Peptic ulcer

A Peptic ulcer is a sore that develops on the lining of the stomach or the upper part of the small intestine.

Causes of Peptic ulcer:

It is caused by an imbalance between stomach acid and the natural defenses of the stomach and duodenum.

Other causative agents of Peptic ulcer:

·       Decreased PG5

·       Increase H+

·       Stress (ICU stress)

·       H-pylori

·       HCO3-

·       NSAIDs

·       Pepsin

·       Bile acids

·       Smoking

·       Alcohol

Symptoms of Peptic ulcer:

Symptoms include

·       Burning stomach pain,

·       Feeling of fullness,

·       Bloating,

·       Nausea and vomiting.

Defensive factors for Peptic ulcer:

·       Mucous

·       Increase blood flow

·       Decrease H+

·       Increase HCO3-

·       Epithelial renewal

Etiology of Peptic ulcer:

Peptic ulcers are a common condition that affects millions of people worldwide. They are caused by an imbalance between the stomach acid and the natural defenses of the stomach and duodenum. The most common causes of Peptic ulcers are infections with the bacteria Helicobacter pylori (H. pylori) and the use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen.

Signs and symptoms of Peptic ulcer:

Symptoms of Peptic ulcers include burning stomach pain, a feeling of fullness, bloating, nausea, and vomiting. The pain is usually felt in the upper part of the abdomen, but it can also be felt in the back or chest. The pain is often relieved by eating or taking antacids, but it can also be made worse by eating or by lying down.

Clinical presentation of Peptic ulcer / diagnosis of Peptic ulcer:

Peptic ulcers are diagnosed by a combination of medical history, physical examination, and tests such as blood tests, stool tests, and endoscopy.

What is endoscopy?

Endoscopy, also known as upper gastrointestinal (GI) endoscopy, is a procedure in which a thin, flexible tube with a light and camera on the end is passed through the mouth and into the stomach and duodenum. This allows the doctor to directly view the lining of the stomach and duodenum and to take a biopsy (a small sample of tissue) if needed.

Management of Peptic ulcer:

Treatment for Peptic ulcers depends on the cause of the ulcer. If H. pylori infection is found to be the cause of the ulcer, treatment usually involves a combination of antibiotics to eliminate the bacteria and a proton pump inhibitor (PPI) or H2 blocker to reduce stomach acid. If NSAIDs are found to be the cause of the ulcer, treatment usually involves stopping the use of the NSAIDs and taking a PPI or H2 blocker to reduce stomach acid.

Pharmacotherapy for Peptic ulcer:

First line treatment of Peptic ulcer:

·       Clarithromycin

·       Amoxicillin

·       PPIs (proton pump inhibitors)

OR

If allergic to penicillin

·       PpI

·       Clarithromycin

·       Metronidazole

OR

If allergic or resistant to clarithromycin

·       PPI

·       Metronidazole

·       Tetracycline

Second line treatment of Peptic ulcer:

Quadrupled therapy of Peptic ulcer:

·       Bismuth

·       Metronidazole

·       PPIs

·       Tetracycline

Third line treatment of Peptic ulcer:

PPIs / levofloxacin / amoxicillin

OR

Quadrupled therapy.

4^th line treatment of Peptic ulcer:

Surgery

Home remedies and natural Treatment of Peptic ulcer:

Lifestyle changes can also help to prevent and treat Peptic ulcers. These include avoiding foods that irritate the ulcer, such as spicy or acidic foods, quitting smoking, and reducing stress. Stress can increase the production of stomach acid and can make existing ulcers worse.

Eating a healthy diet that is high in fruits and vegetables and low in fat can also help to prevent and treat Peptic ulcers. Fruits and vegetables are high in antioxidants and other nutrients that can help to strengthen the stomach and duodenum's natural defenses against acid. Eating smaller, more frequent meals can also help to reduce the amount of acid in the stomach.

Surgical treatment of Peptic ulcer:

Surgery may be necessary in some cases of Peptic ulcers that do not respond to other treatments. Surgery can be used to remove the ulcer, to repair any damage caused by the ulcer, or to remove a cancerous tumor if one is found.

In general, Peptic ulcers are a treatable condition that can be managed with medication, lifestyle changes, and in some cases, surgery. It is important to see a doctor if you have symptoms of a Peptic ulcer, so that the cause of the ulcer can be identified and the appropriate treatment can be started.

In addition to the above, some other important facts to consider:

·       Peptic ulcers can lead to serious complications such as bleeding, perforation, and obstruction if left untreated.

·       It is possible to have an asymptomatic ulcer, which means that the person has the ulcer but no symptoms.

·       H.pylori bacteria are responsible for the majority of stomach and duodenal ulcers.

·       Drinking alcohol and smoking increase the risk of developing Peptic ulcers.

·       If you are taking aspirin or other NSAIDs on a regular basis and