An ulcer is tissue loss caused by the destruction of the stomach or duodenum (duodenum) by stomach acid and digestive juices (for example pepsin). Tissue loss can go deeper with the effect of acid pepsin. It creates a wound that we call inflammation.
What is the cause of the ulcer?
The biggest reason is a microbe called “Helicobacter pylori” and regular NSAIDs (aspirin, antirheumatic drugs) intake. Other possible causes include genetic predisposition (inheritance), all kinds of stress, cortisone-type drugs, alcohol, smoking, coffee habit, environmental pollution.
In what age range is ulcer common?
In our society, the percentage of patients with ulcers (recent or past) at any given time is 2-6%. A duodenal (duodenal) ulcer is much more common than a gastric ulcer. Duodenal ulcer is more common between the ages of 30-50, and it is 2-4 times more in men than in women. Stomach ulcers are more common after the age of 60 and are more common in women.
What are the symptoms of an ulcer?
The most common symptom is a pain in the upper part of the abdomen in the form of gnawing and burning. It usually occurs between meals. It can wake the patient from sleep at night (mostly in duodenal ulcers). The pain is alleviated in a few minutes to a few hours with eating and with the chewable tablets and lozenges that neutralize the stomach acid, which we call an antacid. The frequency of pain increases in autumn and spring. Less common symptoms in patients with ulcers are nausea, vomiting (especially when there is pain, reduction or cessation of pain is very typical when vomiting), loss of appetite, and weight loss.
What are the dangerous consequences of an ulcer?
Ulcers are the major cause of upper digestive system bleeding. Sometimes it can be seen even in people who have never complained of stomach pain before. These people vomit “coffee grounds” colored material or “tar-colored” black stools. People who realize that their stool is black without any other symptoms should definitely apply to a health institution urgently. Before vomiting and black stools occur suddenly, upper gastrointestinal bleeding should be suspected in case of cold sweating.
PERFORATION (STOMACH PUNCHING)
It is the increase in the depth of the existing ulcer and piercing through all the stomach-duodenum layers. As a result of the passage of the stomach acid-pepsin content into the abdominal cavity, a sudden and severe pain occurs. The abdomen hardens like a wooden board, moving and walking becomes difficult due to pain. Treatment is usually by surgery.
Especially in the duodenum and pyloric canal, acute ulcer causes tissue edema (swelling) and scar tissue formation as a result of deep ulcers for a long time, causes the passage of food, drink, and gastric juice to narrow (stenosis) or even to block it. The patient vomits the material that has accumulated in the stomach and cannot go forward as a result of the continual secretion of gastric juice. Vomiting is profuse and continuous. Even if the patient eats, there is continuous weight loss since food cannot pass to organs without digestion (digestion-absorption-not stomach, duodenum, and small intestine). The diagnosis should be made as soon as possible and should be operated on. How is the diagnosis of ulcer made?
With physical examination and ultrasound, the ulcer does not show any signs. However, it gives us a chance to rule out other diseases. Many doctors prescribe acid-blocking drugs and suggest that there is no ulcer (from treatment to diagnosis) as symptoms do not improve after 2 weeks of using the drugs. There are practically no other diagnoses, anyway. Radiological examination of the upper digestive system or upper digestive system endoscopy (esophagogastroduodenoscopy) is required for the diagnosis of ulcer.
STOMACH – DUODENUM GRAPH
By drinking barium, the anatomical structure of the stomach and duodenum line is observed during the passage of barium through the stomach.
It is the direct observation of the esophagus, stomach, and duodenum with a small, lighted, coiled tube. Approximately every part of the organs to be seen can be clearly observed. The procedure is usually done by giving the patient medication to calm them down. During the procedure, a biopsy can be taken for pathological examination and urease test. The biopsy does not cause any discomfort or pain.
In the past, it was said that spicy, bitter, sour, pickled, fatty, and acidic foods should be avoided and milk treatment was given. Today, there is no special diet for ulcers, and even the milk you drink before going to bed at night may be harmful. It has been demonstrated by experiments that special diets do not contribute to ulcer healing. It is said that the foodstuff that is currently considered to cause personal complaints should be restricted. (For example, if a person with an ulcer does not eat onions, it is okay to eat them). However, the ulcer patient should quit smoking (if he/she smokes a lot). Smoking has been shown to delay ulcer healing and cause frequent ulcer mixes. Generally, patients with ulcers should not take aspirin or similar rheumatism drugs. Alcohol intake may disrupt the superficial mucosal resistance, leading to gastritis and delay in ulcer healing. It is beneficial not to be taken especially in acute ulcers.
The drugs used in the treatment of gastroesophageal reflux and ulcers are H2 receptor blockers (Ranitidine, Famotidine, Nizatidine) and proton pump inhibitors (omeprazole, lansoprazole). These relieve complaints by reducing stomach acids. In addition, they eliminate the effect of stomach acid on ulcers and provide healing. Protein pump inhibitors are more powerful at reducing acidity than H2 receptor blockers. However, they are more expensive. In patients with Helicobacter pylori, protein pump inhibitors together with antibiotics are effective in eradicating Helicobacter pylori.
Many ulcers heal with medication. If bleeding, stenosis (stenosis), perforation occurs and does not respond to medical treatment, urgent surgery is required.
What are Helicobacter pylori?
Many ulcers occur with the presence of helicobacter pylori germ. The presence of Helicobacter pylori in duodenal ulcers was found to be higher by almost 100%. Due to the presence of individuals with Helicobacter pylori but no ulcer, it suggests that there should be other factors (such as internity) besides the presence of helicobacter pylori. The presence of Helicobacter pylori is certain to cause chronic gastritis, except that it causes ulcers. It is also claimed to cause stomach cancers.
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