Peptic Ulcer Disease

Peptic Ulcer Disease
 

1.      What is peptic ulcer disease?

Peptic ulcer disease is a medical condition in which there are small ulcerations in the lining of the stomach or the duodenum(the first, small part of the bowel).  Most ulcers are in the duodenum (duodenal ulcers) and a smaller number develops in the stomach (gastric ulcers).

2.      What causes peptic ulcer disease?

Our stomach produces lots of acidic juices which help to digest foods that we eat.  This stomach acid juice can erode the lining of our stomach and duodenum if it is excessively produced.  As a result, stomach or duodenal ulcers are formed.

We also know that a bacteria in the stomach called Helicobacter pylori can exacerbate the ulceration of our stomach or duodenal lining in the presence of the stomach acid juices, hence accelerating and enhancing the formation of peptic ulcer disease. 

 

Other common causes of peptic ulcer diseases are heavy alcohol consumption, heavy cigarette smoking, stress, anxiety and depression. Another common modern cause is the use of drugs to treat arthritis pain known as non-steroid anti-inflammatory drugs (NSAIDS).

3.      What are the symptoms?

The common symptoms of peptic ulcer disease are upper abdominal pain, heart burn, indigestion, “hunger pain” with an empty stomach, pain relieved by antacid and milk. Other uncommon symptoms are back pain and vomiting up blood or bleeding in the bowel motions. Some people may present with anaemia and tiredness.

4.      Who is prone to have peptic ulcer disease?

a.    Men.

b.    Young to middle aged people.

c.      Patients who constantly take certain medications, such as aspirin, cortisone and
NSAIDS.

d.     Heavy cigarette smokers.

e.     Heavy alcohol drinkers.

f.      Heavy coffee drinkers.

g.      Patients who suffer from stress, anxiety and depression.

5.      What are the risks?

Most patients with peptic ulcer disease are relatively easy to treat or control.  However, if left untreated, bleeding can occur, resulting in an emergency situation and anaemia.  Perforation or blockage of the duodenum can occur. Cancer can also occur with stomach ulcers.

6.      What are the tests available?

The diagnosis of peptic ulcer disease can be made based on the symptoms and signs that you have trial treatment medications.  The definitive investigation for it is a gastroscopy which involves a camera going down your throat and through your oesophagus, entering your stomach and small bowel to visualize the ulcerations of the stomach and duodenal lining.  This is done by a specialist under light anaesthetic medications.  It is usually a simple day procedure.  Other tests include a breath test for helicobacter pylori and blood tests.  You should see your doctor to have an assessment and these tests organized and get treated.

7.      What is the treatment?

Effective treatment for peptic ulcer disease is available these days.  This treatment regimen is ranging from self-help measures to medical treatment.

a.      Self-help measures:

·       Do not smoke.

·        Drink alcohol in healthy moderation.

·         Do not take aspirin or arthritic medications unless really necessary.

·         Have a normal regular healthy diet with three balanced meals a day.

·         Do not skip meals or have late night snacks.

·         Avoid foods or drinks that make symptoms worse, such as hot and spicy food.

·         Relieve everyday stress and keep it under controlled.

·         Take antacid medications or medicines to relieve symptoms.

b.      Medical treatment:

Peptic ulcer disease is now very treatable with modern medications.  You should see your doctor for assessment and treated.  Antacids may not be enough and there are other medications which are very effective in treating and controlling peptic ulcer disease.  An appropriate antibiotic course can also help eradicate the stomach bacteria, Helicobacter pylori.  If all of these fail, then an operation can also be very successful.