Gastric ulcer is a chronic relapsing disease that occurs with alternating periods of exacerbation and remission, the main symptom of which is the formation of a defect (ulcer) in the wall of the stomach and duodenum.
An ulcer differs from erosion of the stomach and intestines in that it penetrates deeper into the wall – into the layers under the mucous membrane. The prevalence of peptic ulcer among the adult population is in different countries from 5 to 15% (approximately 7-10%).
Duodenal ulcers are 4 times more common than gastric ulcers. Among patients with duodenal ulcers, men significantly predominate over women, while among patients with gastric ulcers, the ratio of men and women is approximately the same.
The main morphological substrate of the disease is an ulcer – a defect in the mucous membrane of the stomach or duodenum, the appearance of which most experts associate with the aggressive action of gastric juice (primarily hydrochloric acid and pepsin). Most ulcers rarely exceed 1 cm in size.
Causes of gastric ulcer formation
Currently, the main reasons for the development of gastric and duodenal ulcers, experts include:
- bacterium Helicobacter pylori (H. pylori);
- regular intake of non-steroidal anti-inflammatory products such as aspirin, ibuprofen, indomethacin, diclofenac;
- poor quality food;
- diet violations;
- intake of alcoholic beverages;
- heredity plays a role.
- Symptoms of peptic ulcer
The most characteristic manifestation of peptic ulcer disease is pain in the upper abdomen (“in the pit of the stomach”), which often occurs on an empty stomach, i.e. between meals. Pain can also occur at night, causing the patient to wake up and take food or drugs (which either destroy the secretion of hydrochloric acid in the stomach, or neutralize it – the so-called antacids). Pain usually subsides in the first 30 minutes. after eating or taking the named products.
Less specific, but common in peptic ulcer symptoms are nausea, heaviness after eating, a feeling of fullness in the stomach, rarely bringing relief vomiting, loss of appetite, body weight, heartburn.
The most accurate method for diagnosing an ulcer in the stomach or duodenum is endoscopic examination (fibroesophagogastroduodenoscopy). The method not only allows you to “see” the ulcer, but also, having received a piece of mucous from the outgoing part of the stomach (a favorite place for H. pylori colonization), to diagnose / exclude infection with this microorganism. In addition, during the endoscopic examination, local treatment of the ulcer, including bleeding control, can be performed.
With regard to routine activities, the patient with an ulcer should avoid foods that cause or increase pain (coffee, carbonated drinks, strong coffee, tea, tomatoes, and some other foods).
Smokers are advised to stop smoking, as experts have convincingly proven that smoking not only makes healing more difficult (prolongs the treatment period), but also increases the risk of recurrence (recurrence) of the ulcer.
Also, patients with ulcers should avoid taking aspirin, non-steroidal anti-inflammatory products.
Drug therapy for peptic ulcer disease (regardless of the cause – H. Pylori or non-steroidal anti-inflammatory products, aspirin) necessarily includes antisecretory products. The advantage is given to blockers of the proton pump. If the ulcer is caused by H. pylori infection, two antibacterial products are additionally prescribed, but not less than for 7 days. The choice of a specific proton pump blocker, as well as an antibiotic, is determined by what antibacterial products the patient has taken in the past (they are usually not prescribed, since there is a possibility of H. pylori resistance to them).