therapy. Food should be fractional (5 – 6 times a day), food – mechanically and chemically sparing. Fried foods, raw vegetables and fruits containing coarse vegetable fiber (cabbage, pears, peaches, etc.) are traditionally excluded from the diet.), marinades, pickles, smoked meats, strong broths, spices, carbonated drinks, coffee, cocoa.

    Food should contain a sufficient amount of protein and vitamins. Milk and dairy products are most preferred, soft-boiled egg and oatmeal or semolina porridge in the morning. Meat and fish are eaten as steamed dishes.

    Specialists of the ALTERNATIVA PLUS family polyclinic will help you in the treatment of diseases of the gastrointestinal tract, prevent seasonal exacerbations.

    To solve these problems, the polyclinic has a staff of highly qualified gastroenterologists, including a pediatric gastroenterologist, therapists.

    The polyclinic is equipped with modern equipment, has a wide range of laboratory tests, which makes it possible to correctly diagnose and draw up a competent treatment plan, individual, for each patient.

    We wish you good health!

    90,000 Stomach and duodenal ulcer: causes, signs and treatment – what is it?

    Stomach ulcer and duodenal ulcer refers to chronic, recurrent diseases of the digestive system and is characterized by the formation of erosions on the mucous membrane.An increase in gastric acidity with the appearance of ulcers often leads to complications and even sometimes death. If the inflammation spreads below the pylorus of the stomach, the duodenum is affected, where erosive processes occur, therefore, at the first signs of the disease, immediate treatment is required.

    Diagnostics is obligatory to establish the type of peptic ulcer, which is subdivided into:

    • Acute and chronic.
    • Leaking in isolation and against the background of other diseases of the gastrointestinal tract.
    • Infection-provoked and idiopathic.
    • With different localization of single or multiple ulcers of different sizes.
    • No bleeding phenomena, with bleeding and perforation.

    Diet and drugs help prevent destruction of the protective layer of the mucous membrane, reduce the number of exacerbations and prevent dangerous complications.

    Symptoms of stomach and duodenal ulcers

    The manifestations of the disease depend on the stage and are variable in nature. During the period of remission, the patient feels healthy, at the initial stage of the disease, symptoms appear only under certain conditions, with complications, they are acute and are of high intensity. Many symptoms of stomach ulcers are observed in other pathologies (for example, with gastritis or cholecystitis), and uncharacteristic complaints may also occur.

    Peptic ulcer and duodenal ulcer: symptoms

    • Pain. It is noted as low-intensity, aching, and significant, cramping.Pain sensations are concentrated under the sternum and can be given to the back. Attacks are associated with food intake: with damage to the gastric mucosa, discomfort occurs after eating and disappears within 2 hours. If there is a pathology of the duodenum, hungry (occurring on an empty stomach) pains appear.
    • Heartburn of varying intensity, which is caused by excessive production of gastric juice and increased acidity. Burning and soreness can concentrate in the epigastric region and give under the scapula.
    • Appetite disturbance. Symptoms are manifold: nausea after eating, a feeling of heaviness, a full stomach. Flatulence and belching may also occur.
    • Vomiting. Depending on the severity and form of the disease, there is vomiting of food after eating, in masses with an admixture of blood (a type of coffee grounds), bloody vomiting (with perforation).

    Abnormal concomitant signs are stool disturbance, sweating, weakness, weight loss.

    IMPORTANT! Symptoms of exacerbation of gastritis should be distinguished from peptic ulcer disease.These include: pain (acute) between meals, increased salivation or dry mouth, vomiting with mucus and a strong sour odor.

    Complications of duodenal ulcer and stomach

    Late seeking medical attention and an advanced form of the disease can lead to a number of serious life-threatening complications:

    • Occurrence of bleeding of varying intensity associated with a violation of the integrity of the vascular ulcer located on the walls and bottom. Signs: dark vomiting, with mild prolonged bleeding – tarry feces. Increasing dizziness, lightheadedness, shortness of breath, dry mouth. With significant bleeding against the background of an ulcer – loss of consciousness.
    • Perforation (violation of the integrity of the organ). Destruction of the walls of the stomach or intestines can lead to their perforation and the spread of contents and gastric juice into the abdominal cavity. The patient’s condition in this case is severe – sharp pains concentrated in the hypochondrium and upper abdomen, tense abdomen.The attack may end with a “period of apparent well-being” of 1-12 hours.
    • Stenosis. When ulcers located in the outlet of the stomach are scarred, scarring may appear that narrows the passage. This prevents the emptying of the stomach from the contents, leads to its expansion, a feeling of constant heaviness, nausea. In severe cases, there is a sharp weight loss, dehydration.
    • Rebirth into an oncological disease. The affected area can turn into a cancerous tumor with germination into neighboring organs.Symptoms are manifold: constant excruciating pain, fever, exhaustion.

    Stressful situations, smoking, significant physical activity, unbalanced diet, alcohol can worsen the patient’s condition. All of the above complications are life-threatening, but with proper (surgical) treatment, they end in remission.

    Causes of peptic ulcer

    Distinguish between peptic ulcer, provoked by an infection and not dependent on the presence of a pathogen in the body.

    Cause of ulcer

    Signs of disease and differences
    Helicobacter Pylori. It is the cause of 80% of ulcers. The bacterium changes the protective barrier of the mucous membrane, produces toxins. Releases substances that damage the mucous membrane, promotes increased secretion
    Long-term uncontrolled intake of non-steroidal drugs (pain relievers, aspirin). Components of NSAIDs provoke an increase in gastric acidity
    Genetic predisposition. In 50% of cases, the presence of a diagnosis in parents means a tendency to develop peptic ulcer disease. Increases the risk of illness, unhealthy diet, smoking, concomitant diseases (diabetes).

    In isolated cases, peptic ulcer disease can be provoked by diseases and tumors of neighboring organs.

    Diagnostics: what tests need to be taken for stomach ulcers

    In acute conditions, a characteristic clinical picture is observed, and therefore it is not difficult to make a preliminary diagnosis.In this case, emergency hospitalization is required. In case of suspicion and in difficult cases, it is necessary to carry out mandatory diagnostics, including:

    • Ultrasound and radiography . Needed to identify ulcers, tumors, and other pathologies.
    • Endoscopy. The study includes the introduction of a probe with a miniature chamber through the esophagus to study the state of the gastric mucosa. It allows not only to identify erosive processes, but also to determine the location of the ulcer and its nature.
    • Laboratory tests (blood, urine), analysis for the detection of Helicobacter Pylori.

    Modern diagnostics allows you to accurately establish the causes and form of the disease and select tablets for stomach and duodenal ulcers.

    How to treat peptic ulcer

    The treatment of gastric and duodenal ulcers should only be dealt with by a gastroenterologist after a comprehensive examination of the patient. The treatment of this pathology is comprehensively approached. Antibiotics, antispasmodics, drugs to normalize the acidity of gastric juice and others are used.

    Diet for diseases of the duodenum and stomach ulcer

    The process of recovery and the duration of remission depends on many factors. Nutrition is of paramount importance.

    Diet after duodenal ulcer and stomach ulcer includes the following restrictions:

    • Complete exclusion of smoked meats, marinades, fried foods, spicy foods, carbonated drinks, strong coffee.
    • Reducing the amount of sugar and salt consumed.
    • Significant reduction in the menu of black bread, products with coarse fiber.

    The recommended diet is for duodenal ulcer, including: cereals, dairy products, steamed and boiled lean meat, vegetable dishes (zucchini, cauliflower, mashed potatoes). Of the drinks, milk jelly, weak tea, dried fruit compote are preferred.

    Compliance with a diet, a healthy lifestyle, reduction of excess body weight, accelerate the processes of recovery of the mucous membrane and prevent new exacerbations.

    Stomach ulcer – Treatment in Israel

    The essence of ulcers

    With good digestion from the oral cavity, food through the esophagus enters the stomach.

    For the digestion of food, the stomach produces gastric juice, consisting of hydrochloric acid, mucus and enzymes. One of the main enzymes for breaking down food is pepsin. Food from the stomach travels to the upper part of the small duodenum, where the processes of digestion and absorption of nutrients take place.

    Peptic ulcer disease is caused by damage to the gastric mucosa by caustic stomach acid. Depending on the location of the ulcer, there are two types of peptic ulcer: stomach ulcer and duodenal ulcer.

    Every year 4 million cases of inflammation of gastric and duodenal ulcers are diagnosed worldwide. About 20 million Americans have had stomach or duodenal ulcers at least once in their lives.

    Peptic ulcer disease can develop at any age, but is rare among children and adolescents. Duodenal ulcers are more common in men between the ages of 30 and 50. Stomach ulcers are more common in women over 60 years of age.

    Causes of peptic ulcer diseases

    Many peptic ulcer studies at Tel Aviv Sourasky Medical Center indicate the presence of a bacterial infection caused by the bacterium Helicobacter pylori, abbreviated: HP (Helicobacter pylori).

    Other causes of stomach ulcers are smoking, alcohol and caffeine consumption. The lack of effective functioning of the stomach with hydrochloric acid, bile acids and pepsin also contributes to the occurrence of peptic ulcer disease.

    In the United States, the demographic characteristics of peptic ulcer disease are as follows: The prevalence of Helicobacter pylori infection varies among different age groups, ethnic groups, and socioeconomic status of patients.The bacterium is more common in older people, African Americans, Hispanics, and people of low socioeconomic status. A few weeks after infection with the Helicobacter Pylori bacterium, most people with a burdened heredity and unfavorable environmental conditions develop inflammation of the gastric mucosa.

    Helicobacter Pylori is spread through saliva, phlegm, shared utensils, poorly washed vegetables, contaminated food, dirty hands, general hygiene products, and faecal contaminated water.Penetrating into the pyloric compartment of the stomach, the bacterium Helicobacter Pylori causes various inflammations of the gastrointestinal tract.

    The spiral form of the Helicobacter Pylori bacterium, entering the body, in most cases does not cause any problems and is asymptomatic. But in some people, especially those with weakened immune systems, the bacteria Helicobacter Pylori causes infection and ulcers.

    The spiral shape of the bacterium allows it to penetrate deep into the gastric mucosa and begin there with its harmful enzymes and toxins to destroy the protective layer of the gastric mucosa.Bacteria enter the cells of the stomach, weakening the protective mechanisms of the stomach more and more, causing local inflammation. Also, for no apparent reason, bacteria somehow make the stomach produce more acid, causing the stomach to become acidic. This can cause inflammation in the upper part of the duodenum.

    Ulcer Symptoms

    The most common ulcer symptoms are burning and pain in the upper abdomen above the navel. Pain often appears between meals or early in the morning.The pain can last from a few minutes to several hours. A few minutes after eating or taking antacid medications, the pain subsides. In rare cases, symptoms such as nausea, vomiting, decreased appetite, and weight loss appear. Bleeding from stomach or duodenal ulcers may occur. Sometimes the patient is not even aware of bleeding due to slow blood loss and without obvious traces of blood. Patients simply feel very weak and tired. With increased bleeding, traces of occult blood appear in the stool and vomit.

    Diagnosis of stomach ulcers

    At the Ichilov hospital, the diagnosis of stomach and duodenal ulcers can be made through endoscopic imaging studies, X-rays and special breath tests for the bacterium Helicobacter pylori.

    After diagnosis, the doctor will confirm or deny the presence of Helicobacter Pylori bacteria in the patient’s body. Checking for the presence of bacteria in the gastric mucosa at the Ichilov clinic is carried out using clinical blood tests, biochemical breath tests and endoscopic tissue sampling from the stomach for histology (biopsy).By destroying the Helicobacter Pylori bacteria, stomach ulcers can be cured.

    Ulcer treatment

    There are several treatments for gastric and duodenal ulcers. In the Tel Aviv Sourasky Medical Center, individual complex therapy is used in the treatment of ulcers. For the treatment and prevention of peptic ulcer diseases, the following antisecretory drugs are used to neutralize the acidity of gastric juice and astringents:

    • antacids, which reduce acidity and neutralize hydrochloric acid;
    • histamine blockers – h3 blockers that reduce gastric acid secretion;
    • acid release proton pump inhibitors;
    • gastroprotectors – medicinal astringents that protect the gastric mucosa;
    • anticholinergics, which lower the secretion of glands in the stomach;
    • maintenance therapy preparations
    • vitamins, etc.

    In case of infection with Helicobacter pylori, antiulcer drugs are used in combination with antibiotics. When conservative therapy does not help with stomach and duodenal ulcers or serious complications arise, then at the Ichilov hospital they resort to organ-preserving surgery using endoscopic devices and microsurgical instruments. Surgery is considered an effective treatment for gastric and duodenal ulcers to prevent future complications and recurrence.

    It is necessary to remind once again about the dangers of smoking. This is proven by numerous studies: smoking delays the treatment of stomach ulcers, causes aging of the body and is the cause of much suffering. For the prevention of stomach ulcers, it is recommended to quit smoking.

    Medical myths. Does milk improve digestion?

    • Claudia Hammond
    • BBC Future

    Photo by Thinkstock

    Will a glass of milk help with stomach discomfort? As the correspondent found out

    BBC Future , quite the opposite – milk can make you feel worse.

    What could be better than a glass of milk for indigestion or nausea? Milk has a calming effect on the stomach; in addition, it is high in calories, so even if you cannot look at food, it will provide you with some amount of nutrients. Until the 1980s. Doctors often advised patients with duodenal ulcers to drink milk to relieve discomfort.

    Milk is a weakly acidic product, but its acidity is much lower than that of gastric juice produced by the body.Therefore, milk has long been thought to relieve stomach pain by neutralizing stomach acid. Indeed, the milky film on the stomach walls delays the action of the acid, but studies show that milk stimulates the secretion of gastric juice, so that after a short relief, the discomfort may recur.

    In 1976, an experiment was carried out on ten volunteers who had their stomachs washed and then milk was introduced through the nose through a tube. An hour later, the contents of the stomachs were pumped out, after which the volume of gastric juice produced was measured every five minutes.The researchers recorded an increased secretion of gastric juice within three hours from the moment milk entered the stomach. This probably explains the pain that ulcers experience a few hours after eating.

    However, not only milk stimulates the secretion of gastric juice. Comparative studies of the effects of coffee, tea, beer and milk show that all of these foods have this effect. It is most pronounced in beer and milk. In other words, the acidity of the fluid consumed in this case does not play a role.

    What is the ingredient in milk that causes increased gastric secretion? In 1976, scientists conducted a comparative study of the effects of whole milk, low-fat and skim milk. It turned out that in all three cases, milk increases the secretion of gastric juice, that is, fats have nothing to do with it. How about calcium?

    Experiments were carried out with milk with a low calcium content. It turned out that gastric juice is actually produced less, but with one exception – in patients diagnosed with duodenal ulcer, who at the time of the experiment did not experience symptoms of the disease, the secretion was increased.

    Another ingredient in milk that may affect the secretion of juice is the protein casein. It is thought to either stimulate the production of the hormone gastrin, which is responsible for the secretion of gastric juice, or directly affect cells in the stomach lining, known as parietal cells.

    Photo by Thinkstock


    Does milk consumption slow down ulcer healing?

    However, milk is no longer recommended for ulcers, as its consumption can exacerbate the symptoms of the disease. In a controlled clinical trial in 1986, several patients with duodenal ulcers were divided into two groups and admitted to a hospital for four weeks of medication.

    The experimental group drank only milk – two liters per person per day. If desired, patients could add sugar to the milk. The control group was given regular hospital meals. Both groups were also offered fruit in addition to the diet so that the total calories consumed per day were comparable.At the end of the experiment, all patients underwent endoscopy.

    It was found that a significant number of patients were cured of the usual hospital diet. In the “milk” group, however, fewer patients improved than originally expected. Milk intake appears to slow the ulcer healing process.

    A healthy person should not give up milk as a source of protein and calcium. But can milk abuse lead to problems? In 1980 g.in the Norwegian city of Tromsø, a seven-year population health study was launched, involving 21,000 adults. Over the years, 328 people have developed peptic ulcers (a generic term for stomach and duodenal ulcers). As it turned out, the risk of ulcers increases with the consumption of four or more glasses of milk per day, especially in men. At the same time, the fat content in milk does not matter.

    But was it milk that led to the development of ulcers in the inhabitants of Tromsø? It is difficult to say, since some people drink milk precisely in order to alleviate the symptoms of an already onset disease.On the other hand, the risk of developing ulcers was also increased in the case of those experimental who drank a lot of milk before the onset of symptoms.

    So, although milk temporarily envelops the gastric mucosa, softening the action of gastric juice and slightly alleviating discomfort, this effect lasts only about 20 minutes. Milk is a healthy product, but it does not improve digestion.

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