Definition
Peptic ulcer disease 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). If the duodenum is affected, it is called Duodenal ulcer (DU).
Causes of Peptic Ulcer
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. It is mostly found in places where there is poor hygiene as it is transmitted via the fecal-oral-route (small contamination with fecal matter in food or water).
- Chemicals: Strong Chemicals such as alcohol can cause Erosion of the stomach lining leading to development of an ulcer.
- 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:
- Alcohol users and smokers: Remember alcohol is a strong chemical that erodes the stomach lining.
- Obesity and Overweight: the excess fat in the central abdomen pushes stomach acid to higher levels than normal
- Those taking NSAIDs for a long time, eg Arthritis patients.
- Old age people
- Bedridden people are also at risk because the stomach acid is forced to go up in the stomach
Symptoms
Symptoms differ from one person to another, but there are common symptoms which are classical of Peptic Ulcer Disease:
- Dull aching pain below Breast Bone (Sternum) in the epigastric region
- Pain associated with meals (worse when hungry), can sometimes be felt as heartburn and may radiate to the back when lying down.
- It usually wakes the person at night or in early hours of the morning.
- 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 Aluminum Hydroxide, Magnesium Hydroxide or a combination (Myogel) .
- If the cause is NSAIDs then you should stop using them totally and use other forms of anti-inflammatories
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