Ulcer is tissue loss that occurs as a result of destruction of the stomach or duodenum (duodenum) by stomach acid and digestive juices (eg pepsin). Tissue loss can go deeper with the effect of acid pepsin. It creates a wound, which we call inflammation.
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What is the cause of the ulcer?
The biggest cause is a microbe called “Helicobacter pylori” and regular NSAID drugs (aspirin, antirheumatic drugs) intake. Other possible causes include genetic predisposition (heredity), all kinds of stress, cortisone type drugs, alcohol, smoking, coffee habit, environmental pollution.
In which age range is ulcer most common?
The percentage of patients with existing ulcers (new or past) at any time in our society is 2-6%. Duedenal (duodenal) ulcer is much more common than gastric ulcer. Duedenal ulcer is more common between the ages of 30-50, and it is 2-4 times more common in men than in women. Gastric ulcer is more common after the age of 60 and is more common in women.
What are the symptoms of ulcer?
The most common symptom is a gnawing and burning pain in the upper part of the abdomen. It usually occurs between meals. It can wake the patient from sleep at night (mostly in duodenal ulcer). Pain is relieved in a few minutes to a few hours with meals and chewable tablets and lozenges that neutralize stomach acid, which we call antacids. The frequency of pain increases in autumn and spring. Symptoms that occur less frequently 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 ulcer?
Ulcers are the most common cause of upper gastrointestinal bleeding. Sometimes it can be seen even in people who have never had stomach pain before. These individuals vomit “coffee grounds” colored material or defecate “tar-coloured” black stools. People who realize that their stools are black without any other symptoms should definitely apply to a health institution immediately. Upper gastrointestinal bleeding should be suspected in case of sudden malaise, cold sweats before vomiting and black stools.
PERFORATION (STOMACH PERFORATION)
It is the increase in the depth of the existing ulcer and its perforation by passing all the stomach-duedenum layers. As a result of the stomach acid-pepsin content passing into the abdominal cavity, a sudden and severe pain occurs. The abdomen becomes stiff like a plank, and fidgeting and walking become difficult due to pain. Treatment is usually with surgery.
Especially in the duodenum and pyloric duct, acute ulcer causes tissue edema (swelling), and because of the formation of scar tissue as a result of long-term deep ulcers, it causes narrowing (stenosis) or even obstruction of the passage of food, drink and gastric juice. The patient vomits the material that accumulates in the stomach and cannot move forward as a result of the continuous secretion of gastric juice. Vomiting is profuse and continuous. Even if the patient eats, since the food cannot pass to the organs without being digested (digestion-absorption-not in the stomach, but in the duodenum and small intestine), there is constant weight loss. The diagnosis should be made and operated as soon as possible. How is the diagnosis of ulcer made?
On physical examination and ultrasound, the ulcer does not show any signs. But it gives us a chance to rule out other diseases. Many doctors prescribe acid-blocking medication, suggesting that there is no improvement in symptoms after 2 weeks of taking the medication (from treatment to diagnosis). There are practically no other diagnoses anyway. For the diagnosis of ulcer, radiological examination of the upper digestive system or upper digestive system endoscopy (esophagogastroduedenoscopy) is required.
STOMACH – DUEDENUM X-RAY
By drinking barium, the anatomical structure of the stomach and duodenum line is observed during the passage of barium from the stomach.
It is the direct visualization of the esophagus, stomach and duodenum with a small, lighted, bendable tube. Nearly every part of the organs that need to be seen can be observed clearly. The procedure is usually done by giving the patient a medication to calm them down. During the procedure, biopsy can be taken for pathological examination and urease test. A biopsy does not cause any discomfort or pain.
In the past, it was said that spicy, bitter, sour, pickles, fatty and acidic foods should be avoided and milk treatment was given. Today, there is no special diet for ulcers, and even the consumption of milk before going to bed at night can be harmful. Experiments have shown that a special diet does not contribute to healing ulcers. Currently, it is said that the food item that is thought to cause his personal complaint should be restricted. (For example, if a person with an ulcer does not touch onion, there is no harm in eating it). However, the ulcer patient should quit smoking (if he smokes a lot). It has been shown that smoking delays ulcer healing and causes frequent ulcer mixes. Generally, ulcer patients should not take aspirin and similar rheumatism drugs. Alcohol intake can lead to gastritis and delayed ulcer healing by disrupting the superficial mucosal resistance.
The drugs used in the treatment of gastroesophageal reflux and ulcer are H2 receptor blockers (Ranitidine, Famotidine, Nizatidine) and proton pump inhibitors (omeprozole, lansoprol). They relieve symptoms by reducing stomach acids. They also provide healing by eliminating the effect of stomach acid on the ulcer. Protein pump inhibitors are more potent at reducing acidity than H2 receptor blockers. However, they are more expensive. In patients with Helicobacter pylori, protein pump inhibitors are effective in eradicating Helicobacter pylori together with the antibiotics used.
Many ulcers heal with medication. If bleeding, stenosis (constriction-occlusion), perforation occurs, does not respond to medical treatment, urgent surgery is required.
What is Helicobacter pylori?
Many ulcers are caused by the presence of the microbe Helicobacter pylori. Presence of Helicobacter pylori in duedenal ulcers was found to be high, nearly 100%. Due to the presence of people with Helicobacter pylori but no ulcer, it suggests that there must be other factors (eg heredity) besides the presence of Helicobacter pylori. It is certain that the presence of Helicobacter pylori causes chronic gastritis, except that it causes ulcers. It is also claimed to cause stomach cancers.