What are the main symptoms of a gastric ulcer. How is a gastric ulcer diagnosed. What are the most effective treatments for gastric ulcers. Can lifestyle changes help manage gastric ulcers. How long does it typically take for a gastric ulcer to heal.

Understanding Gastric Ulcers: A Comprehensive Overview

Gastric ulcers, also known as stomach ulcers or peptic ulcers, are painful sores that develop on the lining of the stomach. These ulcers occur when the protective mucus layer of the stomach is compromised, allowing stomach acid to erode the sensitive tissue beneath. Gastric ulcers can vary in size, ranging from tiny lesions to sores over an inch in diameter.

Are gastric ulcers common? Gastric ulcers are relatively common, affecting millions of people worldwide. By age 60, approximately half of all individuals have been infected with Helicobacter pylori (H. pylori), a bacteria often responsible for ulcer formation.

Identifying the Primary Causes of Gastric Ulcers

Contrary to popular belief, stress and spicy foods are not the primary causes of gastric ulcers, although they can exacerbate existing ulcers. The main culprits behind ulcer formation include:

• Helicobacter pylori (H. pylori) infection
• Prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs)
• Certain medications, including steroids and blood thinners
• Zollinger-Ellison Syndrome (ZES), a rare condition causing gastrinomas

Is H. pylori the most common cause of gastric ulcers? Yes, H. pylori infection is the most frequent cause of gastric ulcers. This bacteria inflames the stomach lining, leading to ulcer formation over time. The exact mode of transmission for H. pylori is not fully understood, but it may spread through close contact or contaminated food and water.

Recognizing the Symptoms of Gastric Ulcers

Gastric ulcers can present with a variety of symptoms, some of which may be subtle or easily mistaken for other digestive issues. Common symptoms include:

• Burning pain between the breastbone and belly button
• Nausea and vomiting
• Bloating and increased burping
• Loss of appetite and unintended weight loss
• Black, tarry stools or blood in the stool

Can gastric ulcers be asymptomatic? Interestingly, up to three-quarters of people with gastric ulcers may experience no symptoms at all. This highlights the importance of regular check-ups and being aware of any changes in digestive health.

Diagnostic Procedures for Gastric Ulcers

If a gastric ulcer is suspected, healthcare providers may employ several diagnostic techniques to confirm the presence of an ulcer and determine its cause:

1. H. pylori testing: A breath or stool test to detect the presence of H. pylori bacteria
2. Barium swallow: An X-ray procedure using a special contrast dye to visualize the stomach lining
3. Endoscopy: A procedure allowing direct visualization of the stomach lining and tissue sampling

Why is endoscopy considered the gold standard for diagnosing gastric ulcers? Endoscopy allows for direct visualization of the ulcer, accurate measurement of its size, and the ability to take tissue samples for further testing. This comprehensive approach provides the most detailed information for diagnosis and treatment planning.

Effective Treatment Strategies for Gastric Ulcers

The treatment of gastric ulcers depends on their underlying cause. Common treatment approaches include:

• Proton pump inhibitors (PPIs) or H2 blockers to reduce stomach acid production
• Antibiotics to eradicate H. pylori infection
• Protective medications to coat the stomach lining
• Discontinuation of NSAIDs or other ulcer-causing medications

How long does it typically take for a gastric ulcer to heal with proper treatment? With appropriate treatment, most gastric ulcers heal within 4 to 8 weeks. However, complete eradication of H. pylori can be challenging and may require multiple rounds of antibiotic therapy.

Lifestyle Modifications to Support Gastric Ulcer Healing

In addition to medical treatments, certain lifestyle changes can promote ulcer healing and prevent recurrence:

• Stress management techniques
• Avoiding alcohol and tobacco
• Consuming a balanced diet rich in fruits and vegetables
• Limiting dairy, fatty, and spicy foods
• Incorporating probiotic-rich foods like kefir, miso, and sauerkraut

Can dietary changes alone cure gastric ulcers? While dietary modifications can support the healing process and alleviate symptoms, they are typically not sufficient to cure gastric ulcers on their own. Medical treatment is usually necessary to address the underlying cause and promote complete healing.

Potential Complications of Untreated Gastric Ulcers

Left untreated, gastric ulcers can lead to serious complications, including:

• Gastrointestinal obstruction
• Perforation of the stomach wall
• Severe bleeding requiring hospitalization
• Increased risk of gastric cancer (in cases of long-term H. pylori infection)

What is the most common complication of untreated gastric ulcers? Bleeding is the most frequent complication of untreated gastric ulcers. This can range from slow, chronic blood loss leading to anemia to acute, life-threatening hemorrhage requiring immediate medical intervention.

Prevention Strategies for Gastric Ulcers

While not all gastric ulcers can be prevented, certain measures can reduce the risk of developing them:

• Practicing good hygiene to reduce the risk of H. pylori infection
• Using NSAIDs sparingly and as directed by a healthcare provider
• Avoiding excessive alcohol consumption
• Quitting smoking
• Managing stress through relaxation techniques or counseling

Is there a vaccine available to prevent H. pylori infection? Currently, there is no widely available vaccine for H. pylori. However, research is ongoing, and several vaccine candidates are in various stages of development.

The Role of Probiotics in Gastric Ulcer Management

Emerging research suggests that probiotics may play a beneficial role in the management of gastric ulcers. Probiotics are live microorganisms that can provide health benefits when consumed in adequate amounts. In the context of gastric ulcers, probiotics may:

• Help suppress H. pylori growth
• Enhance the effectiveness of antibiotic therapy
• Reduce inflammation in the stomach lining
• Improve overall digestive health

Which probiotic strains are most effective for gastric ulcer management? While research is ongoing, certain strains of Lactobacillus and Bifidobacterium have shown promise in supporting gastric ulcer treatment. However, it’s important to consult with a healthcare provider before starting any probiotic regimen.

The Impact of Stress on Gastric Ulcers

While stress is not a primary cause of gastric ulcers, it can exacerbate symptoms and potentially slow the healing process. Chronic stress can:

• Increase stomach acid production
• Reduce blood flow to the stomach lining
• Weaken the immune system, making it harder to fight H. pylori infection
• Lead to unhealthy coping behaviors like smoking or excessive alcohol consumption

How can stress management techniques help in gastric ulcer treatment? Incorporating stress-reduction practices such as meditation, deep breathing exercises, or regular physical activity can help alleviate ulcer symptoms and support the overall healing process. These techniques can also improve quality of life for individuals dealing with chronic ulcer-related discomfort.

The Connection Between Diet and Gastric Ulcers

While diet alone doesn’t cause gastric ulcers, certain foods and eating habits can influence ulcer symptoms and healing. Consider the following dietary recommendations:

• Eat smaller, more frequent meals to reduce stomach acid production
• Include fiber-rich foods to promote digestive health
• Consume foods high in flavonoids, such as apples, cranberries, and garlic, which may inhibit H. pylori growth
• Limit caffeine intake, as it can increase stomach acid production
• Avoid alcohol, which can irritate the stomach lining

Are there specific foods that can help heal gastric ulcers? While no single food can cure gastric ulcers, certain nutrients may support healing. Foods rich in vitamins A and C, zinc, and amino acids like glutamine may help repair damaged stomach tissue. However, a balanced diet in conjunction with medical treatment remains the best approach for ulcer management.

The Importance of Patient Education in Gastric Ulcer Management

Effective management of gastric ulcers relies heavily on patient understanding and adherence to treatment plans. Healthcare providers play a crucial role in educating patients about:

• The importance of completing full courses of prescribed medications
• Potential side effects of treatments and when to seek medical attention
• The need for follow-up appointments and repeat testing to confirm ulcer healing
• Lifestyle modifications to support healing and prevent recurrence
• The importance of disclosing all medications and supplements to healthcare providers

How can patients actively participate in their gastric ulcer treatment? Patients can take an active role in their treatment by keeping detailed records of symptoms, adhering to medication schedules, making recommended lifestyle changes, and communicating openly with their healthcare providers about any concerns or challenges they face during the treatment process.

Emerging Research and Future Directions in Gastric Ulcer Treatment

The field of gastric ulcer research continues to evolve, with several promising areas of investigation:

• Development of more targeted and effective H. pylori eradication therapies
• Exploration of novel protective agents for the stomach lining
• Investigation of the gut microbiome’s role in ulcer formation and healing
• Research into genetic factors that may influence ulcer susceptibility
• Advancements in minimally invasive techniques for treating complicated ulcers

What potential breakthroughs might we see in gastric ulcer treatment in the coming years? While it’s difficult to predict specific breakthroughs, ongoing research may lead to more personalized treatment approaches based on individual patient factors, improved diagnostic techniques for early ulcer detection, and potentially even preventive strategies for high-risk individuals.

The Global Impact of Gastric Ulcers

Gastric ulcers represent a significant global health issue, with prevalence rates varying across different regions and populations. Factors influencing the global impact of gastric ulcers include:

• Varying rates of H. pylori infection in different parts of the world
• Differences in access to healthcare and diagnostic services
• Cultural and dietary factors that may influence ulcer risk
• Economic burden of ulcer treatment and related complications
• Impact on workforce productivity due to ulcer-related illness

How do gastric ulcer prevalence rates compare between developed and developing countries? Generally, H. pylori infection rates and associated gastric ulcers tend to be higher in developing countries due to factors such as lower sanitation standards and limited access to healthcare. However, the overall burden of gastric ulcers remains significant in both developed and developing nations, underscoring the need for continued research and improved treatment strategies worldwide.

Visual Guide to Stomach Ulcers

Medically Reviewed by Minesh Khatri, MD on November 27, 2022

When your stomach’s healthy, it’s coated in a layer of sticky mucus. This protects it from the harsh acid that breaks down your food. If something upsets this balance, you end up with more stomach acid and not enough mucus. Over time, that acid gnaws away at the tissue that lines your stomach. The painful and sometimes bloody open sore it causes is called an ulcer. Some are tiny, while others are over an inch long.

The most frequent cause of ulcers isn’t stress or super-spicy food. Those only make the problem worse. A bacteria in your gut called Helicobacter pylori (H. pylori) is often the culprit. It inflames your stomach wall until an ulcer forms. It’s not yet clear how you get this bug. It may be spread through close contact, like kissing, or through tainted food or drink. By age 60, about half of all people have been infected.

You could develop an ulcer if you’re a regular user of some over-the-counter pain relievers like aspirin, ibuprofen, ketoprofen, or naproxen. When you take these nonsteroidal anti-inflammatory drugs (NSAIDs) too often or for a long time, they inflame the lining of your stomach. Your ulcers won’t have a chance to heal until you stop taking them.

It’s rare, but sometimes tumors cause stomach ulcers. If you have something called Zollinger-Ellison Syndrome (ZES), it means one or more growths called gastrinomas form in your small intestine and pancreas. These tumors release hormones that force your stomach to churn out more acid than normal, which leads to ulcers.

Gastrinomas do not always mean you have cancer. They can be benign (harmless) and may not spread.

You may get a queasy feeling or a need to throw up. You could burp more than normal or feel bloated. You may also have black stools or see blood when you poop. Some people with stomach ulcers don’t feel like eating and lose weight without trying. On the other hand, nearly three-fourths of people with ulcers have zero symptoms.

If your doctor thinks you have an ulcer, a test of your breath or stool can check to see if you have the H. pylori germ. A stomach X-ray — or what’s called a “barium swallow” — will look for any sign of ulcers. At the lab, you’ll be asked to drink a thick, white liquid that coats your stomach. This makes ulcers easy to spot on the X-ray image.

This procedure lets your doctor see any ulcers and take a tissue sample, which can be tested for H. pylori. The doctor gives you medicine to make you feel sleepy, then puts a skinny tube with a tiny camera down your throat and into your stomach. Your doctor is likely to suggest this test if you’re older, have signs of bleeding, or find it hard to swallow, eat, or keep on enough weight.

How your doctor treats your ulcer depends on its cause. Several types of drugs can cut the amount of acid in your stomach. They also coat your stomach to protect your ulcer so it has a chance to heal. Your doctor may suggest you take an over-the-counter antacid to get some quicker short-term relief.

You’ll need to take them if your ulcer is due to H. pylori. These medications cure most ulcers caused by this bacteria, but it can be tough to get rid of H. pylori once and for all. Your doctor may give you as many as four drugs that you’ll take for up to 2 weeks. For them to work, follow your doctor’s exact instructions. It’s also important to finish all the medicine they give you.

There are lots of good reasons to get help. If you put off treatment, your ulcer may start to block food from moving smoothly through your digestive system. You may often throw up or feel too full to eat. Over time, your ulcer could make a hole through your stomach lining and put you at risk of a severe infection. An ulcer that bleeds can also land you in the hospital.

Easy changes to a few habits can help your ulcer heal. For starters, get a better handle on your stress. When you worry, your symptoms will get worse. Get enough rest and avoid alcohol and tobacco. Eat a healthy diet full of fruits and veggies. Cut back on dairy and fatty and spicy foods, since they can make your belly hurt. You may want to try foods with probiotics (“good” bacteria) like kefir, miso, and sauerkraut.

Avoid NSAIDs during treatment and afterward. If you still use them, your ulcer may not heal or could go away and then come back. To ease pain, try acetaminophen, which is easier on your stomach. Your doctor can also prescribe a pain reliever that’s gentle on your stomach. If you must have an NSAID, take the smallest dose that still helps you, and swallow it with food.

Stomach ulcers often respond well to treatment and sometimes heal within weeks. Your doctor may want to do another H. pylori test or endoscopy to make sure. An ulcer that doesn’t clear up could be due to many reasons, from not taking your drugs the right way or another health problem like Crohn’s disease. Be patient. Your doctor will gather more info about your symptoms and try other treatments to get your stomach feeling better.

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SOURCES:

American Gastroenterological Association: “Peptic Ulcer Disease. “

American College of Gastroenterology: “Peptic Ulcer Disease.”

Mayo Clinic: “Peptic Ulcer.”

NHS: “Stomach Ulcer.”

Merck Manual (Consumer Version): “Helicobacter pylori Infection.”

CDC: “Helicobacter pylori: Fact sheet for health care providers. (Updated July 1998.)”

Cedars-Sinai, “Ulcers.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Treatment for Peptic Ulcers (Stomach Ulcers,” “Zollinger-Ellison Syndrome.”

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Ulcers (for Teens) – Nemours KidsHealth

What Is an Ulcer?

An ulcer is an open, painful sore. Peptic ulcers affect the stomach and the upper part of the small intestine, called the duodenum (pronounced: doo-uh-DEE-num). Ulcers in the stomach are also called stomach ulcers or gastric ulcers. Those in the duodenum are also called duodenal ulcers.

Peptic ulcers are common, but mostly affect adults. Most can be cured.

What Causes an Ulcer?

Most peptic ulcers are caused by:

• bacteria called Helicobacter pylori (or H. pylori) infecting the stomach and upper intestine. They weaken the protective coating of the stomach and upper small intestine. Acid in the stomach then gets through to the sensitive lining underneath. Acid and bacteria irritate this lining, causing ulcers.
• using nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin. These medicines fight inflammation and help treat long-term, painful conditions like arthritis. If taken in high doses over a long period of time, NSAIDs can cause ulcers in some people.
• smoking cigarettes. Smoking increases the risk of ulcers because nicotine causes the stomach to make more acid. Drinking a lot of alcohol each day for a period of time can also increase a person’s risk of ulcers. Over time, alcohol can wear down the lining of the stomach and intestines.

Sometimes stress can help cause ulcers. Usually this happens only when a person has an illness involving severe emotional or physical stress. Any illness that makes it hard for the body to heal (such as serious burns from a fire) also can make someone more likely to get an ulcer.

What Are the Signs & Symptoms of Peptic Ulcers?

Stomach pain is the most common sign of an ulcer. It usually feels like sharp aches between the breastbone and the belly button. This pain often comes a few hours after eating. It can also happen during the night or early in the morning, when the stomach is empty. Eating something or taking acid suppressor (antacid) medicine sometimes eases the pain.

Other symptoms of ulcers can include:

• loss of appetite
• sudden, sharp stomach pains
• nausea
• burping or hiccupping a lot
• weight loss
• vomiting (if there’s blood in the vomit or the vomit looks like coffee grounds, which only happens with severe ulcers, call a doctor right away)
• bloody or blackish bowel movements (this could be a sign of a serious problem, so call a doctor right away if you see this)

Anyone who thinks they might have an ulcer needs to see a doctor. An ulcer that’s not treated can grow larger and deeper. This can lead to other problems, such as bleeding in the digestive system or a hole in the wall of the stomach or duodenum, which can make someone very sick.

How Are Ulcers Diagnosed?

To diagnose a peptic ulcer, doctors do an exam, ask about symptoms, and take a medical history. If you have stomach pain or other symptoms of an ulcer, the doctor will do some tests.

One test is called an upper gastrointestinal (GI) series. These are X-rays of the stomach, duodenum, and esophagus, the muscular tube that links the mouth to the stomach. A person drinks a liquid called barium while getting an X-ray. If there’s an ulcer, it should show up on the X-ray.

Another common test to look for an ulcer is an endoscopy (pronounced: en-DOSS-kuh-pee). A person is sedated for this procedure. Then, the doctor puts an endoscope — a small, flexible tube with a tiny camera on the end — down the throat and into the stomach and duodenum. The doctors can see the lining of the esophagus, stomach, and duodenum to check for possible ulcers.

A doctor also can do a blood test that looks for H. pylori bacteria. This may be important if the upper GI series showed an ulcer. The blood test can be done right in the doctor’s office. Sometimes doctors test a poop sample (called a stool test) or a person’s breath to check for the H. pylori bacteria.

How Are Ulcers Treated?

Most H. pylori-related ulcers can be cured. Treatment involves two kinds of antibiotics and an acid suppressor (antacid). The person takes the antibiotics for 2 weeks and the antacid for 2 months or longer. The ulcer may take 8 weeks to heal, but the pain usually goes away after a few days or a week.

Can Peptic Ulcers Be Prevented?

Doctors aren’t sure how H. pylori bacteria spread from person to person. The bacteria have been found in saliva (spit), so kissing may be one way. They also may spread through food, water, or contact with vomit (puke) that’s infected with the bacteria.

Regular use of NSAIDs can cause gastrointestinal problems and bleeding in some people. Acetaminophen does not cause stomach ulcers and is a good alternative to NSAIDs.

As with many infections, washing your hands well and often is an important part of ulcer prevention. This is extra important after you use the bathroom and before you eat. And take good care of your body by exercising regularly and not smoking or drinking.

Gastric ulcer: causes, symptoms and treatment

Likbez

Health

17 February

This is an important reason to avoid certain over-the-counter pain relievers.

What is a gastric ulcer

An ulcer is an open sore on the lining of the stomach.

See how a stomach ulcer looks like

Close

Sometimes the same kind of wounds occur in the part of the intestine just behind the stomach. In this case, we speak of a duodenal ulcer. Both types of ulcers are called peptic (“digestive”). They appear, develop and are treated according to the same scenario, so the concept of a peptic ulcer can be considered an exact synonym for a stomach ulcer.

Peptic ulcers are very common. For example, in the United States, every tenth suffers from this disorder at one time or another in life.

The older the person, the higher the risk of developing an ulcer. It occurs especially often in people over the age of 60.

What causes stomach ulcers

The stomach contains acid that helps digest food. But it can also digest the walls of the organ itself. To prevent this from happening, the inside of the stomach is lined with a protective cell layer that actively produces mucus. If for some reason this layer is destroyed, there is less mucus, the acid begins to corrode the wall of the organ. This is how an ulcer is formed.

There are several factors that can damage the protective layer.

1. Bacterial infection

It is most often caused by Helicobacter pylori (H. pylori) bacteria that have entered the stomach from dirty hands or other objects. Under some not fully understood conditions, these microbes first cause inflammation of the gastric mucosa (gastritis) and then break the integrity of the protective layer.

Curiously, up to 50% of the world’s population is infected with the bacterium Helicobacter pylori. But in most cases, this does not affect health. A stomach ulcer develops in only 10–15% of those infected.

2. Taking certain painkillers

Non-steroidal anti-inflammatory drugs (NSAIDs) such as:

• Aspirin are known to cause peptic ulcers. Even if the tablets are coated with a protective shell and dissolve far beyond the stomach.
• Ibuprofen products.
• Preparations based on diclofenac sodium.
• Painkillers based on naproxen.
• Certain prescription NSAIDs.

Paracetamol-based products are not classified as non-steroidal anti-inflammatory drugs and do not harm the protective layer of the stomach.

It is important to note that not everyone who takes NSAIDs gets peptic ulcers. The risk is increased if painkillers enter the stomach, which is already infected with Helicobacter pylori bacteria. Also, taking non-steroidal anti-inflammatory drugs can be especially dangerous if:

• You do not follow the instructions and drink painkillers uncontrollably, exceeding the dosage.
• You are taking NSAIDs for many days in a row.
• You are over 70 years old.
• You are a woman.
• You are taking corticosteroids. Such drugs are prescribed for asthma, arthritis, lupus.
• You have already been diagnosed with a peptic ulcer once.

3. Some lifestyle factors

It used to be that spicy food, coffee, alcohol, stress can thin the protective layer of the stomach. But to date, there is very little evidence for this.

The only more or less confirmed harmful factor is smoking. It can provoke the formation of an ulcer and reduce the effectiveness of treatment.

4. Other causes

In rare cases, peptic ulcers may appear on the background of:

• severe infectious diseases;
• previous abdominal surgery;
• certain medications such as steroids;
• a rare disease called Zollinger-Ellison syndrome, in which a tumor (gastrinoma) develops on acid-producing cells.

Why stomach ulcers are dangerous

Sometimes nothing. If the ulcer is small, the body may well cope with it on its own. The wound on the gastric mucosa will heal, and the digestive system will continue to function normally.

But this is not always the case. In some cases, the ulcer grows, deepens, and may one day reach the blood vessels. If this happens, there will be massive internal bleeding, fraught with deadly blood loss.

Another no less unpleasant complication occurs when the ulcer becomes penetrating. The contents of the stomach or intestines through the resulting hole enters the abdominal cavity, and this can cause peritonitis. Inflammation of the peritoneum, if not stopped in time, leads to blood poisoning, failure of vital organs and rapid death.

It is impossible to predict how events will develop in your case without a medical examination. Therefore, it is so important to know the symptoms of a peptic ulcer so that if they appear, see a doctor as soon as possible.

What are the symptoms of a stomach ulcer and when to see a doctor

Sometimes there are no symptoms at all. But more often the ulcer manifests itself as characteristic signs.

• Burning, “drilling” pain in the upper central part of the abdomen. It is most pronounced on an empty stomach.
• Pain relieved after eating or taking antacid medications.
• Nausea or vomiting occurs regularly.
• There are heartburn, bloating.

If you experience any of the above symptoms, you should consult with a general practitioner or gastroenterologist as soon as possible.

Call an ambulance if there are signs of a complication of a peptic ulcer:

• vomit that is blood-streaked or has a dark brown grainy appearance that looks like coffee grounds;
• dark, sticky, tarry stools;
• sudden sharp pain in the abdomen that gets worse.

How to treat a stomach ulcer

Therapy will depend on what exactly caused the ulcer. If you strictly follow the doctor’s prescriptions, you can get rid of the ulcer in a month or two.

For treatment, you may be prescribed:

• Antibiotics. Such medicines are indicated if the protective layer in the stomach is thought to have been damaged by a bacterial infection.
• Medicines that reduce stomach acid production.
• Antacid drugs, whose task is to reduce the acidity of the stomach, that is, to neutralize the gastric juice.
• Protective equipment. When taken, they cover the ulcer with a protective layer, that is, they serve as a kind of liquid bandage.

If the ulcer is bleeding, surgery will be required. Doctors will insert a special probe into the stomach and use it to clamp the edges of the wound or cauterize it to stop the bleeding.

What to do to prevent stomach ulcers

Guarantee. that an ulcer will definitely not arise, it is impossible. But you can reduce the risks. Here are some easy ways.

• Avoid taking pain medications (NSAIDs) unless absolutely necessary.
• If you need to bring down the temperature or reduce the pain, choose the smallest effective dosage of NSAIDs. Which one is written in the instructions.
• Take NSAIDs with meals.
• Discuss with your physician which pain reliever is the safest for you. You may find an alternative to non-steroidal anti-inflammatory drugs.
• Quit smoking.
• Limit your alcohol intake.

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• Gastritis: is it possible to eat dry food and not get sick?0038
• What is heartburn and how to get rid of it
• Why gallstones appear and how to get rid of them
• Food for a healthy stomach
• Where does bad breath come from and how to get rid of it

Stomach ulcer, duodenal ulcer, diagnosis and treatment

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Stomach and duodenal ulcers.

Ulcer is a long-term non-healing deep defect in the wall of the stomach or duodenum. Most often, ulcers form in patients with an increased acid-forming function of the stomach and a long stay (persistence) of bacteria in it Helycobacter pylori .

Normally, the gastric mucosa has an amazing property – the ability to protect itself from the aggressive action of hydrochloric acid, which is produced by special glands of the gastric mucosa for successful digestion. When the protective properties of the gastric mucosa are weakened, the pathogenic “tandem” of Helycobacter pylori bacteria and acidic gastric juice play a decisive role, chronic inflammation of the mucous membrane occurs and then an ulcer forms. The protective properties of the gastric mucosa can also weaken from prolonged smoking, alcohol abuse, emotional overload, long-term daily intake of certain medications (for example, aspirin and its derivatives).

Such ulcers, with proper therapy and the abolition of the provoking factor, respond well to treatment.
Not the last role in the formation of ulcers is played by genetic prerequisites: for example, duodenal ulcers often occur in people with the first blood group, gastric ulcers – with the second.

Peptic ulcer is a common disease, more often it has a seasonal character, periods of remission (clinical calm) are replaced by exacerbations that occur in autumn and spring.
Of course, gastroenterologists are interested in ulcers for a reason: long-term ulcers are dangerous due to complications. For example, when ulcers heal in the duodenal bulb, dense scars form on its walls, and if there are many of them, they narrow the intestinal lumen, causing food stagnation. This state is called stenosis. A long-term ulcer may be complicated by bleeding from a vessel located in its bottom. This is a life-threatening complication that requires immediate medical attention: first, they try to stop the bleeding with the help of an endoscope and a special set of tools, if these attempts fail, the patient undergoes an abdominal operation.
An ulcer is a defect in the wall of an organ. The deeper the defect, the more likely the danger of perforation (breakthrough) of the wall of this organ. This complication of peptic ulcer disease is treated only surgically and is also life-threatening.
Stomach ulcers, unlike duodenal ulcers, with their long-term uncontrolled existence, can become malignant (stomach cancer) and therefore require careful monitoring and competent treatment.
To detect gastric and duodenal ulcers, endoscopic examination is performed: esophagogastroduodenoscopy, video endoscopy. If an ulcer is detected during an endoscopic examination, then to clarify its boundaries, chromogastroscopy is performed – staining with vital (harmless) dyes, express testing for Helycobacter pylori is performed, and the study is completed with a biopsy from the edges of the ulcer.
If an ulcer is detected on time, the cause of its occurrence is correctly determined (for example, a stress ulcer, or an ulcer caused by the bacterium Helycobacter pylori) – with well-chosen therapy, ulcers are successfully treated in 12-20 days, depending on their location and depth.

Gastritis — inflammation of the gastric mucosa in response to injury. There are several different forms of gastritis.

Acute gastritis

occurs most often when exposed to stress factors: severe emotional overload, after surgical interventions, in severe patients with liver and kidney failure, when exposed to caustic alkalis and acids and certain drugs (non-steroidal anti-inflammatory drugs).

When exposed to aggressive agents, the gastric mucosa becomes inflamed, and defects can form on it: acute erosions. They are found when performing esophagogastroduodenoscopy, video endoscopy. With adequate treatment, they disappear in 10-12 days. However, without proper treatment, there is a risk of complications – bleeding from erosions, then their bottom turns black, and the patient’s stool also becomes black if the bleeding is significant.

Chronic gastritis

develops gradually and may last for years.

Various factors lead to its development. Perhaps the most famous and discussed now by all physicians in the world is a microorganism (bacterium), which bears the Latin name Helycobacter pylori . This microorganism has “adapted” to living in the hydrochloric acid of the stomach, which neutralizes most microorganisms. The fact is that when it enters the stomach, Helicobacter secretes the substance urease, thanks to which it is able to exist in an acidic environment. With the help of flagella, which this bacterium is equipped with, it penetrates through the protective layer of the mucus of the stomach, “sticks” to its mucous membrane, partially even penetrates into its depth, and multiplies intensively. In the gastric mucosa, the process of inflammation begins, leading to the formation of chronic erosions, ulcers, atrophic gastritis, and metaplasia.
Long-term existence of this microorganism in the stomach and duodenum can lead to the development of severe complications – gastric tumors belonging to the group of lymphomas (MALT-lymphomas). Helycobacter pylori is recognized by the World Health Organization (WHO) Expert Group as a carcinogen (causing cancer), especially if it is present in the stomach and duodenum in adults from childhood.
Detect this bacterium using various tests. One of the most convenient and quickest is gastroscopy with express testing for Helycobacter pylori. To do this, during a conventional gastroscopy, a small fragment is taken from the gastric mucosa with a special tool, which is placed on an indicator disk. When a blue color appears (the presence of urease), the test is recognized as positive and the patient is prescribed a course of treatment, which includes drugs that destroy Helicobacter pylori.

Chronic erosions – defects in the mucous membrane, which look like rounded raised areas with a depression in the center. Usually there are several. Most often, chronic erosive gastritis is caused by the presence of Helycobacter pylori bacteria in the stomach, long-term use of certain drugs (for example, aspirin and its derivatives), and constant reflux of bile from the duodenum into the stomach.

Reflux gastritis — inflammation of the gastric mucosa in response to its constant irritation by bile components. Normally, bile is not thrown into the stomach. Such reflux (reflux) often occurs after removal of the gallbladder, in patients with a weak evacuation (contractile) function of the stomach and duodenum.

Atrophic gastritis

With a long-term inflammation in the gastric mucosa, in some of its small and then large areas, foci

of atrophy appear (ATROPHY – a decrease in the size of an organ or tissue with a violation (cessation) of their functions). Atrophic foci are often found in the elderly. In non-elderly patients, an undoubted decisive factor in the formation of atrophic foci is prolonged inflammation, especially caused by the bacterium Helycobacter pylori. In the foci of atrophy, the process of intestinal metaplasia can begin. In this case, the normal mucous membrane of the stomach is replaced in some places by the intestinal one. The process of appearance of intestinal metaplasia is the initial stage of the process, which can lead to the formation of a malignant tumor. Foci of metaplasia are found when examining the gastric mucosa in special light filters (NBI), which are equipped with Japanese-made high-resolution endoscopes, a biopsy of the area suspicious of metaplasia is performed. With a large extent of the lesion, the patient is shown observation.
In some patients, in whom atrophy occupies the mucous membrane of almost the entire stomach, antibodies to the own mucous membrane of the stomach are found in the body. When eating, the absorption of many vital substances is disrupted, including vitamin B-12, which is responsible for proper blood formation. These patients develop a severe form of anemia called B-12 deficiency anemia.
Esophagogastroduodenoscopy is of decisive importance in the diagnosis of atrophic gastritis 0180 with biopsy.

Duodenitis

– inflammation of the duodenal mucosa, may be the initial stage of duodenal ulcer formation.

It occurs for various reasons, the most common of which is the long-term presence of a microorganism (bacteria) Helycobacter pylori in the lumen of the duodenum.
Other bacteria, giardia, helminths can also cause inflammation of the mucous membrane of the duodenum. Duodenitis may be associated with problems in the biliary system. Diagnosis is made after performing gastroscopy with rapid testing for Helycobacter pylori. If the test is positive, the patient is prescribed a course of treatment, which includes antibiotics.

Tumors of the stomach

Gastric polyps are benign neoplasms of the gastric mucosa, so named for their round, protruding shape. By their nature, polyps are different: for example, hyperplastic polyps, adenomas. Hyperplastic polyps are the most benign neoplasms, they appear most often in those places where, in response to inflammation (gastritis), regeneration processes outstrip normal tissue growth. Such polyps rarely degenerate into malignant ones. The exceptions are the zones of the stomach and esophagus, which are constantly injured by food (for example, the narrow transition zones of the esophagus into the stomach or the stomach into the duodenum). Polyps of large sizes, polyps on a wide and short stalk are reborn more often.

Gastric adenomas (adenomatous polyps) are true tumors (benign) of the gastric mucosa. These polyps are considered dangerous in terms of oncology, in the sections of these polyps there is always an atypical (altered) mucosa to one degree or another.
What to do with polyps? Polyps are found most often by chance during videogastroscopy, gastroscopy. First, a detailed examination of the polyp is carried out, photographs are taken, then a piece of the polyp is taken with the help of special miniature tweezers for a special study of its tissues (biopsy).
Large polyps, adenomas, polyps of “dangerous” localizations are considered dangerous and, accordingly, expedient for removal. In general, it is better to get rid of a polyp in time, like a headache, than to constantly think about what it will turn into. Removal of a polyp (endoscopic polypectomy) is performed during a conventional gastroscopy using a special set of tools, often on an outpatient basis. An ulcer is formed at the site of the removed polyp, which heals within 7-20 days.

Leiomyomas are benign tumors that originate from the muscular layer of the stomach. Sometimes they reach a gigantic size and may have an ulceration (ulcer) on the surface. They are easily detected by gastroscopy. Leiomyomas are usually observed, with their rapid growth, they are surgically removed.

Aberrant (additional) pancreatic lobule is an anomaly in the development of the pancreas in the form of a small accumulation of its tissue with its own excretory duct. It can be located in the abdominal cavity outside the usual gland, for example. in the wall of the stomach, small intestine, liver, spleen capsule, etc. In the lumen of the stomach, it looks like a small “crater-like” neoplasm with a depression in the center, which is found in the outlet section of the stomach. Does not require treatment except in cases of acute inflammation.

Stomach cancer

What is a malignant tumor?

To put it simply, it is a tumor that consists of body cells that have undergone transformation, or malignant transformation. Malignant cells differ from normal cells in their atypical structure, they divide rapidly and uncontrollably, forming tumor nodes and screenings (metastases) in the lymph nodes and many vital human organs – the liver, brain, lungs, bones.
Stomach cancer is an extremely common disease. In 2000, 48,300 patients with stomach cancer were diagnosed in Russia alone.
Why do malignant tumors appear? What causes the normal cells of the mucous membrane that covers the stomach from the inside to change and become cancerous?
There are several of the most well-studied causes that most often lead to stomach cancer. The main conditions that can lead to the development of gastric cancer are atrophic gastritis, chronic ulcers, long-term infection with Helycobacter pylori, an operated stomach, gastric polyps, and the presence of gastric cancer in relatives. All these causes can cause the cells of the stomach to change. Before becoming malignant, a cell of the gastric epithelium undergoes a series of changes, under the influence of which it is less and less like a normal cell.

Smoking, excessive consumption of salty, overcooked foods, animal fats, marinades in salted, smoked

and canned foods play an important role in the formation of stomach cancer (salts and marinades may contain
various carcinogenic substances, namely nitrosamines and their precursors – nitrates and nitrites).
Testing is required to diagnose and stage stomach cancer. The greatest information about the spread of cancer in the gastric mucosa is given by gastroscopy with a biopsy. In the event that a tumor is detected during the examination, it can be accurately assumed whether this neoplasm is benign or malignant.
Modern video endoscopes have a high resolution, allowing
to examine tissues with high magnification.

What is done with malignant tumors of the stomach?

The answer is simple: they perform a cavity (wide) surgical operation. Is it for all patients? Yes, to all patients, except for those for whom it is contraindicated (for example, very elderly patients, patients with severe concomitant diseases, etc.). Is it possible to get rid of cancer without surgery?

The exception is small malignant tumors, which are called “early cancer”. Early cancer (Japan Society of Gastrointestinal Endoscopy) is a small tumor that is limited to the mucous membrane or submucosal layer, regardless of the presence or absence of metastases to regional lymph nodes. In order to find out how much the tumor grows into the wall of the stomach, the patient is performed endosonography (endoscopic ultrasound), and the patient is carefully examined to search for metastases (screenings).