Miscellaneous

Stomach ulcer: symptoms and treatment regimen at home

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Gastric ulcer - a chronic disease in which the formation of ulcers of the gastric mucosa. Most often suffer from a stomach ulcer men from 20 to 50 years. For the disease characterized by a chronic course with frequent relapses, which are usually in spring and autumn.

The stomach contains sufficiently aggressive media in the form of hydrochloric acid, a bile acid produced liver and enters the duodenum, throw the contents into the duodenum stomach. This aggressive environment neutralizes the mucus, which is generated mucosal cells, normal blood flow, timely restoration of mucous cells.

What it is?

Gastric ulcer - a local defect of the gastric mucosa (sometimes with capture submucosal layer) formed under the influence of hydrochloric acid, pepsin and bile. Calling on this site trophic disorders. The secretion of gastric acid when this is not usually increases.

Peptic ulcer disease is characterized by recurrent, ie alternating periods of exacerbation (usually in spring or autumn) and remission periods. Unlike erosion (mucosal surface defect), the ulcer heals with scarring.

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Causes of ulcers

Cause Description
Infection with Helicobacter pylori (Helicobacter pylori) The main cause of the disease. This spiral bacterium causes 45-75% of all cases of stomach ulcers. The source of infection is a sick person or bacillicarriers. Microbe can be transmitted through:
  • saliva (at a kiss)
  • dirty dishes
  • eating contaminated water
  • poorly sterilized medical instruments (eg fibrogastroscopy)
  • from mother to fetus
In patients receiving medicines It is the second most common cause of stomach ulcers. These include:
  • antihypertensive medications central action - "reserpine";
  • potassium preparations - "Asparkam", "Panagi" "Potassium chloride";
  • cytostatics - "Fluorouracil", "Azathioprine", "Azathioprine";
  • corticosteroids - "Betamethasone" "Dexamethasone", "Prednisolone";
  • nonselective NSAIDs - "Phenylbutazone", "Indomethacin", "diclofenac" acetylsalicylic acid.
As a complication of a variety of chronic diseases This can be:
  • hyperparathyroidism
  • tuberculosis
  • Crohn's disease
  • chronic renal failure
  • diabetes
  • sarcoidosis
  • lungs' cancer
  • chronic viral hepatitis
  • cirrhosis of the liver
  • pancreatitis
  • Chronical bronchitis
  • celiac disease
  • syphilis
On the background of acute diseases and conditions of the organism ( "stress ulcers") This illnesses such:
  • trauma;
  • acute liver and renal failure;
  • sepsis;
  • frostbite;
  • extensive burns;
  • all kinds of shocks
social reasons Ulcers on the development impact:
  • negative emotions;
  • constant stress;
  • gross errors in the diet;
  • abuse of alcohol and cigarettes;
  • financial well-being.

What types of ulcers, we consider in more detail:

Localization release: On the size of the defect: The stages of development: By the number of ulcers:
  • cardiac side
  • subcardial part
  • corpus (for large or small curvature)
  • antrum
  • pyloric
  • giant - more than 3 cm;
  • large - 2-2,9 cm;
  • average - 0.6 - 1.9 cm;
  • small - 0.5 cm
  • active stage
  • healing stage
  • Step scarring (red or white scar)
  • remission
  • multiple;
  • solitary

Symptoms of stomach ulcers

Sometimes peptic ulcer does not manifest itself, suggesting the need for regular inspection. As a rule, during the ulcerative process without noticeable symptoms observed in 25 - 28% of cases, and it revealed the presence of ulcers after the death of the patient.

Suspected of gastric lesion can be on the following grounds:

  1. Strengthening gassing.
  2. Quickly come a feeling of fullness.
  3. The emergence of a sense of gravity in the abdomen, observed after a meal.
  4. Decreased appetite in peptic ulcer disease may be due to the fear of human experience pain or impaired GI motility.
  5. Burp, which is characterized by the uncontrolled reflux of gastric juice into the mouth. In this case, the patient feels bitter or sour taste in the mouth.
  6. Stool irregularities. Most often, patients complain of constipation, and diarrhea are not typical for a peptic ulcer. Difficulty with bowel movements are experiencing up to 50% of patients, especially in acute gastric ulcer.
  7. Pain localized in the upper abdomen. This symptom is manifested in 75% of cases. Half of the patients complain of sensations of weak intensity, the remaining 50% are more pronounced and amplified during exercise after ingesting alcohol or spicy foods during the long breaks between food.
  8. Nausea, sometimes accompanied by vomiting. This symptom is caused by a gastric motility disorders. When the plague of vomiting observed after 1.5-2 hours after a meal and as the release of the stomach brings a sense of relief. Therefore, patients often cause vomiting alone.
  9. Heartburn. It is expressed in a burning sensation in the epigastric region. It arises due to the fact that the acidic stomach contents, having an aggressive medium enters the lumen of the esophagus, irritating its walls. This symptom occurs frequently and is found in 80% of patients. Heartburn usually appears within 1-2 hours after eating.

Among the outward signs of stomach ulcers should also note the presence of a gray coating on the tongue, which is almost always indicative of a GI problems. The patient may suffer from excessive sweating of the palms and experience pain with pressure on the epigastric region.

Characteristics of the pain associated with gastric ulcer:

  1. Ulcer located in the upper curvature of the stomach, has a very hidden within it can be quickly and diagnose very rare, and in fact the upper curvature of the stomach ulcers are cancerous character.
  2. The defeat of the ulcer of the antrum of the hollow body characterized by pain in the evening and at night, may be completely unrelated to food intake. The pain is constant, aching, accompanied by belching and heartburn.
  3. If the ulcer is located in the pyloric stomach, the pain is acute, episodic, long-term (in some cases, a single seizure lasts more than 40 minutes).
  4. With the localization of ulcer disease in the lesser curvature of the stomach pain is especially intense in the left iliac region. Syndrome occurs after 1 hour after ingestion, stabilized state after the stomach contents digest. The most frequent complaints from patients about pain comes in the evening, sometimes accompanied by vomiting.
  5. If the ulcer is located in the cardinal or subcardinal department stomach, the pain appears 20 minutes after eating the food, its location is very high - almost in the solar plexus. Very often the pain radiates to the heart, so heart attack may be mistakenly diagnosed (this happens when self-diagnosis). With this arrangement, a defective education is never pain after exercise, and after drinking even a small amount of the patient's condition stabilizes milk.

Symptoms of stomach ulcers in acute:

1) Dull cutting, stabbing pain in the upper abdomen, often in the middle (epigastric), may be given in the left upper quadrant. Pain appearance is associated with food consumption, about 0.5-1 hour after a meal, be interrupted for approximately 2 hours, this is due to gastric emptying. The pain appears as a result of irritation ulcer surface, food, it docked antacids (Almagel). Just the pain is characterized by seasonality, ie aggravation occurs in spring and autumn.

2) dyspepsia:

  • heartburn is a result of a throw of acidic gastric contents into the lower esophagus. It appears simultaneously with the appearance of pain;
  • Nausea and vomiting also occur at the same time, when there is pain. Vomiting accompanied by relief for the patient;
  • sour belching, constipation, developing due to increased gastric acidity;

3) Weight loss occurs because of the fear of food intake, which contributes to the appearance of pain.

perforated ulcer

If you ignore the disease, there is a perforation of the stomach ulcers and penetration. Wall rupture occurs and its germination ulcers on adjacent organs. The contents of microorganisms and penetrating into the abdominal cavity, causing peritonitis.

Chronic discomfort that the patient used to feel, suddenly transformed into a sharp dagger pain. Man covered with sweat, the stomach binds.

Such a complication requiring surgery intervention. At 6 hours the patient has a chance to escape, if he will have time to put on the operating table, wash the damaged tissue and sew it, thereby stopping profuse internal bleeding.

Diagnostics

Currently, the diagnosis of gastric ulcers is based on endoscopy.

The method is called fibrogastroscopy (FGS), during it through the esophagus into the stomach introduces a thin, flexible instrument, equipped with a light source and a camera that is broadcasting the image on the monitor. This allows you to see the ulcerative gastric mucosa defect, determine its location and size. Previously widely used method of X-ray contrast is still in use, but is only of secondary importance.

Conducted laboratory studies of gastric and intestinal contents for the presence of H. pylori and occult blood test, to assess the overall condition of the body appointed by common blood and urine tests.

Treatment of stomach ulcers

How to cure stomach ulcers? - Need a complex therapy, including not only medication, but also correction of lifestyle.

The course of the treatment of gastric ulcers consists of:

  • eliminate factors that have led to the disease;
  • drug therapy;
  • clinical nutrition;
  • physiotherapy, laser therapy, magnetic therapy, etc.

Identify several major groups for the treatment of peptic ulcer disease:

drugs group Title Mechanism of action
Antagonists of H2 histamine receptors Today drugs are used mainly on the basis of two active ingredients: ranitidine, famotidine. It has a strong anti-secretory effects. Reduce the production of hydrochloric acid, stimulate the formation of gastric mucus.
antibiotics Clarithromycin, amoxicillin, tetracycline. The drug is prescribed for suppressing Helicobacter pylori of life.
Proton pump inhibitors Omeprazole, pantoprazole, rabeprazole, lansoprazole, esomeprazole. The main group for the treatment of peptic ulcer. When receiving the final stage is blocked acid chloride formation.
antacids Maalox, Rennie, Gastal, Almagel, Fosfalyugel. Used as a complement to the basic therapies. They do not affect the production of hydrochloric acid, neutralized with an existing acid.
M-cholinolytics Gastrotsepin, Gastromen, Piregeksal. Drugs selectively block M-holonoretseptory stomach without affecting the function of other organs. Prescribed for severe pain that is not eliminated by antacids.
bismuth preparations De-Nol, ventrisol, Ulkavis. It has astringent, enveloping and antiseptic effect. In the interaction with the gastric juice occurs precipitation of insoluble salts. This protects the mucosa from hydrochloric acid, eliminates pain.

Scheme of treatment Helicobacter pylori

Destruction of Helicobacter pylori promotes the best scarring of the ulcer. This is the first step of treatment of peptic ulcer disease. There are two main schemes of antibacterial therapy. They are appointed by the step by step, that is the first line medication does not work, then try a second circuit.

The first line eradication (within a week):

  • Proton pump inhibitors, 20 mg twice a day.
  • Makrodidy (Clarithromycin) 500 mg twice a day.
  • Semisynthetic penicillins (amoxicillin) 1000 mg twice a day or derivatives nitroimidazole (metronidazole) and 500 mg twice daily.

In case of failure of eradication offered second line (1 week):

  • Proton pump inhibitors, 20 mg twice a day.
  • Bismuth subcitrate (De Nol) 120 mg 4 times a day.
  • Tetracyclines (tetracycline) of 0.5 g 4 times a day.
  • Derivatives nitroimidazole (metronidazole) and 500 mg three times a day.

Currently, doctors are developing new methods for the treatment of disease. Already being tested a vaccine against H. pylori. For better healing mucosa defect using cytokine preparations trefoilevye peptides and growth factors.

Diet

Specific requirements are put forward to the food. It should spare the mucosa against mechanical and chemical damage and still be full. Nutrition should be a fraction of 5-6 times a day. All meals must be ground or to use in liquid form, in steamed or boiled, not cold and not hot.

Shows mashed, easily digestible food, did not increase the secretion of gastric juice:

  • boiled eggs, scrambled eggs for a couple;
  • milk and dairy products;
  • boiled beef dishes, chicken, veal, cutlets for a couple;
  • boiled fish low-fat varieties;
  • white, slightly dried bread;
  • dairy soups, chicken, vegetables, potatoes, beets;
  • cooked vegetables: carrots, potatoes, beets, zucchini, pumpkin;
  • buckwheat, semolina, rice, oats, pasta;
  • weakly brewed tea;
  • sweet jellies, compotes;
  • broth hips, wheat bran, sour berry juices;
  • alkaline mineral water without gas.

The symptoms of peptic ulcer disease aggravated:

  • sharp and salty;
  • canned, smoked food, sausages;
  • baked goods from pastry, cakes, rye bread;
  • strong tea, coffee;
  • products of fatty meat, fat, rich broth;
  • roast;
  • various spices: mustard, pepper, cloves, etc .;
  • carbonated drinks.

Is to abandon the products containing coarse fibers, they are mechanically irritate the stomach: radish, turnip, radish, beans, bran bread.

Folk remedies

Herbal medicine is not a substitute for medical treatment. It increases its effectiveness. In the case of peptic ulcer proper use of medicinal plants (as a supplement to the received drug) allows:

  • reduce the intensity of the inflammation;
  • cope with the pain;
  • stimulate the healing of ulcers;
  • normalize the chair;
  • protect the gastroduodenal mucosa from the aggression factors;
  • improve the supply of gastroduodenal mucosal nutrients.

Possess anti-inflammatory effect healing charges including St. John's Wort, yarrow, marigold, and others. The role of natural muscle relaxants may make mint, oregano, chamomile, dill. Eliminating the spasm of smooth muscles of the stomach, these wonderful herbs cropped pain. Enveloping effect inherent licorice devyasilu, flax seed. Full scarring ulcers contribute celandine, chicory, fireweed, shepherd's purse, burdock root. For relief of the chair can be used buckthorn, zhoster, rhubarb, watch trifoliate et al.

These medicinal plants are recommended to be used in the form of infusions, decoctions, fitoapplikatsy on the abdominal wall and therapeutic baths. It should not be forgotten that fitoapplikatsii strictly prohibited for bleeding, pregnancy (all time), fever, any oncological diseases.

Operation

How to treat stomach ulcers, when conservative treatment does not bring the expected results? Unfortunately, there are cases when you do not do without surgery. However, surgical intervention should be based on the absolute indications, which include:

  • ulcer perforation;
  • occurrence of bleeding;
  • ulcers transformation in oncology;
  • III degree of stenosis.

Surgical intervention is not possible and the relative indications, including the degree of stenosis II, the ability to frequent relapses, multiple scars, callous ulcer, penetration, inability to heal ulcers over time.

If there are indications for surgery to avoid its undesirable, even pulling process is quite dangerous. The reason is that every scheduled operation is less dangerous than the emergency intervention. Plus, emergency surgery is not always effective, but has a higher risk of postoperative complications.

Gastric ulcer surgery

After surgery, the patient can start to work in about two or three months. It all depends on how you behave gastric ulcer after surgery, when the stitches will be removed and discharged from the hospital. It all depends on the course of recovery and healing of wounds. If all goes well, sutures are removed after about 7-9 days, but discharged from the hospital a little earlier.

It is very important to follow a diet after surgery. Typically, the liquid is allowed to use two days later, on half a glass of water a day dosing teaspoon. Gradually, day by day the water is replaced by a soup or broth. Then, about eight days, allowed to eat meat, potatoes, cereals and so on, but only in a shabby. To prevent damage to the postoperative state, you should follow a strict diet and listen to the doctor.

Forecast

Prognosis conditionally favorable with adequate timely treatment quality of life does not suffer, work capacity is fully restored. However, possible development of a number of life-threatening complications, such as bleeding from the ulcer or ulcer perforation, and as a consequence of the development of peritonitis.

pathology Prevention

Among the main preventive measures include:

  1. Reducing stress levels. Needs timely rest, restful sleep.
  2. Compliance with the rules of healthy eating. Care should be taken to avoid constipation, diarrhea, gas formation processes.
  3. Avoiding alcohol. Even small doses of a negative impact on beneficial microflora of the gastrointestinal tract. At its violation risk of peptic ulcer increases several times.

In conclusion, we note that at the time discovered a peptic ulcer in the presence of high-grade treatment has a favorable prognosis. When complications can be life-threatening condition.

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