What are Duodenal or Peptic Ulcers?
Peptic ulcer is sore in the lining of stomach ,first part of small intestine known as duodenum.burning pain is the common symptom.Starts before or after meals,troubles more during nights.
Pain lasts for minutes to hours.suffers from days to weeks.
Peptic ulcer happens when the acids that helps to digest the food , damages the lining of stomach ,duodenum
Peptic ulcers may be acute ulcers which are shallow and multiple. Chronic ulcers are single deep ,scirrhous.
CAUSES FOR ACUTE ULCER:
- Half of the patients suffers from acute ulcers because of ingestion of aspirin,and pain killer drugs.
- Stress causes more secretion of acid and forms stress ulcer.
- After cerebral trauma and neurological operations forms cushing ulcers.this is because of higher gastrin levels.
- After suffering from major burns , ulcers forms known as curlings ulcer.
- Patients on steroids may develop acute ulcers known as steroid ulcers.
- Helicobacter pylori infection.
CAUSES FOR CHRONIC PEPTIC ULCERS:
- Diminished mucosal resistance.
- Pyloro duodenal reflux,regurgitated bile and duodenal juices causes for the formation ulcers in stomach.
- Deficient mucosal barrier:a surface layer of mucus protects from acid.when this layer is deficient ,causes ulcers.
- Anxiety Stress,Sleeplessness.
- Irregular diet ,Spicy food,Excessive drinking of tea.
- Smoking Drinking
Gastric ulcers may be acute or chronic.85 per chronic ulcers are found in lesser curvature.10 percent found in antrum,2 percent in pyloric canal, 5 per in fundus.
Acid which helps in digestion of food destroys the mucosa of the stomach forms ulcers.
These ulcers sometimes shows proliferative changes turns into carcinoma of stomach.
CAUSES FOR DUODENAL ULCERS:
- Hypersecretion of hydrochloric acid by stomch.usually it 2 times morethan the normal levels.
- Genetic factors.People who have strong family history of ulcers,persons of blood group o are apt to develop duodenal ulcers.
- endocrine organ dysfunction:over production of gastrin by pancreatic tumour condition known as ZOLLINGER ELLISON SYNDROME.cushing syndrome causes ulcers because of excessive steroid secretion.parathyroid tumour causes ulcer because of hyper calcaemia .
- Chronic Liver disease.
- Emotional factors such as anxiety depression,stress
- Irregular diet ,spicy food,excessive drinking of tea.
- Smoking ,Drinking alcohol
CLINICAL FEATURES OF ULCER AND DIFFERENCE BETWEEN GASTRIC ULCER AND DUODENAL ULCER
|Chronic Gastric Ulcer||Duodenal Ulcer|
|1.Patients are usually middle age||1.Usually young adults|
|2.More common in males.||2.Common In both sexes.|
|3.Patients look thin.||3.Patients look obese.|
|4.Periodicity is less marked.||4.Periodicity is well marked.|
|5.Pain in mid epigastrium slightly.||5.Pain in transpyloric plane To left.|
|6.Taking food aggravates the pain.||6.Taking food relieves the pain.|
|7.Pain is not felt at night||7.Pain felt at night|
|8.Vomiting is common found after food||8.Vomiting is rare unless pyloricstenosis complicates|
|9.Pt learn to avoid spicy food.||9.Any food doesn’t intiate pain so He doesn’t avoid.|
|10.Pt looses weight||10.Pt gains weight|
|11.Haematemesis is common||11.Memaena is more common|
DIAGNOSIS FOR PEPTIC ULCER:
- Upper GI Endoscopy
- Stool examination for occult stool.
- Gastric function test.
- Barium meal x ray test.
COMPLICATIONS OF PEPTIC ULCER:
- Haemorrhage.Haematesis or malena
- Perforation of Ulcer leads to peritonitis.
- Duodenal ulcer can complicate as pyloric stenosis.
- Ulcer may turn into carcinoma.
Other remedies are nux vomica, anacardium,sulphur,natrum sulph,robinea,natrumphos
NUX VOMICA: heaviness after eating food. Nausea vomiting after food.stomach is very sensitive to pressure.bloating in epigastrium.desiresspicy , fat food.desires for stimulants
NATRUM PHOS:Sour eructation,sour vomiting,greenish diarrhoea.excessive flatulence,dyspepsia.sour vomiting
PHOSPHORUS: hunger soon after eating.sour erructations after meal,loud belchings after food.throughs ingesta by mouthfuls.vomits water as soon as it gets warm in stomach.cardiac opening seems to be contracted Stomach pain is relieved by taking cold water.
ANACARDIUM:Empty feeling sensation in stomach,weak digestion with fullness distension.erructations ,nausea vomiting.eating relieves the pain.