Peptic Ulcer Disease, Causes, Symptoms, Treatment, Prevention, Diet And Nutrition!

Understanding Peptic Ulcer, Causes, Symptoms, And Prevention:

What Is Peptic Ulcer?

 

A. How do NSAIDs cause a peptic ulcer?

To understand how NSAIDs cause peptic ulcer disease, it is important to understand how NSAIDs work. Nonsteroidal anti-inflammatory drugs reduce pain, fever, and inflammation, or swelling. Everyone has two enzymes that produce chemicals in your body’s cells that promote pain, inflammation, and fever. NSAIDs work by blocking or reducing the amount of these enzymes that your body makes.

However,

One of the enzymes also produces another type of chemical that protects the stomach lining from stomach acid and helps control bleeding. When NSAIDs block or reduce the amount of this enzyme in your body, they also increase your chance of developing a peptic ulcer.

B. How do H. pylori cause a peptic ulcer and peptic ulcer disease?

• H. pylori are spiral-shaped bacteria that can cause peptic ulcer disease by damaging the mucous coating that protects the lining of the stomach and duodenum.
• Once H. pylori have damaged the mucous coating, powerful stomach acid can get through to the sensitive lining.
• Together, the stomach acid and H. pylori irritate the lining of the stomach or duodenum and cause a peptic ulcer.

 

C. How do tumors from ZES cause peptic ulcers?

• Zollinger-Ellison syndrome is a rare disorder that happens when one or more tumors form in your pancreas and duodenum.
• The tumors release large amounts of gastrin, a hormone that causes your stomach to produce large amounts of acid.
• The extra acid causes peptic ulcers to form in your duodenum and in the upper intestine.

 

D. When should you call or see a doctor?

You should call or see your doctor right away if you have:

• Difficulty breathing.
• Red blood in your vomit or vomit that looks like coffee grounds.
• Feel weak or faint.
• Red blood in your stool or black stools.
• Sudden, sharp stomach pain that doesn’t go away.

 

These symptoms could be signs that a peptic ulcer has caused a more serious problem.

Diagnosis of Peptic Ulcers (Stomach Ulcers):

Your doctor will use information from your medical history, a physical exam, and tests to diagnose an ulcer and its cause. The presence of an ulcer can only be determined by looking directly at the stomach with endoscopy or an X-ray test.

Medical history:

To help diagnose a peptic ulcer, your doctor will ask you questions about your medical history, your symptoms, and the medicines you take.

Be sure to mention medicines that you take without a prescription, especially nonsteroidal anti-inflammatory drugs (NSAIDs), such as

• aspirin (Bayer Aspirin).
• ibuprofen (Motrin, Advil).
• naproxen (Aleve).

 

1. Physical Exam:

A physical exam may help a doctor diagnose a peptic ulcer. During a physical exam, a doctor most often

• Checks for bloating in your abdomen.
• Listens to sounds within your abdomen using a stethoscope.
• Taps on your abdomen checking for tenderness or pain.

 

2. Lab tests:

To see if you have a Helicobacter pylori (H. pylori) infection, your doctor will order these tests:

• Blood test:
  • A blood test involves drawing a sample of your blood at your doctor’s office or a commercial facility.
  • A health care professional tests the blood sample to see if the results fall within the normal range for different disorders or infections.

 

• Urea breath test:
  • For a urea breath test, you will drink a special liquid that contains urea, a waste product that your body makes as it breaks down protein.
  • If H. pylori are present, the bacteria will change this waste product into carbon dioxide-a harmless gas.
  • Carbon dioxide normally appears in your breath when you exhale.

 

A health care professional will take a sample of your breath by having you breathe into a bag at your doctor’s office or at a lab. He or she then sends your breath sample to a lab for testing. If your breath sample has higher levels of carbon dioxide than normal, you have H. pylori in your stomach or small intestine.

• Stool test:
  • Doctors use a stool test to study a sample of your stool. A doctor will give you a container for catching and storing your stool at home.
  • You return the sample to the doctor or a commercial facility, who then sends it to a lab for analysis.
  • Stool tests can show the presence of H. pylori.

4. Upper gastrointestinal (GI) endoscopy and biopsy:

In an upper GI endoscopy, a gastroenterologist, surgeon, or other trained health care professional uses an endoscope to see inside your upper GI tract. This procedure takes place at a hospital or an outpatient center.

• An intravenous (IV) needle will be placed in your arm to provide a sedative.
• Sedatives help you stay relaxed and comfortable during the procedure.
• In some cases, the procedure can be performed without sedation.
• You will be given a liquid anesthetic to gargle or spray an anesthetic on the back of your throat.
• The doctor will carefully feed the endoscope down your esophagus and into your stomach and duodenum.
• A small camera mounted on the endoscope sends a video image to a monitor, allowing close examination of the lining of your upper GI tract.
• The endoscope pumps air into your stomach and duodenum, making them easier to see.

 

The doctor may perform a biopsy with the endoscope by taking a small piece of tissue from the lining of your esophagus. You won’t feel the biopsy. A pathologist examines the tissue in a lab.

5. Upper GI series:

An upper GI series looks at the shape of your upper GI tract. An x-ray technician performs this test at a hospital or an outpatient center. A radiologist reads and reports on the x-ray images.

• You don’t need anesthesia.
• A health care professional will tell you how to prepare for the procedure, including when to stop eating and drinking.
• During the procedure,
  • you’ll stand or sit in front of an x-ray machine and drink barium, a chalky liquid. Barium coats your esophagus, stomach, and small intestine so your doctor can see the shapes of these organs more clearly on x-rays.
  • You may have bloating and nausea for a short time after the test.
  • For several days afterward, you may have white or light-colored stools from the barium.
  • A health care professional will give you instructions about eating and drinking after the test.

6. Computerized tomography (CT) scan:

A CT scan uses a combination of x-rays and computer technology to create images. For a CT scan, a health care professional may give you a solution to drink and an injection of a special dye, which doctors call contrast medium.

• You’ll lie on a table that slides into a tunnel-shaped device that takes the x-rays.
• An x-ray technician performs the procedure in an outpatient center or a hospital, and a radiologist interprets the images. You don’t need anesthesia.
• CT scans can help diagnose a peptic ulcer that has created a hole in the wall of your stomach or small intestine.

Pectic Ulcer Treatment Options:

There are several types of medicines used to treat peptic ulcers. Your doctor will decide the best treatment based on the cause of your peptic ulcer.

NSAID-induced peptic ulcer Treatment:

How do doctors treat an NSAID-induced peptic ulcer?

If NSAIDs are causing your peptic ulcer and you don’t have an H. pylori infection, your doctor may tell you to

• Stop taking the NSAID.
• To reduce how much of the NSAID you take.
• The switch to another medicine that won’t cause a peptic ulcer.

 

Your doctor may also prescribe medicines to reduce stomach acid and coat and protect your peptic ulcer. Proton pump inhibitors (PPIs), histamine receptor blockers, and protectants can help relieve pain and help your ulcer heal.

I. PPIs:

Reduce stomach acid and protect the lining of your stomach and duodenum. While PPIs can’t kill H. pylori, they do help fight the H. pylori infection. PPIs include:

• Esomeprazole (Nexium).
• Dexlansoprazole (Dexilant).
• Lansoprazole (Prevacid).
• Omeprazole (Prilosec, Zegerid).
• Pantoprazole (Protonix).
• Rabeprazole (AcipHex).

 

II. Histamine receptor blockers:

Work by blocking histamine, a chemical in your body that signals your stomach to produce acid. Histamine receptor blockers include:

• Cimetidine (Tagamet).
• Famotidine (Pepcid).
• Ranitidine (Zantac).
• Nizatidine (Axid) Protectants.

 

III. Protectants:

• Protectants coat ulcers and protect them against acid and enzymes so that healing can occur. Doctors only prescribe one protectant—sucralfate (Carafate) —for peptic ulcer disease.
• Tell your doctor if the medicines make you feel sick or dizzy or cause diarrhea or headaches. Your doctor can change your medicines.
• If you smoke, quit. You also should avoid alcohol. Drinking alcohol and smoking slows the healing of a peptic ulcer and can make it worse.

 

If You,

A. Take NSAIDs for other conditions, such as arthritis:

• You should talk with your doctor about the benefits and risks of using NSAIDs.
• Your doctor:
  • Can help you determine how to continue using an NSAID safely after your peptic ulcer symptoms go away.
  • May prescribe a medicine used to prevent NSAID-induced ulcers called Misoprostol.

 

B. Have an H. pylori infection,

a doctor will treat your NSAID-induced peptic ulcer with PPIs or histamine receptor blockers and other medicines, such as antibiotics, bismuth sub-salicylates, or antacids.

PPIs reduce stomach acid and protect the lining of your stomach and duodenum. While PPIs can’t kill H. pylori, they do help fight the H. pylori infection.

How do doctors treat an H.pylori-induced peptic ulcer?

Doctors may prescribe triple therapy, quadruple therapy, or sequential therapy to treat anH. pylori-induced peptic ulcer.

1. Triple therapy:

For triple therapy, your doctor will prescribe that you take the following for 7 to 14 days:

• Antibiotic clarithromycin.
• A PPI.
• Antibiotic metronidazole or the antibiotic amoxicillin.

2. Quadruple therapy:

For quadruple therapy, your doctor will prescribe that you take the following for 14 days:

• a PPI.
• bismuth subsalicylate.
• the antibiotics tetracycline, and metronidazole

 

Doctors prescribe quadruple therapy to treat patients who:

• Can’t take amoxicillin because of an allergy to penicillin. Penicillin and amoxicillin are similar.
• Have previously received a macrolide antibiotic, such as clarithromycin.
• Are still infected with H. pylori after triple therapy treatment.
• Doctors prescribe quadruple therapy after the first treatment has failed.
• In the second round of treatment, the doctor may prescribe different antibiotics than those that he or she prescribed the first time.

3. Sequential therapy:

For sequential therapy, your doctor will prescribe that you take the following for 5 days:

• A PPI.
• Amoxicillin.

 

Then the doctor will prescribe you the following for another 5 days:

• A PPI.
• Clarithromycin.
• The antibiotic tinidazole.

 

Triple therapy, quadruple therapy, and sequential therapy may cause nausea and other side effects, including:

• An altered sense of taste
• Darkened stools
• A darkened tongue
• Diarrhea
• Headaches
• Temporary reddening of the skin when drinking alcohol
• Vaginal yeast infections

 

Talk with your doctor about any side effects that bother you. He/ she may prescribe you other medicines.

How do doctors treat peptic ulcers caused by ZES?

Doctors use medicines, surgery, and chemotherapy to treat Zollinger-Ellison syndrome.

What if a peptic ulcer doesn’t heal?

Most often, medicines heal a peptic ulcer. If an H. pylori infection caused your peptic ulcer, you should

• Finish all of your antibiotics and take any other medicines your doctor prescribes.
• The infection and peptic ulcer will heal only if you take all medicines as your doctor prescribes.

 

When you have finished your medicines, your doctor,

• May do another breath or stool test in 4 weeks or more to be sure the H. pylori infection is gone.
• Sometimes, H. pylori bacteria are still present, even after you have taken all the medicines correctly.
• If the infection is still present, your peptic ulcer could return or, rarely, stomach cancer could develop.
• Your doctor will prescribe different antibiotics to get rid of the infection and cure your peptic ulcer.

Can a peptic ulcer come back?

Yes, a peptic ulcer can come back. If you smoke or take NSAIDs, peptic ulcers are more likely to come back. If you need to take an NSAID, your doctor may switch you to a different medicine or add medicines to help prevent a peptic ulcer. Peptic ulcer disease can return, even if you have been careful to reduce your risk.

How can You prevent a peptic ulcer?

To help prevent a peptic ulcer caused by NSAIDs, ask your doctor if you should

• Stop using NSAIDs.
• Take,
  • NSAIDs with a meal if you still need NSAIDs.
  • A lower dose of NSAIDs.
  • Medicines to protect your stomach and duodenum while taking NSAIDs.
• switch to a medicine that won’t cause ulcers.

 

To help prevent a peptic ulcer caused by H. pylori, your doctor may recommend that you avoid drinking alcohol.

Eating, Diet, And Nutrition for Peptic Ulcers (Stomach Ulcers)

 

Fitting in with family meals:

Special cooking can be avoided if the diet is made the basis of family meals. The family can have whole vegetables while the patient has the same vegetables pureed. For this reason, it is extremely useful to have a blender or food mill.

• As ulcer sufferers cannot have highly seasoned or spiced food, these can be added to other portions after the patient’s portion has been removed from the dish.
• The way food is cooked is very important too. Frying is forbidden because it makes food indigestible and hot fat contains a substance call acrolein which irritates the lining of the intestine.
• Some ulcer sufferers can be made ill by the very smell of deep fat frying, so it is better to cut this out altogether.
• Grilling and baking are healthy substitutes for frying and will improve family health too.
• Poaching, boiling baking, stewing, and roasting (but not in fat, as in roast potatoes) are all good methods.
• Gravies should be strained and skimmed with fat.
• Try to keep away from onions and herbs as they can cause pain.

 

Emergency Foods:

For the times when the ulcer is causing particular suffering (usually if the patient is worried or under stress), sieved baby foods and rosehip syrup are excellent standbys.

A Typical Day:

As already stated, one of the most important things about this diet is that food should be taken frequently.

Here is a typical meal pattern:

• On Waking: weak tea.
• Breakfast: lightly boiled egg, well-grilled bacon, grilled fish, scrambled or poached egg. Tea.
• Mid-morning: milky drink and plain biscuit or cake.
• Lunch: meat or fish or poultry with allowed vegetables or sweets.
• Tea: weak tea, plain cake, sandwiches, or bread and butter with preserves.
• Evening: meat, fish, egg, or cheese dish with allowed vegetables. An alternative is a soup with
• Sandwiches. Also a milk pudding.
• Bedtime: milk drink.
• If work commitments make this kind of regime difficult, carry plain biscuits or malted milk tablets.

 

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Disclaimer: “Nothing in this article makes any claim to offer cures or treatment of any disease or illness. If you are sick please consult with your doctor.”

Sources

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