1 Causes of pathology

The main causes of the formation in the wall of the stomach of a small or deep flawed mucosa - infection with the Helicobacter pylori microbe. At first the bacterium provokes a gastritis, but without the corresponding treatment it passes into a peptic ulcer.

The competing reason is called the imbalance between the mechanisms protecting the stomach and aggressive factors. As a protection against highly acidic gastric juice and enzymes, the mucous membrane, the lining organ, produces mucus. However, under the influence of certain factors, the acidity of the gastric juice increases sharply, so the protective mechanisms do not work, and an ulcer appears in the stomach wall.

The main reasons for increasing the acidity of gastric juice are:

1. Frequent use of spicy, acidic, solid, pickled, irritating food, this includes abuse of fast food. Such products stimulate the secretion of gastric juice, and also lead to the possible formation of inflammation and erosion on the gastric mucosa.
2. Power in a hurry and dry.
3. Spirits and smoking.
4. Irregular feeding.

In addition to the above, peptic ulcer disease is due to:

1. The increased acidity of gastric juice.
2. Hereditary factor.
3. Acute or chronic gastritis.
4. Nervous stress and stress, provoking so-called "stressful" ulcers.
5. Reduced immunity.
6. Drinking too hot and cold food, fried, smoked, spicy dishes and spices, carbonated drinks and purchased semi-finished products.
7. Previously blood loss, 2-3 degree burns and injuries( so-called "shock ulcers").
8. Long-term use of drugs that have a destructive effect on the gastric lining - preparations containing glucocorticosteroids, for example, Prednisolone( "steroid" ulcers);non-steroidal anti-inflammatory drugs( Ibuprofen, Acetylsalicylic acid) and others.

2 Signs of a stomach ulcer

In order not to miss the onset of the disease, you need to know the symptoms of a stomach ulcer. This will allow you to quickly seek the help of medics, until the defect of the mucosa is not so deep. In this case, there are many chances that one can manage in conservative ways and avoid surgery and a long recovery.

If you noted one or more of the following signs, consult a doctor:

1. Pain localized in the upper third of the abdomen. This symptom occurs in 3/4 of the cases. In half of patients with ulcer intensity of pain is weak, and in others - pronounced. Pain in gastric ulcer can increase with physical stress, after drinking, acute or irritating food, with long intervals between meals.
2. Heartburn. The patient may feel a burning sensation in the epigastrium or behind the breastbone. Throwing the acid-containing contents of the stomach results in the erosion of the walls of the esophagus, which is accompanied by unpleasant sensations. This symptom is observed in the vast majority of patients. Heartburn manifests itself on average 2 hours after eating.
3. Nausea. In some cases, nausea is inextricably linked with vomiting. This happens 2 hours after eating. After vomiting, a person feels better, so some patients themselves cause vomiting. These phenomena develop as a result of a violation of the motility of the organ, which is typical of gastric ulcer.
4. Impairment of appetite. Constant pain, nausea, or vomiting leads to the fact that the patient is afraid of repeated suffering, which naturally reduces appetite. Loss of appetite can also be associated with dysfunction of the gastrointestinal tract.
5. Belching is the exit of accumulated or formed in the stomach gases through the mouth. They go along with some acid and digestible food. Thus the person feels an acidic or bitter taste in a mouth.
6. Intensified gas formation - flatulence.
7. Sensation of severity in the stomach after eating.
8. Too fast satiety with food.
9. Noticeable weight loss. It is associated with poor appetite and constant pain.
10. Constipation. At half of patients with a peptic ulcer frequent constipations occur.

In many patients, signs of gastric ulcers are supplemented by a touch on the tongue, signaling problems in the digestive system. Among other things, the patient feels pain when pressing on the epigastric region. He may experience increased sweating of the palms.

3 Diagnostic measures

During the consultation, the doctor will necessarily ask the patient about the presence of pain in the area of ​​the stomach and their connection with food intake. Important information about the seasonality of exacerbations, when they occur in the spring or autumn, and with what the patient connects the emerging symptoms of gastric ulcer.

To make an anamnesis, you need information about whether the patient ever had gastrointestinal disease - gastritis, duodenitis, and others. The doctor will definitely ask if anyone in the family has such complaints about health, because infection with the Helicobacter pylori bacterium can occur from another person when kissing, using common utensils and cutlery.

Next, the patient will be sent to a general analysis of urine and blood. Elevated levels of leukocytes and ESR are characteristic for the inflammatory process. To find out whether there is bleeding in the digestive system, the feces are analyzed for occult blood.

Instrumental examinations are very important: the study of gastric acidity, the detection of Helicobacter pylori and endoscopic examination of the stomach. Esophagogastroduodenoscopy is the introduction through the esophagus into the stomach and duodenum of special endoscopic equipment, equipped with a mini-camera and instruments for biopsy.

During the procedure, the doctor examines all mucous membranes up to the duodenum for ulcers, their location and quantity.

If necessary, take a biopsy - a piece of a suspicious mucous membrane. This sample is sent to a cellular study.

Indirect evidence of the presence of Helicobacter pylori is the exhalation of urea. For this, a respiratory radionuclide urease test is done. In addition, antibodies to these pathological bacteria can be detected in blood and feces.

4 Methods of treatment

In medicine, there is no universal regimen for the treatment of gastric ulcers. At appointment the doctor takes into account the patient's age, physiological condition, presence of other diseases of the gastrointestinal tract - gastritis, duodenitis, colitis, etc. Symptoms and treatment of peptic ulcer disease may vary depending on the severity of symptoms, be it pain, nausea, or vomiting. The main thing is that a doctor-gastroenterologist must treat this illness. Very often, when the patient drows pain in the abdomen with anesthetics and postpones the visit to the doctor, the stomach ulcer is opened, the contents of the stomach are poured into the peritoneum, infection begins, and eventually the person dies. To prevent this from happening, it is important to consult a doctor at the first sign of problems with the stomach and digestion.

Pathology is treated with a whole complex of measures.

Diet and proper nutrition. First you need to completely eliminate alcohol, coffee, very hot and cold food, hard meat, mushrooms, sharp, fried, salted, smoked and pickled dishes, seasonings - horseradish, mustard and wasabi.

During the day, you should take small amounts of food at regular intervals about 3-4 hours. Preferred soft and grated food, a variety of cereals, vegetable soups and mashed potatoes, steam omelet, etc. For better healing of ulcers, food should include a large number of vitamins and proteins.

Medications. Medicamental therapy, consisting of several groups of drugs, is selected individually for each specific case. Antibiotics for the destruction of Helicobacter pylori. For this purpose, the following types of antibiotics are used:

• Macrolides( Clarimycin);
• Penicillins( Amoxicillin);
• Nitroimidazoles( Metronidazole).

Reduces the acidity of gastric juice to eliminate heartburn and pain. For this purpose, the following can be prescribed:

1. Proton pump inhibitors( Pariet, Omeprazole, Pantoprazole, Rabeprazole, Esomeprazole, Nexium).They interfere with increased production of hydrochloric acid and block the proton pump.
2. Blockers of H2-histamine receptors( Roxatidine, Ranitidine, Nizatidine, Famotidine, Kwamatel).Now these drugs are almost not prescribed because of the fact that after their withdrawal the manifestations of peptic ulcer are returned again.
3. Antacids( Maalox, Almagel, Sucralfate, Keal) envelop the walls of the stomach, thereby eliminating the corrosive effect of hydrochloric acid.
4. Bismuth preparations( De-nol) are designed to kill Helicobacter. They also have astringent and gastro-cytoprotective actions.
5. Synthetic analogues of prostaglandin E1( Saitotec, Misoprostol) are designed to increase the production of mucus and bicarbonates, as well as reduce the production of hydrochloric acid.
6. Means blocking M-holinoretseptory( Gastrotsepin, Buskopan, Pirenzepin).These drugs help to eliminate pain in the stomach ulcer by reducing the production of hydrochloric acid.

Depending on the severity of the symptoms, the results of the tests and the severity of the condition, the doctor will prescribe a therapy consisting of 3-4 preparations of different pharmaceutical groups. If the tablet form of the drugs is poorly tolerated by the body, the doctor can recommend injections.

Surgical intervention. The operation is performed in critical situations - when the ulcer has opened, gastrointestinal bleeding has begun, the inferiority of the lower part of the stomach has developed. During the operation, resection of individual parts of the stomach or the intersection of nerves that stimulate gastric secretion.

5 Prevention

Stomach ulcer can relapse to relieve periods of relative well-being, preventive measures need to be taken.

Prevention includes:

1. To cure sick teeth, if necessary, restore the missing ones. Such activities should guarantee a full chewing on the food.
2. Create a calm psychological environment at home and at work.
3. Quit smoking and forget about alcohol.
4. Ensure a full night's rest for 6-8 hours.
5. Avoid fried, spicy, salty, smoked, canned and fatty foods, very cold and hot dishes.
6. In case of exacerbation, immediately consult a doctor and go to a 5-6-times-a-day diet.

Gastric ulcer is a very unpleasant chronic disease that manifests itself not only in epigastric pain, but also with constant nausea, vomiting, bad smelling belching and annoying heartburn. Symptoms of stomach ulcers reduce appetite, and a person ceases to enjoy eating. Do not discount the inflammatory diseases of the duodenum and stomach. Symptoms of these diseases can quickly degenerate into manifestations of stomach ulcers, and later in life-threatening complications.