Peptic ulcer is a very dangerous pathology faced by people regardless of gender and age. The disease is accompanied by lesions of the gastric mucosa, the formation of ulcers and serious digestive disorders. If left untreated, the pathology leads to dangerous complications up to the violation of the integrity of the walls of the digestive tract.
Of course, many people are looking for more information about pathology. Why do ulcers appear? What symptoms should be looked out for? What treatments can modern therapy offer? Is surgery necessary for stomach ulcers? The answers to these questions are of interest to many readers.
General information about the disease
Peptic ulcer of the stomach is a pathology that is accompanied by a violation of the trophism of the mucous membrane of the organ and the further formation of small ulcers. At first, damage covers only the surface layers, butthen the pathological process spreads to deeper tissues - if left untreated, the disease can result in massive bleeding and perforation of the stomach.
According to statistics, 70% of patients are men aged 20 to 50 years. Less often, the disease manifests itself in old age. Of course, women are not immune from such a pathology either.
It is worth noting that peptic ulcer is a chronic process, which, as a rule, worsens in autumn and spring.
Main causes of pathology
According to statistics, in 75% of cases, stomach ulcers are the result of penetration into the body of Helicobacter pylori. This is a spiral bacterium that is resistant to the aggressive environment of the stomach and is able to neutralize the effects of hydrochloric acid. The activity of this pathogenic microorganism leads to damage to the cells of the gastric mucosa, and later to the formation of ulcers. The infection is transmitted through contact with the carrier, as well as through food, water, tableware, medical instruments, etc.
In addition, there are other causes of stomach ulcers.
- First of all, it is worth mentioning taking medicines. The group of potentially dangerous drugs includes non-steroidal anti-inflammatory drugs, cytostatics, antihypertensive agents and potassium preparations. Of course, in this case we are talking about long-term use of large doses of these medications. The risk of ulcers increases withif the patient is over 65.
- Peptic ulcer may be the result of other pathologies. For example, the disease often develops against the background of diabetes mellitus, pancreatitis, hepatitis, tuberculosis, cirrhosis of the liver, syphilis.
- The list of causes includes various injuries of the stomach, burns or frostbite on large surfaces of the body, shock conditions.
- There is also genetic inheritance.
- It has been proven that the likelihood of developing such an ailment is much higher in patients with the first blood type.
For one reason or another, the defense mechanisms of the stomach are weakened, as a result of which the gastric mucosa succumbs to the aggressive effects of gastric juice.
In the process of diagnosis, it is extremely important to determine what exactly caused the development of the disease - the success of therapy largely depends on this.
Peptic ulcer: risk factors
Doctors also highlight risk factors, the impact of which increases the likelihood of damage to the mucous membranes of the digestive tract.
- First of all, it is worth mentioning smoking. By the way, not only ordinary cigarettes are potentially dangerous, but also cigars and hookah mixes.
- Alcohol also irritates the stomach lining - alcohol abuse is dangerous.
- Risk factors also include the abuse of soda and drinks that contain caffeine (this is not only coffee, but also various energy drinks).
- Irregular eating, diet structure, eating too hot or,on the contrary, cold food, cakes, buns, sweets - all this negatively affects the inner walls of the stomach.
- Risk factors include frequent stress, depression, as all this affects the work of the endocrine glands.
Main symptoms of pathology
Symptoms of gastric ulcer directly depend on the stage of development. There are several very characteristic signs of the disease.
- In most cases, the first symptom of a stomach ulcer is pain. It is usually located in the upper abdomen. Pain may worsen during physical exertion, as well as after drinking alcohol, eating spicy foods, or on an empty stomach.
- The list of signs includes heartburn. It is associated with the ingress of gastric juice into the lumen of the esophagus. As a rule, an unpleasant burning sensation appears 1-2 hours after eating.
- Due to the formation of ulcers, the digestion process is disturbed, as well as the motility of the stomach. That is why patients are worried about nausea, which occurs several hours after eating. Often, an attack of nausea ends with vomiting - this greatly alleviates the condition of a person, so patients often induce vomiting on their own.
- Symptoms also include loss of appetite and belching, accompanied by a sour or bitter taste in the mouth.
- When eating, a feeling of fullness quickly comes. After eating, patients report a feeling of heaviness instomach.
- Patients also suffer from constant constipation and increased gas production.
The appearance of such disorders is a reason to see a doctor. It is impossible to ignore the symptoms, as the ulcerative process is constantly progressing.
Stages of disease development
In modern medicine, there are several stages of gastric ulcer, each of which is characterized by a certain set of symptoms.
- The first stage is considered a kind of pre-ulcerative condition. Small areas of erosion appear on the mucous membrane, but patients feel relatively normal. The symptoms of peptic ulcer disease are very mild. Relapses happen every 2-7 years.
- Second stage - here we are talking about moderate and severe form of peptic ulcer.
- Complications already present in the third stage, including bleeding and perforation.
- The fourth stage is said in the event that the patient had a relapse after a correctly performed surgical intervention.
Complications due to the disease
Complications of stomach ulcers can be extremely dangerous.
- Sometimes, against the background of the disease, penetration develops. Gradually, the wall of the stomach is destroyed, as a result of which the bottom of the ulcer becomes a nearby organ, for example, the gallbladder, pancreas, lesser omentum. Gastric juice destroys the tissues of the body. For example, if we are talking about the pancreas, then patients develop destructive pancreatitis.
- Ifthe ulcerative process extends to deeper layers, then perforation of the stomach may occur. As a result, the entire contents of the organ are poured into the abdominal cavity.
- Gastrointestinal bleeding is considered a very common complication - approximately 20% of patients with this diagnosis are accompanied by blood loss. Pathology is accompanied by sharp pains in the abdomen. The vomit looks like coffee grounds. There are also traces of blood in the stool. In the absence of timely assistance, this condition ends in the death of the patient.
- There is a possibility of malignant degeneration of tissues against the background of ulcerative lesions. According to statistics, this disease ends with stomach cancer in 3% of cases.
- Pyloric stenosis is also a dangerous complication. This pathology is accompanied by a narrowing of the pyloric part of the stomach, as a result of which food cannot move into the intestines.
That's why it's so important to see a doctor when the first symptoms appear. Complications of gastric ulcer require emergency care.
Diagnostic measures
Diagnosis of gastric ulcer includes several main steps. It is extremely important to determine the cause of the development of the disease, the area of the mucosal lesion, the presence of complications.
- First of all, the patient takes blood and urine samples for analysis. Feces are also examined for traces of occult blood.
- Mandatory is fibrogastroduodenoscopy. With the help of a specialoptical equipment, the doctor carefully examines the mucous membrane of the esophagus, stomach and duodenum. If necessary, tissue biopsy is performed during the procedure - samples are subsequently sent for laboratory analysis.
- Ultrasound of the stomach, liver, gallbladder and pancreas is also performed.
- Informative is radiography using a contrast agent.
- Sometimes additional monitoring of the pH of gastric juice is carried out. This is a rather painful study, which, nevertheless, helps to assess the acidity of gastric juice and the change in this indicator during the day.
- In addition, samples of feces and gastric mucosa (taken during a biopsy) are checked for the presence of Helicobacter pylori. A laboratory blood test is also carried out to determine the presence of antibodies to this bacterium.
Standards for the treatment of stomach ulcers
Depending on the data obtained during the diagnosis, the doctor will draw up a treatment regimen. To date, a variety of drugs are used. With gastric ulcer, it is necessary to eliminate the infection, restore the structure of the mucous membrane, and eliminate the causes of the development of the disease.
- First of all, antibiotic therapy is carried out to help get rid of Helicobacter pylori. In most cases, antibiotics of the penicillin group ("Amoxicillin"), macrolides ("Clarithromycin"), tetracyclines, as well as nitromidazole derivatives are used.
- Treatment of peptic ulcerstomach disease necessarily includes the protection of the inner surface of the organ. Drugs such as De-nol and Sucralfate help create a special protective film on the surface of the mucous membrane.
- Also, patients are prescribed Enprostil, Biogastron, Ventroxol. These funds stimulate the processes of regeneration of the mucous membranes, accelerate the healing of tissues.
- Treatment of gastric ulcer necessarily includes taking antisecretory drugs. Proton pump blockers are introduced into the therapy regimen, in particular, Rabelok, Nexium and Omez. These drugs inhibit the secretion of hydrochloric acid.
- Antacids, in particular Antareyt, Almagel, help neutralize the effects of acid, have enveloping and anti-inflammatory properties.
- Medications such as Cytotec and Misoprostol reduce hydrochloric acid secretion and also increase mucus production to protect the lining of the stomach.
- Patients are also recommended to take prokinetics - such drugs activate the motility of the digestive tract. Such drugs as Domperidone and Mltilium are considered effective.
- Anspasmodics, such as Drotaverine and No-shpa, help relieve spasm of the gastric wall and cope with pain.
- Probiotics are also used to help restore the normal microflora of the digestive tract.
- If necessary, patients are additionally prescribed mild sedatives and antidepressants.
The course of therapy lasts from 14 days to 1.5-2 months depending on availabilitycertain symptoms, the degree of damage to the stomach.
Diet as part of therapy
Diet for stomach ulcers is very important. The body needs to be saturated with useful substances and energy substrates, while avoiding additional irritation of the mucous membrane of the digestive tract.
First, let's talk about some basic rules. Patients are recommended fractional meals - eat at least 5 times a day, but in small portions (this way you can avoid stretching the stomach). Food should not be cold or hot. Products are best boiled or steamed. Diet for stomach ulcers involves the use of the following products:
- soft-boiled eggs;
- slimy soups from rice, oats, cereals;
- liquid porridge (mashed);
- lean meats (shredded);
- jelly;
- cottage cheese and low fat cream.
The following foods should be completely excluded from the diet:
- fried and fatty foods, smoked meats;
- products containing dyes and preservatives;
- sauces, spices, spicy seasonings;
- rich meat soups, broths;
- bread, bakery products;
- fruits and vegetables that irritate the lining of the stomach, in particular legumes, tomatoes, gooseberries, citrus fruits, legumes, dates, radishes.
When is surgery needed?
Unfortunately, sometimes medical treatment of gastric ulcer does not give the desired effect. Moreover, illnesssometimes leads to the development of dangerous complications that require emergency surgical intervention. The indications for the operation are as follows:
- gastric bleeding;
- perforation of the gastric wall;
- pronounced stenosis;
- malignant degeneration of tissues (beginning of cancer);
- penetration process;
- presence of ulcers that do not heal for a long time even after treatment;
- more frequent relapses of the disease;
- scar formation on the walls of the stomach with further deformation of the organ;
- Medication has no effect even after 2-3 years of drug therapy.
There are many methods of surgical treatment of this disease. For example, sometimes it is necessary to close the place of perforation of the stomach, and sometimes a complete or partial resection of the organ is necessary. In some cases, it is advisable to perform a vagotomy - the essence of the procedure is to cut the trunk of the vagus nerve or its individual branches.
Prevention measures
There are a huge number of pathologies that can lead to the development of stomach ulcers. Bleeding, perforation of the walls of the digestive tract - all these are dangerous complications. It is much easier to try to prevent the development of such a disease. Prevention in this case is quite simple.
- It is worth trying to avoid the penetration of Helicobacter pylori into the body. To this end, people are advised to use personal crockery and cutlery, to follow the rules of personalhygiene.
- It is important to exclude exposure to risk factors, in particular, give up alcohol, stop smoking.
- Doctors recommend eating right. It is better to eat in small portions, give up spices, spicy, fatty and fried foods.
- You should not arbitrarily take drugs that contribute to the appearance of erosions and ulcers on the mucous membrane of the stomach and intestines (for example, non-steroidal anti-inflammatory drugs). If there is still a need to use the drug, then the dosage and schedule of administration should be determined only by the attending physician.
- Stocking, physical activity, outdoor recreation all help to strengthen the immune system.
- Doctors also recommend avoiding stress, as it is accompanied by hormonal disruptions, which sometimes leads to damage to the mucous membrane.
- Don't forget about quality rest, proper work schedule, good sleep.
- All diseases that in theory can lead to the development of gastritis and peptic ulcer should be treated in time - they should not be ignored in any case.
If the patient has already had a stomach ulcer, then he needs to visit the doctor regularly, undergo examinations and take tests - this way you can detect a relapse in time. Of course, you need to adhere to an appropriate diet and give up bad habits. They say about remission if the exacerbation of the disease was not observed in the patient for three years.
Prognosis in most cases is favorable, especially if the patient turned todoctor for help.
