Peptic ulcers are one of the most common gastrointestinal tract disorders. The recent past few decades have witnessed an increase in the rate of peptic ulcers occurrence in our human community (Thompson, 1996). It has evidently been shown from available statistics that an approximated over 10 percent of the human population are extremely at risk of suffering from the disease at some point in their lifetime (Cohen, 2007). Such statistics have also identified that peptic ulcers is more common in men than in women. This is attributed by many to the higher numbers of men engaged in alcohol drinking and cigarette smoking in the society compared to women (NDDIC, 2004). A peptic ulcer is a sore wound or red erosion area on the coating lining of the stomach called (gastric ulcer) or the small intestine called (duodenal ulcer). Duodenal ulcers tend to occur between the ages of 25 – 75, while gastric ulcers peak between the ages of 55 and 65. Other causes which have been associated with the disease include infections by helicobacter pylori. This is a bacterium which is known to attack the gastrointestinal tract thus leading to ulcers. However, it should be noted that genetic factors have also been claimed to cause peptic ulcer. There are many effects of peptic ulcer in the human body. Such include recurrent pains along the gastrointestinal tract, vomiting heartburns poor appetite and weight loss among others (The American College of Gastroenterology, 2009). It should however be realized that with our modern advancements in the medical field the treatment of peptic ulcers is now effective and sufficiently reliable. Such treatments might involve medication, dictated lifestyle, dietary supplements and undergoing surgical operation depending on the severity of the condition.
Peptic Ulcer Disease
Peptic ulcer disease had a great effect on morbidity and mortality until the last decades of the 20th century, when epidemiological trends started to point to a remarkable fall in its incidence. In addition, two important developments are associated with the decrease in rates of peptic ulcer disease: the discovery of effective and strong acid suppressants, and of Helicobacter pylori. The treatments of peptic ulcer disease have been changed with the discovery of the causes of peptic ulcer (Malfertheiner, P. & Chan, F. & McColl, K. 2009).
Although significant advances in sciences, this disease remains an important medical problem, because the large use of non-steroidal anti-inflammatory drugs (NSAIDs), excessive smoking, increase alcohol consumption, and life style that increase the risk of the disease. Therefore, this explains the reason for choosing this topic in order to promote healthy behavior and improve health outcomes throughout lifespan by giving attention to the preventive measures.
This paper is written as a critical analysis and discussion of peptic ulcers disease. It gives a discussion on the causes and effects of peptic ulcers in the human body. Still discussed are the signs and symptoms, diagnosis, treatment and prevention of the disease as well the common types of peptic ulcers that are found in the society.
Peptic Ulcers Overview
First is a definition of peptic ulcer and its types. An ulcer can be defined as; an area in digestive system where the tissue has been damaged or destroyed by stomach acid and other digestive enzyme. Peptic ulcer disease is a common term for ulcers that occur either in the stomach or upper part of the small intestine. A peptic ulcer is a lesion or open sore in the wall of the gastrointestinal tract. The digestive enzyme which is acidic and is secreted by the stomach cells oxidized the lining of the stomach or upper part of the small intestine (duodenum) causing ulcer. Therefore, eroding can be seen in the mucous membrane which is lining the digestive tract. Moreover, this will lead to cause a gradual breakdown of tissue. This breakdown causes a concerning or burning pain in the upper middle part of the abdomen (Stratemeier, 2009). Even though most of peptic ulcers are small in size, ulcers average between one-quarter and one-half inch in diameter they can cause a significant amount of symptoms and discomforts. It is to be noted here that the pain caused by peptic ulcers is recurrent and may come and go for a few days or weeks but mainly goes after eating. In addition, there are two different types of peptic ulcers namely; duodenal ulcers and gastric ulcers. Stomach or gastric ulcers is the type of peptic ulcers which mainly affects the stomach while duodenal ulcers affect the upper most part of the small intestine near the stomach. Ulcers can happen at any age, although they are rare in children and teenagers. Duodenal ulcers usually occur twice as common in men more than women. On the other hand, stomach or gastric ulcers usually occur in people older than 60 years and are more common in women (Stratemeier, 2009). It is difficult to estimate exactly how common peptic ulcers are because so many people they will not suffer from any symptoms. However, a study that tested 1,000 adults at random found that four per cent of them had a peptic ulcer (NHS Choices, 2009).
Second is a discussion on the causes of peptic ulcers. To start with, in the normal lining of the stomach and small intestines there are a protective process from auto digestion by the gastric mucosal barrier, this gastric mucosal barrier will prevent the irritating acids from diffusing back to the underlying tissue. This defensive process can stop working properly, and the lining of the stomach or intestine breaks down for different reasons. Scientific evidence has sufficiently proved that peptic ulcers are caused by the malfunctioning of the stomachs natural lining protection mechanisms against the damage effects of digestive juices (NDDIC, 2004). Such malfunctioning have been claimed to be caused by a number of factors, like is the helicobacter pylorus, a bacterial organism which is the most frequent cause of peptic ulcers. This bacterium mainly eats the protective lining of the gastrointestinal tract. This allows the digestive juice produced by the human body to damage the inner and sensitive part of the stomach or duodenum lining thus causing pain. Just to be stated here is the evidence that though helicobacter pylori is the most common cause of peptic ulcers, there are many people in our population living with the bacteria but do not exhibit signs of the disease (Thompson, 1996). Still clear is that H. pylori is believed to be transmitted through oral to oral contact, so those living in crowed areas increases ones chances of contracting the infection. Another common cause of peptic ulcers is the continuous use of painkiller drugs such as, aspirin, ibuprofen, naproxen or other non-steroidal anti-inflammatory drugs. Scientific evidence has clearly shown that such drugs are highly acidic and thus can easily lead to the wearing out of the digestive system lining (NDDIC, 2004). Still evident is the fact that this type of drugs blocks the flow of prostaglandins in the human body. It should be understood that this is the substance which is responsible for helping the flow of blood in the stomach and thus it helps in protecting the stomach from injury. This means that such drugs can compromise the stomach lining protection mechanism of the body and thus risking the occurrence of peptic ulcers in the body (Lanza, Chan, & Quigley, 2009). Other causes of peptic ulcers include Zollinger-Ellison syndrome. This is commonly said to be a condition in which the pancreas and duodenum which are responsible for the production of gastric acid have a tumor. Such leads to the excessive production of gastric acid which is responsible for digestion of food in the stomach, a factor which might risk causing ulcers (Dugdale, D. & Zieve, D. 2008). In adding together, it has been evidently noted that peptic ulcers are genetic. Therefore, if you have a family history of ulcers or the blood type O, you are more likely to get a duodenal ulcer (Shayne & Miller, 2009). Still established is the fact that cigarette smoking and excessive intake of alcohol are not only a cause of peptic ulcers but also a great threat to the efficient treatment of ulcers. Apart from the many causes of peptic ulcers, are any thing that leads to the direct damage of the digestive wall lining. Such might include physical injury or even radiation therapy. Likewise, a very sick patient who is on a ventilator support is at high risk for a condition called stress ulceration. It is here to be noted that unlike many belief, diet has not been scientifically proven to cause peptic ulcers (Dugdale, D. & Zieve, D. 2008). The last and most common factor to peptic ulcers is living in chronic stress or depression (Shayne & Miller, 2009). This has been claimed to lead to the excess production of digestive acids thus eating out the stomach lining.
Sign and Symptoms
Thirdly is a discussion on the signs and symptoms of peptic ulcers. The most common symptom of peptic ulcers is having recurrent abdominal pains which are marked with a burning sensation. Such pains are located in the upper middle part of the abdomen. Also it can be felt like burning or gnawing and it may radiate to the back. It can be aggravated when the stomach is empty, and can worse at night and early morning. Another sign is the constant experiencing of heartburns and indigestion. It is to be noted that though peptic ulcers are more painful when the stomach is empty, such are a leading cause of lack of appetite and vomiting on the individual. Peptic ulcers are also attributed to the sudden loss of body weight in (gastric ulcer) because eating does not relieve the pain and could still worsen it. Yet (duodenal ulcers) will lead to gain weight because the patient eats to relieve pain (Lanza, Chan, & Quigley, 2009). Other symptoms of peptic ulcers include the following: discomfort, Bloating, and feelings of fullness. Added more symptoms are, feeling of an empty in the stomach, regurgitation (feeling of acid backing up into the throat), and belching. Still to be noted is that peptic ulcers have been closely associated with chest pains and feelings of fatigue. It should however be noted that some symptoms like sudden increase in abdominal pains, vomiting of blood and blood in stool are considered as critical signs of chronic peptic ulcers. All this signs are symbolic of the possibility that ulcers have either broken a blood vessel or perforated the stomach or duodenum walls. Such could also be as a result of the blockage of food from moving from stomach into the duodenum and thus causing vomiting (The American College of Gastroenterology, 2009).
Effects of Peptic ulcer
Peptic ulcers have many effects in the victim’s life. The most common is the fact that ulcers in most cases can not be full treated. They are usually recurrent particular to alcohol abusers and smokers. Just to be stated is that the majority of people with chronic ulcers experience considerable pain and sleeplessness; this can have a remarkable and adverse impact on their quality of life (Thompson, 1996). Another effect of peptic ulcers in the body is that they can lead internal bleeding especially when they perforate the stomach lining or break a blood vessel. Peptic ulcers can cause the ultimate obstruction of the gastric outlet, stomach and intestines as well as leading to the inflammation of tissues lining the abdomen. This leads to a serious health complication which might call for a surgical operation or even death (Cohen, 2007). Peptic ulcers if not treated early enough can penetrate into other internal body parts like liver as well as the pancreas and cause severe back pain. It has also been found out that peptic ulcers can lead to perforation of the wall of the digestive system thus leading to the spilling of digestive system contents into the abdominal cavity. Such are very catastrophic to the patient’s life as can lead to acute peritonitis (The American College of Gastroenterology, 2009). It should also be noted that peptic ulcer can lead to the swelling of the abdominal wall thus compromising the free flow of food in the digestion system. Lastly, it has been established that peptic ulcers are a great contributing factor in causing peptic cancer. Such could mean a lifetime health complication on the person. This is because even after undergoing surgery operation for treating the problem, it is rarely possible for the individual to fully assume his or her normal lifestyle (NDDIC, 2004).
Owing to our modern advancements in technology and medical research, the diagnosis, treatment and prevention of peptic ulcers has been made easier and more reliable. The diagnosis of peptic ulcers mainly involves an interview by the doctor to identify the presence of the many symptoms and signs of the condition. Such include recurrent abdominal pains, vomiting and blood in the patients stool (Cohen, 2007). It should however be noted that for a doctor to qualify a patient to be suffering from peptic ulcer requires for a number of medical tests. The first is the esophagogastroduodenoscopy which involves the insertion of a thin tube attached to a camera through the patient’s mouth into the digestive system. This helps the doctor to see the presence of sore in the stomach and small intestine walls. It should be noted here that helicobacter pylori is the most common cause of peptic ulcers (NDDIC, 2004). It is due to this reason that the doctor might take a biopsy from the patient’s stomach walls to test for the presence of the bacterium. Another test which is conducted is the upper G1 test. This involves a series of x-rays on the patient’s abdomen and is usually conducted after the patient has taken barium (Shayne & Miller, 2009). It should be understood that the doctor might also request for a laboratory test of both blood and stool. The stool test seeks to establish the presence of blood in the patients stool while the hemoglobin test checks for anemia. All this tests are conducted as a way of ascertaining the level of the condition which helps in deciding the type of medication to be used.
Treating of peptic ulcers has been greatly improved not only due to our medical advancements but due to the identification of the two major causes of disease among other risk factors. The treatment of peptic ulcers is mainly conducted as a concern for eliminating the underlying causes of the disease. This is because such an approach prevents any further damage and thus reducing chances of reoccurrence of the condition. Therefore, medication is mainly given for eliminating the helicobacter pylori bacteria as well as helping the body overcoming the symptoms of peptic ulcers. Many antacids are available without a prescription, since they are the first drugs suggested to alleviate heartburn and mild digestive disorders. Antacids are not useful to prevent or heal the ulcers; however they are able to assist in the neutralizing stomach acid. When the cause for the ulcer is H. pylori infection, a three-drug course of therapy for two weeks is the standard therapy for curing. This three-drug course of therapy consists of two antibiotics and a proton pump inhibitor (PPI). The most common antibiotics usually used to treat H. pylori infections are amoxicillin, or metronidazone. Proton pumps inhibitor (PPI) therapy (such as omeprazole or lansoprazole) these are drugs that reduce acid secretion by inhibiting the gastric acid pump. Other medications may include one or more of the following: Acid blockers (such as cimetidine or ranitidine) (NDDIC, 2004). However, if a peptic ulcer bleeds severely, an Endoscopy might be needed to stop the bleeding. Otherwise if the bleeding cannot be stopped with an Endoscopy, surgery might be essential. This involves the physical removal of the sores in the stomach or duodenum through endoscopy. A further surgical procedure is vagotomy which is cutting one or more branches of the vagus nerve to reduce hydrochloric acid secretion (Dugdale, D. & Zieve, D. 2008). Apart from medication and surgery as ways of treating peptic ulcers, doctors usually advice on self-control from risk factors by the patient. These mainly include alcohol abuse and cigarette smoking as well as changes in diets. It has been evidently proved that taking of foods rich in fibers greatly reduces chances of sustaining peptic ulcers
It should be noted that prevention is better than cure. It is therefore mainly advised that people avoid risk factors which can lead to peptic ulcers. In the past, it was broad way to tell people with peptic ulcers to change the way of eating habits by consuming small amount of meals, and frequent amounts of bland foods. Also people can stay away from peptic ulcers by avoiding things that increase stomach acid secretion and break down the stomach’s protective barrier. These things include alcohol consumption, cigarette smoking, and non steroidal anti-inflammatory drugs along with aspirin. For preventing H. pylori caused peptic ulcers, people are advised to avoid living in crowded places, avoid contaminated water or food, and stick to strict principles of precautions as well as personal hygiene (NDDIC, 2004). Furthermore some evidence suggests that exercise may help reduce the risk for ulcers in some people. Other than, stress relief programs have not been shown to promote ulcer healing, but they may have other health benefits (Stratemeier, 2009).
In conclusion, it has been evidently established that peptic ulcers is becoming a common disease across the globe. Which can affect quite a lot of people especially Cigarette smokers and alcohol consumers. In addition the main causes of this disease are helicobacter pylori and non-steroidal anti-inflammatory drugs. It has however been clear recognized that there are many risk factor to the disease. Men are more victims to the disease as opposed to women (NDDIC, 2004). Such have been mainly attributed to genetic and hormonal composition of men as well as to the high prone rate of men to risk factors as compared to women. It was also clear that the ulcer caused by numerous reasons, and these reasons leading to several effects such as bleeding, perforation, and obstruction. However, peptic ulcers can be cured and even prevented if the patients are ready to modify their lifestyle and stick to their drug remedy. At last, the need for health educational activities is compulsory to increase the perception and awareness about the disease in the society.
Cohen, S. (2007). Peptic Ulcer Disease. Retrieved December 25, 2009, from http://www.merck.com/mmpe/sec02/ch013/ch013e.html
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Lanza, F., Chan, F. Quigley, E. (2009). Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol, 104, 728-738.
Malfertheiner, P. & Chan, F. McColl, K. (2009) Peptic Ulcer Disease. Retrieved November 25, 2009. from http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60938-7/abstract
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