Introduction
A peptic ulcer is a disease that affects the linings of the stomach or duodenum. It occurs as a result of distorting in the acidic environment of the stomach when the wall lining of the stomach or duodenum erodes due to an increase in gastric acid; this triggers the development of a peptic ulcer. The patient experiences extreme pain in the stomach and sometimes, at a critical stage, may call for duodenal or gastric perforation.
Etiology of peptic ulcer
There is no single factor that can be said to be the main cause of the peptic ulcer. The disease is caused by a combination of factors that contribute to its development. It is believed that peptic ulcer is caused by acid and pepsin, but other factors should not be left behind. When the degree of acidity increases in the stomach or duodenum, it affects the mucus that protects the wall lining of the stomach. Erosion of stomach lining among individuals contributes to the development of the disease. An increase in gastric acid may be brought by poor eating habits, excessive use of drugs, and stress, just to name but a few. “Individuals or children taking medicine known as non-steroid anti-inflammatory drugs (NSAID) have been diagnosed with ulcer later in their life. Scientists have discovered that peptic ulcer is caused by a bacterium called Helicobacter pylori.” (Finbarr & Daniel, 1998) The bacterium is contracted in the early stages of childhood mainly from contaminated food, water, or other infected people through body contact. Though one may be having the bacterium, the symptoms may stay for a very long period of time without displaying. For this reason, it is believed that the majority of people are living unaware that they are infected by the bacterium.
Classification and different types of peptic ulcer
The disease is classified according to the various locations it may arise. It is usually referred to according to the location. For instance, the one which arises in the stomach is referred to as the gastric ulcer. The one that affects the esophagus is called esophageal ulcer, which arises in the duodenum is called duodenal ulcer, and that affects Meckel’s diverticulum is referred to as Meckel’s diverticulum ulcer.
There are four types of the peptic ulcer which are known. The first type is the ulcer that affects the lesser curve of the stomach. The other type is a combination of two ulcers, one gastric and one duodenal, when they arise together. The third is a prepyloric ulcer, and the last type is a proximal gastroesophageal ulcer.
General signs and symptoms
Individuals with peptic ulcers experience abdominal pain normally after or before taking the meal. It is believed that for the duodenal ulcer, pain decreases after taking food, while for individuals having gastric ulcers, the pain increases shortly after taking food. However, this should not prove that one is suffering from a peptic ulcer. Patients also experience the rush of saliva, and this helps the acid in the esophagus to be reduced or diluted. They vomit a lot and experience bloating, nausea, and abdominal fullness. “Loss of appetite eventually leads to weight loss. Sometimes they vomit blood, a condition known as hematemesis.” (Richard A. 2001). This occurs mainly due to the bleeding of gastric ulcer as well as damage of food pipe from excessive vomiting. Oxidized iron from hemoglobin makes the fecal material of the patient have a bad odor or foul smell. It should be noted that it is on rare occasions that peptic ulcers can lead to either duodenal or gastric perforation. Perforation is so painful, and it requires the patient to undergo a surgical operation. Patients may also experience severe heartburns though this does not mean individuals who experience this suffer from peptic ulcers. The victim may also suffer from feeding difficulties and have frequent burping and hiccups. We should note that some of these symptoms appear in most of the kids, and this does not mean that they have peptic ulcers.
Major imaging or laboratory
Images are very vital in differentiating between peptic ulcers and other cell growth. Laboratory information or outcomes must be put into consideration before the patient is treated for the disease. “Optical gastroscopy need to be carried which involves scanning of duodenum and stomach lining to know whether they are worn out.”(Fibarr & Daniel, 1998) This may include the x-ray of the esophagus, duodenum, and stomach. If the doctor suspects that a patient has an ulcer, then a flexible tube with a tiny camera is inserted into one’s throat for the doctor to see whether the linings of the stomach, duodenum, and esophagus are worn out. A PH probe may also be carried out that measures the amount of gastric acid going to the esophagus. It is after the laboratory results that the doctor can know the right cause of action. If an individual has a peptic ulcer, then he/she must test positive to have the bacterium. Some of the tests that are carried in the laboratory to detect whether one has an ulcer include; tissue, blood, stool, and breathe tests.
Pathophysiology
There are several myths that are associated with the cause of the peptic ulcer. Some believe that cigarette smoking, eating spices, poor eating habits, and blood group inheritance are some of the factors that contribute to peptic ulcer development. These are not the cause of the disease. The main cause of peptic ulcers is the failure of antibodies to clear the inflammation caused by the bacterium called Helicobacter pylori. The bacterium interferes with the process of gastric production in the stomach. The result is either an increase or decrease in the amount of gastric acid produced in the stomach. A decrease in gastric production does not have much effect, but an increase in gastric acid produced contributes to the wear of the stomach lining. The doctor recommends that to reduce the gastric acid, one needs to eat cabbage or take cabbage juice. Individuals are also supposed to use drugs that will reduce stomach pain.
General treatment
The patients are given antacids before the test is carried out on a patient who is suspected of having peptic ulcers. In order to reduce the side effects brought about by taking NSAIDs, the patient should be prescribed to take Misoprostol. If the bacterium Helicobacter pylori are found in the body, then the patient should be given two antibiotics from Amoxicillin, Metronidazole, Clarithromycin, or Tetracycline and combine with Proton Pump Inhibitor (PPI). Prescription can also be three antibiotics and PPI. In case the bacterium is not found, then the patient is supposed to take PPI for a long period of time. The surgical emergency of peptic ulcers is not many, but in case a patient has a perforated peptic ulcer, then they can be referred to the theatre.
Conclusion
To summarize, peptic ulcer is a very common disease that may cause stomach cancer in life if not treated early enough. People need to consult doctors for medical check-up whether they have the bacterium. “In United States, one in every ten people got an ulcer in their lifetime.” (Richard A. 2001).
References
Finbarr Martin, Daniel Stiel, (1998) Peptic ulcers. New York: Hamlyn paperbacks.
Richard A. Lenhe, (2001) Pharmacology for Nursing Care. Michigan: University of Michigan.