Stomach ulcer: causes and symptoms of stomach ulcer, treatment options

Stomach ulcer (PUD) is an ailment characterized by the formation of ulceration of the gastric walls. According to statistics, this disease is registered in the urban population 5 times more often than in rural residents.

There is a gender feature - women get sick more often than men. As a rule, the disease appears in persons under the age of forty, but in recent years it has been increasingly common in children. This is due to the popularization of fast food, products with dyes, nitrates, flavors and other chemical food additives.

Causes and mechanism of the pathological condition

An ulcer of the epigastric region of the stomach almost always begins with the onset of erosion.

As a rule, the bottom of the erosive surface is lined with fibrin, and it practically does not differ from healthy tissue. If there is no scarring of erosion, as often happens with erosive gastritis and colitis, then the formation of the ulcer itself begins.

A similar violation appears for other reasons:

• infection with the bacterium Helicobacter pylori (Helicobacter pylori, HP). Although the presence of a microorganism in the stomach does not automatically mean ulceration;
• genetic predisposition;
• taking aggressive pharmacological drugs. For example, long-term hormone therapy with non-steroidal drugs;
• diseases: HIV infection, cirrhosis, some types of damage to the kidneys, lungs, connective tissue, hyperparathyroidism, etc.
• stress factors, especially with a labile (easily excitable) nervous system and low stress resistance of the body;
• pathology of the gastrointestinal tract: duodeno-gastric reflux, hypodynamia of the stomach.

Along with the reasons, it is customary to single out a number of provoking factors important in the pathogenesis that can trigger the mechanism for the development of the disease, or cause its exacerbation. These include the abuse of strong alcoholic beverages, smoking more than 10 cigarettes per day, some occupational hazards, and working the night shift.

Coarse and / or junk food, the use of large amounts of nitrates, the absence of a strict diet are additional factors leading to the appearance of ulcers in the epigastric region.

Symptoms and signs of the disease

The symptomatic picture of the disease largely depends on the localization of the affected area.

If the ulcer affects the subcardial and cardiac parts of the organ, then weak pain impulses emanating from the region of the xiphoid process begin to appear within 20 minutes after eating. Almost always they are accompanied by vomiting, severe heartburn, unpleasant belching. Pain often resembles heart pain, which makes it difficult to verify the diagnosis. Antacids and milk improve the condition of the sufferer.

With peptic ulcer of the lesser curvature of the stomach the pain is localized in the epigastric region, appears 60 minutes after eating, but, despite the presence of nausea, it is almost never accompanied by vomiting. As the food lump is evacuated from the stomach cavity, mild aching pains subside.

Ulcer of the greater curvature of the stomach proceeds with an erased symptomatic picture, where the intensity of the pain syndrome is practically zero. Due to the absence of complaints from the patient, the diagnosis of this type of pathology is very difficult. But, despite this circumstance, the ulcerative defect of the gastric wall of the greater curvature of the stomach is prone to malignancy and the development of cancer.

Antrum YB manifests itself in morning and night pains in the epigastric region, which are almost always accompanied by sour belching and heartburn.

In case of ulcer of the pyloric canal manifest night and / or hunger pains, increased salivation, heartburn, which is present almost around the clock. Rarely, but in some patients it is impossible to trace the connection between the appearance of pain impulses and food.

If disorders of the pancreas have joined, then pain appears, radiating to the subscapularis or lumbar region. The increased acidity of gastric juice provokes constipation, sour belching. Neurocirculatory dystonia, in tandem with nonspecific intoxication, are the root causes of the following symptoms: emotional instability, signs of astheno-neurotic syndrome, disorders of the autonomic nervous system, headache, poor sleep, hypersecretion of sweat.

Diagnostics

An ulcer of the stomach wall in modern medicine is easy to diagnose. The simplest and most harmless way of instrumental diagnostics is to conduct EFGDS (esophagofibrogastroduodenoscopy). During the study, the doctor is able not only to see the wall defect itself, but also to assess the size of the ulcer, its depth and the condition of the bottom.

To verify the diagnosis, a scraping or biopsy (piece of tissue) is taken to detect the HP bacterium or to conduct a histological examination to exclude / confirm gastric cancer.

For instrumental diagnosis of the disease, ultrasound is still actively used. The Rg-study is somewhat outdated, but it is suitable for patients who refuse to undergo EFGDS. Since a stomach ulcer invariably increases the acidity of gastric juice, intragastric pH-metry will be very informative. If you suspect a peptic ulcer, a fecal occult blood test, a complete blood count, urine, feces, tests for the detection of HP bacteria are performed.

Peptic ulcer: surgical care and possible complications, diet

It is very dangerous not to treat an ulcer. Over time, its depth may increase, which will lead to perforation (rupture) of the gastric wall. This condition is very life-threatening, and without urgent surgical care, it ends in death.

Even if the operation is done in a timely manner, as a rule, peritonitis develops - an inflammatory process abdominal wall, which leads to intoxication, hyperthermia, the need for long-term rehabilitation period.

Other complications

The diagnosis "Peptic ulcer" can be complicated by bleeding, penetration, pylorus stenosis, perivisceritis. Bleeding occurs most often, pathology is recorded in 80% of patients with peptic ulcer. It begins with the appearance of vomiting, and the vomit resembles coffee grounds. With profuse vomiting, anemia quickly joins, the skin turns pale, covered with sweat sticky to the touch. In the clinical picture, a sharp weakness and deterioration in the general condition of the affected person come to the fore.

Penetration is called the germination of an ulcer into nearby organs (hepato-duodenal ligament, pancreas, omentum, liver). This complication occurs in 1.5% of patients, but it can significantly worsen the course of the underlying disease. In the symptomatology, persistent vomiting comes to the fore, which does not bring relief, acute pain and intoxication syndrome, heartburn.

Pylorus stenosis results from scar formation when scar tissue interferes with the timely evacuation of food from the stomach. Chronic congestion leads to a sharp loss of body weight, an unpleasant feeling of a full stomach, prolonged nausea, and frequent belching. To alleviate their condition, patients independently induce vomiting. Perivisceritis, an inflammatory process of the outer membranes of the organ, is less common than the listed complications of the underlying ailment.

Operation

There are absolute indications for surgical intervention: pylorus stenosis, perforation, profuse bleeding, ulcer germination into neighboring organs. If massive drug therapy has been carried out, but remission has not occurred, or is often observed recurrent course, deterioration of the general condition of the patient, then they talk about relative indications for operations.

Surgical intervention can be performed by resection of the stomach, complete removal of the organ (gastrectomy) and suturing of the ulcer. Gastric resection with endoscopic devices is less traumatic when compared to open surgical access. Gastrectomy is indicated for the degeneration of an ulcer into a malignant process.

Rehabilitation in the postoperative period includes early activation of the patient, regular breathing and therapeutic exercises, dietary recommendations. These measures can significantly speed up the regeneration (recovery) processes and prevent the development of postoperative complications. If the prognosis is favorable, then the stitches will be removed after 8 days, and discharge home occurs on days 10-14, depending on the condition of the patient himself.

Diet with exacerbation

Peptic ulcer, especially during periods of exacerbation, requires strict adherence to a certain type of diet, therefore, consistently appoint a table number 1a, 1b, and then number 5. If possible, remove fiber-rich dishes from the diet, coarse indigestible, salty, pickled, spicy, bitter foods. The temperature of the foodstuffs consumed should be at room temperature. They are steamed or boiled thoroughly.

The patient is shown mucous soups and cereals based on semolina, rice, oatmeal. Eggs are limited, they are used only in the form of an omelet or soft-boiled. In case of bleeding, it is important to take fortified meals containing a large amount of iron (grated lean liver, meat).

YABZH: conservative traditional and folk methods, preventive measures

Drug therapy is one of the types of conservative techniques that can defeat gastric ulcer.

The treatment regimen traditionally includes:

• antibiotics (in injections or tablets), through the appointment of Amoxicillin, Tetracycline, Clarithromycin, nitromidazole derivatives;
• medicines to protect the mucous membrane: Sucralfat, Ventroxol, De-nol, Enprostil;
• drugs that inhibit the secretion of hydrochloric acid: antacids (Sucralfat, Antareit), proton pump blockers (Esomeprazole, Pantoprazole), histamine H2 receptor blockers (Roxatidine, Nizatidine, Famotidine), blockers of M-cholinergic receptors (tablets Metacin, Neoskapan, Gastrocepin), synthetic analogs of prostaglandin E1 (Ryoprostil, Misoprostol).

Of the drugs of other groups, according to indications, antispasmodics, prokinetics, sedatives, antidepressants, vitamins are prescribed. The course of drug therapy lasts from 14 to 45 days, depending on the severity of the clinical picture and other factors.

The use of physiotherapeutic aid is shown. In the acute stage, a positive effect is observed after inductothermy, microwave and microwave therapy. With severe pain, electrophoresis with antispasmodic drugs is indicated. In the stage of incomplete remission, electrosleep, magnetotherapy, ozokerite, paraffin wraps, hydrotherapy are shown. During the period of stable remission, drinking of mineral waters, exercise therapy, rehabilitation in climatic sanatoriums and sanatorium treatment are indicated.

Folk remedies

They are struggling with YABZH using folk recipes. To accelerate the scarring of the ulcer, it is useful to take freshly squeezed potato juice, which carefully protects the cells of the mucous membrane stomach, reduces the concentration of hydrochloric acid in gastric juice, has a mild analgesic and anti-inflammatory property. The medicine is prepared quickly, because the root crop should be peeled, rinsed and passed through a juicer.

If there is no juicer, then the peeled tubers are rubbed on a fine grater, the gruel is placed in a gauze bag and the liquid is squeezed out. In the first 7 days from the start of therapy, only 20 ml of juice is enough for one dose, it must be taken at least half an hour before each meal (5-6 times a day). In the second week, the dosage is doubled, in the third week, the dosage is tripled. Then take 100 ml at a time.

Here are some more time-tested and effective recipes for dealing with peptic ulcer:

1. propolis and unsalted butter. Propolis has wound healing, regenerating, anti-inflammatory, antimicrobial properties, therefore it is able to cope with an ulcerative defect of the gastric wall. Homemade oil (100 g) is slowly melted in a water bath, avoiding boiling. As soon as it becomes liquid and warm enough, we throw 10 g of propolis into the substance and wait until the beekeeping product dissolves without residue. Store the medicine in a glass container with a ground-in lid, placing it on the bottom shelf of the refrigerator. Take 1 tsp. spoon three times a day, be sure to half an hour before eating.
2. Curcumin. It is found in large quantities in turmeric and several other types of aromatic seasonings. Curcumin has pronounced antiseptic and other beneficial effects, therefore, a rapid subsidence occurs. inflammatory process, a new vascular bed is actively forming, intensively secreted (produced) collagen. But it is important to strictly adhere to the dosage of turmeric consumption, 100 mg of seasoning per 1 kg of body weight is the ideal amount to combat UBI.
3. Chaga mushroom, which is also popularly called a tinder fungus, a black mushroom. This is the most ancient medicine for inflammatory and ulcerative lesions in the epigastric region, because it was practiced by Avicenna himself. To begin with, the tinder fungus is thoroughly soaked, washed with cold running water, then poured over with very hot water, but in no case is it boiled. In a three-liter glass container, place 100 g of mushroom, 200 g of natural, better than May or lime honey, and add water to the full volume. For infusion at room temperature, three days are enough. Then the liquid is filtered and taken in 50 ml in the morning 30 - 40 minutes before breakfast.
4. Calendula oil. It is prepared by mixing 60 g of blossoming plant flowers and 200 ml of natural extra virgin olive oil. I mix the ingredients thoroughly, place for 2 hours in a water bath for simmering at a temperature not exceeding 80 grams. Celsius. After 24 hours, the oil is filtered, then taken in a dosage of 5 ml before each meal, but at least 3 times a day. The course of treatment should not exceed 3 weeks.
5. Chewing on freshly picked plantain leaf. Leaves can only be harvested in ecologically clean areas, away from highways and industrial urban areas. Plantain is thoroughly washed under running water, allowed to dry a little and chewed thoroughly until it turns into water. The procedure is repeated daily, it is possible during the entire spring and summer period.

It is impossible to count all the popular recipes for fighting UBI, because clinical remission causes eating fresh egg protein, cabbage juice, anti-inflammatory herbs, honey with lemon, honey curdled milk. It is important to remember that "grandmother's" therapy can cause allergies, therefore, at the first manifestations of an allergic reaction, the drug is stopped.

Prophylaxis

Primary prevention are aimed at preventing the appearance of pathology, and the secondary one - at reducing the risk of exacerbations and the appearance of relapses. Preventive measures for primary prevention include: preventing infection with Helicobacter pylori, limiting the use of alcoholic beverages, daily healthy food. It is important to carry out balanced drug therapy, timely sanitation of chronic inflammatory foci and treatment of other pathologies.

Secondary prevention is concluded in a sanatorium-resort preventive treatment, adherence to a diet prescribed by a gastroenterologist, regular and sufficient monitoring of the condition of the ulcer. It is important in the fall and winter to carry out anti-relapse treatment, which includes physiotherapy procedures, herbal medicine, pharmacological preparations (with and without prescription), intake of mineral medicinal water.