Peptic Ulcer Disease (stomach ulcers)

Definition

It is simply defined as an ulcer (wound) in the internal lining of the stomach or the first part of the intestines (Duodenum).

When the ulcer is in the stomach, it is called Gastric Ulcer (GU). When in the Duodenum, it is called Duodenal ulcer (DU).

Causes

There are many causes of Peptic Ulcer Disease but can be grouped as follows:

• Infection: Helicobacter Pylori (Bacteria) is the only known infection that causes Peptic Ulcer Disease
• Chemicals: Strong Chemicals such as alcohol can cause Erosion of the stomach lining
• Drugs: Certain Medications such as those that belong to a class of drugs called NSAIDs, which are used to treat inflammation and Arthritis are known to cause Ulcers. Examples include Aspirin, Ibuprofen, Diclofenac, Indomethacin, Naproxen, etc.

People At Risk

Some people are at more risk of developing ulcers based on the above mentioned Causes:

1. Alcohol users and smokers: Remember alcohol is a strong chemical that erodes the stomach lining.
2. Obese/Overweight: the excess fat in the central abdomen pushes stomach acid to higher levels than normal
3. Those taking NSAIDs for a long time, eg Arthritis patients.

* Spicy Foods, chilli Pepper and acidic drinks (Carbonated drinks) DO NOT Cause Peptic Ulcer Disease, But they provoke symptoms in someone who has the Ulcers.

Symptoms

Symptoms differ from one person to another, but there are common symptoms which are classical of Peptic Ulcer Disease:

1. Dull aching pain below Breast Bone (Sternum) in the epigastric region
2. Pain associated with meals (worse when hungry), can sometimes be felt as hurtburn and may radiate to the back when lying down.
3. It usually wakes the person at night or in thr early hours of the morning.
4. Other symptoms: Vomiting brown/reddish puke, chest pain, excessive saliva in the morning.

Treatment

Treatment requires a multi-disciplinary approach and is mostly based on causes.

• We treat possible infection with antibiotics such as Amoxicillin, Metronidazole, and Azithromycin.
• Acid Suppressing Over-The-Counter (OTC) Antacids. The active ingredient is usually Alluminium Hydroxide,Magnesium Hydroxide or a combination (Myogel) .
• If the cause is NSAIDs then the patient is advised to stop taking them and an alternative is used.