TOWARDS A WORLD WITHOUT ULCER

Introduction

Your stomach makes a lot of acid, which helps digest food. Normally, the lining of your stomach and intestines has defenses against the acid. If something interferes with those defenses, the acid can cause damage.

An ulcer is a sore that develops on the lining of the oesophagus, stomach or small intestine.

*Occurrence*

Ulcers occur when stomach acid damages the lining of the digestive tract. Common causes include the bacteria Helicobacter pylori and anti-inflammatory pain relievers including aspirin.

It is most common in males but can affect both sexes. Also common in persons from age 19.

In Nigeria, there are more than 100 thousand cases per year.

*Types of Ulcers*

The types of Ulcers include ;

Gastric Ulcer : This occurs on the inside of the stomach most especially the linings of the stomach

Esophageal Ulcer : This occurs inside the hollow tube (esuphagus) that carries food from your throat to your stomach .

Duodenal Ulcer : This occurs on the inside of the upper portion of your small intestine (duodenal). It is a sore that forms in the linings of the duodenum

*Causes of peptic ulcers*

Different factors can cause sores to develop in the lining of the stomach. These include:

*Helicobacter pylori (H. pylori): Most people infected with H. pylori do not get ulcers. But in others, it can raise the amount of acid, break down the protective mucus layer, and irritate the digestive tract.

*Frequent use of aspirin, ibuprofen, and other anti-inflammatory drugs lower the stomach’s ability to make a protective layer of mucus. This makes it more susceptible to damage by stomach acid

*Smoking

*Drinking too much alcohol

*Radiation therapy

*Stomach cancer

*Risk Factors*

From a population based prospective cohort study comprising 2,416 Danish adults, The main risk factors for peptic ulcer were Helicobacter pylori infection, tobacco smoking, and use of minor tranquillisers. Intake of non-steroid anti-inflammatory drugs (NSAIDs) did not affect the incidence of peptic ulcer. In those with increased antibodies to Helicobacter pylori, tobacco smoking, and intake of spirits increased the risk of peptic ulcer, whereas moderate leisure time physical activity protected against peptic ulcer.

Conclusions: Tobacco smoking and Helicobacter pylori infection are the main risk factors for peptic ulcer in adults. Physical activity may protect against peptic ulcer in those infected with Helicobacter pylori.

*COMPLICATIONS OF PEPTIC ULCER*

The risk of complications increases if the ulcer is left untreated, or if treatment is not completed. These complications include:

*Internal bleeding: If a peptic ulcer develops near the site of a blood vessel, it can damage the vessel and cause bleeding. Signs of a bleeding ulcer include lightheadedness, dizziness, and black stools.

*Scar tissue: This is thick tissue that develops after an injury. This tissue makes it difficult for food to pass through your digestive tract. Signs of scar tissue include vomiting and weight loss.

*Perforation: A hole develops in the lining of the stomach. A sign of a perforated ulcer is sudden, severe abdominal pain.

Signs and symptoms of Ulcer Burning pains Fatigue Heartburn Loss of Appetite Weight loss Vomiting Nausea Bloating Burping Abdominal/body pain

*Lifestyle changes in the management of ulcer* You may find relief from ulcer pains if you do the following ; Choose a healthy diet : A healthy diet that is rich in fruits and vegetables will promote the rapid healing of ulcer Reduce the use of NSAIDs for pain relief : the use of NSAIDs such as Diclofenac , Ibuprofen , tend to worsen the cases of ulcer . Hence consult your doctor/ pharmacist to know what other pain medications you can use . Control Stress : learn to avoid things that would stress you unnecessarily . Try relaxing after work . Avoid Smoking : Smoking may interfere with the protective lining of your stomach making you more susceptible to ulcer pains . Smoking increases stomach acid. Limit / Avoid alcohol consumption: The excessive use of alcohol can irritate and erode the mucous lining of your stomach and intestine which causes inflammation and bleeding.

*Preventive measures* helpful tips to prevent or allow healing of ulcers include:

•Avoid foods that irritate your stomach. Use common sense: If it upsets your stomach when you eat it, avoid it. Everyone is different, but spicy foods, citrus fruits, and fatty foods are common irritants. •Stop smoking. Heavy smokers are more likely to develop duodenal ulcers than nonsmokers. •Practice moderation. Heavy consumption of alcohol and has been shown to contribute to the development of ulcers, so keep your intake to a minimum. •Take nonsteroidal anti-inflammatory drugs (NSAIDS including aspirin and ibuprofen) with food, as this may decrease your risk of irritating the lining of your stomach •Learn how to control your stress levels. Regular exercise and mind-body relaxation techniques (such as guided imagery and yoga or tai chi) are often helpful.

TREATMENT OF PEPTIC ULCER

Treatment depends on the underlying cause of your ulcer.

If the ulcer is due to Helicobacter pylori infection, a combination of medications will be prescribed. The medications include antibiotics* to help kill infections and proton pump inhibitors(PPIs) such as *omeprazole, rabeprazole, esomeprazole(Nexium)* to help reduce stomach acid.

*If Aspirin and other Non-steroidal anti-inflammatory drugs (NSAIDs) are behind the ulcer, you may need to cut down on them, stop taking them altogether, or switch to another pain reliever like Acetaminophen.

* Antacids which neutralize existing stomach acid and can provide rapid pain relief may also be included in the drug regimen.

NOTE: Antacids can provide symptom relief, but generally aren't used to heal your ulcer

The PDF of this article is also available for download below(3MB)

PEPTIC ULCER OVERVIEW.pdf

Download PDF • 3.74MB

By : Edward-Tobi Norbert, Usidamen Blessing and Egbeh Benedict Chidera