Peptic Ulcer Disease is a condition that affects the stomach and the duodenum of the digestive tract of our body resulting in break in the continuity of the lining epithelium.It is just like any other wound on our body surface,the only thing is that it is present on the mucosal lining of the stomach or duodenum.
Peptic Ulcers are divided into two categories-
The division is helpful as the two conditions have different symptoms and signs and are managed on different lines.
The causative factors are many but principally two-one is use of NSAIDs(pain-killers) and H.pylori(a bacteria).There are various risk factors like less intake of fibre diet,use of smoked foods,stressful conditions,environmental factors and genetic factors.
One suffering from this condition complains of nausea,vomiting,hunger pains,heart burns and in severe cases can present with blood vomiting(called hematemesis).In some patients a sort of periodicity is found with a symptom-free interval in between two bouts of attacks.
The best way to detect it is by Upper gastrointestinal endoscopy as one can visualise the part of mucosa affected and the severity of the condition can be accurately assessed.
The condition can be managed by medical and surgical measures.The various medical measures or drugs includes-
1.PPIs(Proton Pump Inhibitors)-most effective,prescribed for 4-6 weeks once daily.Drugs included are Omeprazole,Rabeprazole,Pantoprazole,Esomeprazole.
2.H2-Blockers include Ranitidine,Famotidine,Cimetidine
3.Ulcer protective drugs like Sucralfate,ProstaglandinE2 agonists like misoprostol protect the ulcer base from the direct action of gastric acid.
4.Antacids are helpful in relieving pain till the PPIs and H2 blockers act.
5.Antibiotics are also needed as H.pylori is a causative agent for the condition and can be eliminated with antibiotic use.Antibiotics used are Amoxycillin,Metronidazole and clarithromycin.
A combination of two antibiotics and a PPI is prescribed as HP-Kit for eradication of H.pylori for a period of 2-4 weeks and is very effective.
Complications of peptic ulcer occur in long-standing cases and they are-
1.bleeding from the ulcer
2.perforation of the ulcer
In such cases,surgical treatment becomes necessary which includes a large number of options and is instituted according to the needs of the patient.
Gastric Ulcers need special mention as chronic or long-standing gastric ulcers can give rise to gastric cancer and has a greater morbidity and mortality associated with it.
With the stressful life in various parts of the world the incidence of this disease is on the rise.But,the availability of excellent drugs and effective surgical modalities the condition can be very easily and efficiently manageable.