Peptic ulcer: decoding the painful peptic ulcer disease

Mark, who is 38 years old, had recurrent complaints of abdominal pain and discomfort. Symptoms of the disease Mark had received less attention for several months before seeking help. Laboratory findings diagnosed Mark with a duodenal ulcer (a type of peptic ulcer) caused by Helicobacter pylori (H. pylori). Therefore, management with antibiotics and proton pump inhibitors was implemented. Finally, Mark could address his symptoms as they were, and because he could avoid further complications, he could take care of himself without much difficulty.

Wondering what exactly is this Peptic Ulcer? Read on. 

What is Peptic Ulcer?

A peptic ulcer is an open sore in the lining of the stomach or duodenum (the first part of the small intestine) 

To simplify, there are two major kinds: peptic ulcers; these are ulcers that happen in the stomach known as gastric ulcers, and ulcers that happen in the first part of the small intestine known as the duodenum. Peptic ulcer information is significant now more than ever because millions of people have the disease and if not treated, often results in major health issues.

Peptic ulcers are a common phenomenon in various groups of people. Authorities have indicated that Indians have a 11.22% lifetime prevalence of developing peptic ulcer at some time during their lives. The possibility of developing peptic ulcer increases with age and the prevalence of developing peptic ulcer reaches a whopping 28.8 % in the 5th decade of life in case of Indians. Generally, these ulcers comprise a common problem for those individuals aged 50 years and above but also tend to affect some younger adults. Lifestyle factors, use of some drugs, and diseases may be regarded as important contributing factors. 

Peptic Ulcer Types

 There are two main types of peptic ulcers: 

• Gastric ulcers, which appear on the inside of the stomach. 
• Duodenal ulcers, which appear on the inside of the upper part of the small intestine, called the duodenum. 

Peptic Ulcers Causes 

The general overview of the determinants of peptic ulcers can therefore help in the protocol and prevention.

• HELICOBACTER PYLORI Infection 

Helicobacter pylori (H. pylori) is a bacterium that currently infects the gastric mucosa and significantly affects the formation of most peptic ulcers . It erodes the protectant mucus layer and results in inflammation and ulcers. The treatments for this infection usually involve use of antibiotic and drugs that reduce acidity in the stomach to help in the healing process.

The great majority of peptic ulcers result from an infection by a bacterium known as — H. pylori which fails to allow the production of protective mucous in the stomach. H. pylori is responsible for the majority of peptic ulcers 

• NON STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS) 

Regular use of certain pain relievers. Taking aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) over time can irritate or inflame the lining of the stomach and small intestine. 

• Other Causes of Peptic Ulcer 

Other causes of peptic ulcers are: 

• Stress: This is not a cause but may make ulcers worse and potentially cause them in susceptible people. 
• Tobacco Smoking: There is an association made for smoking to be at least a potential risk cause for peptic ulcers 
• Alcohol Intake: Alcohol misuse leads to stomach lining irritation besides enhancement in acid production 

Peptic Ulcers Symptoms

Understanding the symptoms of peptic ulcers facilitates easier detection and, consequently, better management after diagnosis.

Symptoms 

Many people with peptic ulcers don't have symptoms. If there are symptoms, they may include: 

• Dull or burning stomach pain. For some people, pain may be worse between meals and at night. For others, it may be worse after eating. 
• Feeling of fullness or bloating. 
• Belching. 
• Heartburn. 
• Nausea. 

Peptic ulcers can cause bleeding from the ulcer. Then symptoms might include: 

• Vomiting blood, which may appear red or black. 
• Having dark blood in stools, or stools that are black or tarry. 
• Feeling dizzy or fainting. 

Also Read : Best Bloating Treatment That Works

Diagnosis of Peptic Ulcer

Accurate diagnosis is very essential for successful management. 

Diagnostic Techniques of Peptic Ulcer 

Several diagnostic tests can confirm the peptic ulcers: 

1. Endoscopy: A procedure in which a flexible catheter with a camera is passed through the mouth for an excellent view of the digestive system. 
2. Diagnostic Imaging Tests: This is an X-ray or CT test that is used to determine complications related to ulcers. 
3. Breath Tests: It entails the examination of chemical compositions in the exhaled breath that may be a feature of H. pylori infection

Why is Diagnosis Important? 

Proper diagnosis will lead to treatment directed to the root causes of peptic ulcers which are either infection or drug-induced. 

Complications of Peptic Ulcers

If left untreated, peptic ulcers may lead to severe complications below. 

Possible Peptic Ulcer Complications 

Common complications of peptic ulcers include: 

• Bleeding: As an ulcer erodes the stomach or duodenum wall, it can damage blood vessels, causing bleeding. Bleeding can be slow, leading to anemia, or severe enough to require a hospital stay or blood transfusion. Symptoms include black or bloody vomit or stools.
• Perforation: In extreme cases, an ulcer can make a hole in the stomach or duodenum, which causes digestive contents to leak into the abdominal cavity. This can lead to infection and inflammation, known as peritonitis. In peritonitis, an infection can rapidly spread into the blood (sepsis) before spreading to other organs. This carries the risk of multiple organ failure and can be fatal if left untreated.
• Obstruction: In some cases, an inflamed (swollen) or scarred stomach ulcer can stop food from going through your digestive system. This is known as gastric outlet obstruction.

Symptoms of Peptic Ulcer Complications and When to See a Doctor 

See your doctor if you're vomiting blood, having dark blood in stools or are feeling dizzy. 

Also Read : Gastritis : Decoding the Stomach Inflammation Causing Disease 

Peptic Ulcer Treatment

Peptic ulcers are treated with medications and changes in lifestyle.

Peptic Ulcer Medications 

Some of the common medications for peptic ulcers include: 

• Antacids:. Antacids neutralize gastric acid. Antacids neutralize gastric acid.
• Proton Pump Inhibitors (PPIs) These function to reduce the production of acids in the stomach. 
• Antibiotics: Antibiotics are used to treat H. pylori if it is detected 

Peptic Ulcer Lifestyle Modifications

Lifestyle modifications are also needed with treatment for peptic ulcers:

• Dietary modifications: The patient might benefit from excluding spicy foods, caffeine, and alcohol from the diet. 
• Stress management: It might get rid of some features of stress: practice yoga or meditation 
• Reduction of irritants: As with all medications, particularly NSAIDs, the prophylactic use of these drugs should be minimized as much as possible to prevent additional inflammation to the tissues.

Peptic Ulcer Surgery

In very rare scenarios if drugs do not work or complications set in, then surgical interventions might be pursued to remove portions of the stomach surgically or to correct damage from ulcers. 

Management Of Peptic Ulcer

Role of diet and nutrition 

Dieting is critical in the treatment of peptic ulcers as well as preventive measures against ulcers. By avoiding certain foods that may trigger the symptoms or supplying more healing nutrients, patients can relief the symptoms, heal and prevent further complications. Knowledge of the diets needed for the management of peptic ulcer as well as for overall gut health cannot be overemphasized.

Include these foods:

1. Dairy Products:

  Low-Fat Milk: A highly nutritious food containing calcium and Vitamin D which if taken in moderation prevents osteoporosis.

  Yogurt: Contains probiotics and aids digestion.

2. Vegetables:

- Cruciferous Vegetables: Contain high fiber, vitamin, and antioxidants. Some of the Cabbage family foods are broccoli, cauliflower, Brussels sprout, and kale.

3. Whole Grains:

  In the brown rice, quinoa, and oats group, it meets the body’s nutritional requirements and is rich in fibre content whilst maintaining energy levels.

4. Spicy Foods:

  Chili peppers, hot sauce has chances of mostly giving a metabolism boost and enhances the flavor of food potentially enhancing digestion.

5. Caffeinated Beverages:

- Coffee and Green Tea: May have alertness enhancing properties, and in moderate quantities, may have antioxidant benefits.

6. Moderate Alcohol

  - Red Wine: May be good for the heart if consumed moderately because of its antioxidant influences.

Foods to Limit or Avoid

1. High-Fat Dairy Products

  - Full-Fat Milk and Cream: Containing a considerable amount of saturated fat making it unfriendly to the heart when consumed in large amounts.

2. Starchy Vegetables:

- Potatoes and Corn: Healthier but contain slightly higher carbs; should not be taken in large amounts.

3. Refined Grains:

  Baked foods- they raise blood sugar and are not nutritious in any way.

4. Very Spicy Foods:

  Hot Foods Overdoing- This sort of foods maybe hard for some people to take due to digestion problems.

5. Too Much Caffeine:

- Energy Drinks or High amounts of Coffee: This may cause jitters and interfere with the body natural rhythms of sleep.

6. Excessive Alcohol Consumption:

  - Beer, Sugary Cocktails: High empty calorie foods also contribute to addition of weights as well as other illnesses.

Balancing Diet and Healing  

A well-balanced diet aids in recovery not only from the development of peptic ulcers but also enhances overall health, thereby minimizing the risks associated with peptic ulcers in the future.

Also Read : What to Eat and What Food to Avoid If You Have Ulcer 

Preventive Measures of Peptic Ulcer

Prevention of peptic ulcers necessitates the establishment of healthy habits.

How to Reduce the Risk 

1. Prevent or limit NSAIDs. 
2. Maintain hygiene as a measure against infection through H. pylori. 
3. Never smoke and do not indulge in excess alcohol consumption. 

Lifestyle Interventions for Health 

General sustainable health occurs through exercises and stress-related measures which significantly reduce ulcers' development. 

Peptic Ulcer : Common Misconceptions and Myths

There are several prevalent misconceptions and myths linked with peptic ulcers. 

1. Myth: Stress causes ulcers. 

- Fact: Stress worsens the symptoms but does not cause ulcers; H. pylori infection and NSAIDs are the villains.

2. Myth: Peptic ulcers are found only in old patients. 

- Fact: That is, it is a common disease in the elderly, though it can affect any age group, and the elderly are more prone to it because they tend to take NSAID drugs for chronic pains. 

3. Myth: Consuming spicy foods brings about peptic ulcers. 

- Fact: Spicy foods have nothing to do with it, and they will only exacerbate the condition for those already suffering. 

Peptic Ulcer : Conclusion

Awareness and proper care will therefore imply that people are better placed to take charge of their health outcomes in this regard. Knowing the causes of peptic ulcers followed by timely recognition of symptoms, seeking an early diagnosis, and adherence to treatment plans including lifestyle changes will give one the chance to effectively manage this condition. 

Knowledge about H. pylori infections and wise use of drugs like NSAIDs forms a great part of prevention. With appropriate care and management, life can be perfectly lived with peptic ulcer disease. 

References: 

1. Peptic Ulcer Disease. American College of Gastroenterology [Internet]. https://gi.org/topics/peptic-ulcer-disease/. Accessed Nov. 05, 2024.

2. 8 Things to Know About Peptic Ulcers. Yale Medicine[Internet]. https://www.yalemedicine.org/news/8-things-to-know-about-peptic-ulcers . Accessed Nov. 12, 2024.

4. Peptic Ulcer Disease. American Academy of Family Physicians[Internet]. https://www.aafp.org/pubs/afp/issues/2007/1001/p1005.html. Accessed Nov. 07, 2024.
5. Definition & Facts for Peptic Ulcers (Stomach or Duodenal Ulcers). National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)[Internet]. https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/definition-facts. Accessed Nov. 10, 2024.