ovarian cancer Stages and Treatment

 

Stomach and duodenal ulcer: acid burns associated with chronic infection

Peptic ulcer disease has long been considered a chronic acid-related disease. In fact, it is primarily an infectious disease related to a bacterium, Helicobacter pylori. Rather, stress and non-steroidal anti-inflammatory drugs are causes or aggravating factors, often associated with gastric bleeding.

Words for ailments

A peptic ulcer is a term which includes ulcers of the stomach, called gastric, and those of the duodenum because the diseases are close.

The stomach is normally protected from acidic gastric juice by mucus

The duodenum is the first part of the small intestine after the stomach

Helicobacter pylori is a bacterium capable of causing acute and chronic infection of the stomach and duodenum.

 What is a stomach or duodenal ulcer (peptic ulcer)?

A peptic ulcer is a loss of substance from the lining of the intestines, the lining of the intestines, and many organs. The ulcer locally burrows into the wall, starting with the mucous membrane, and its natural healing is difficult.

It is an erosion or a deep wound, which affects the third layer of the digestive wall, called the muscular layer, related to the acidity of the gastric fluid.

This term "gastroduodenal" is used because the two areas are close and the causes are similar. However, the course and treatment may differ and it is therefore important to know the precise location.

The disease most often results in stomach pain, punctuated by meals. It is also what we can commonly call the “pit of the stomach”. Long considered a disease of acidity and stress, it is mostly a chronic infectious disease linked to a bacterium, Helicobacter pylori, which initially causes simple gastroenteritis. Its persistence can lead to reduced secretion of protective mucus in the stomach, increased acidity and changes in the lining of the duodenum.

What are the signs of stomach and duodenal ulcer?

The main sign is pain in the stomach, under the breastbone, in the epigastric region ("epigastric pain"), like cramps or painful hunger. It is typically punctuated by meals: initially calmed by food intake, it reappears early at the end of the meal in the event of a gastric ulcer and later in the event of a duodenal ulcer. All of these typical signs are called “ulcer syndrome”.

Sometimes the symptoms are different. The ulcer can be responsible for a dyspeptic syndrome, a set of various digestive signs including nausea, bloating, transit disorders and stomach pain (often burning). Symptoms of the ulcer may also be minimal (latent ulcer) or cause simple local discomfort.

The main fear and sometimes revealing symptom of this disease is acute gastrointestinal bleeding, which manifests as vomiting of red blood, possibly mixed with some food. The ulcer can also appear during its perforation in the cavity of the belly, inside the peritoneum: it is then a generalized pain to all or part of the belly, with stiffness of the wall on palpation and risk of shock and peritonitis.

What are the causes of stomach and duodenal ulcers?

Peptic ulcer disease is caused by an imbalance between stressors and defense factors in the lining of the stomach or duodenum.

In about 85 to 95% of cases, the ulcer is linked to the presence of a bacterium: Helicobacter pylori. Unlike other bacteria, this one has the particularity of being able to survive in the acidity of the stomach and duodenum. It is contracted in childhood through the mouth. It then causes an infection by invading the wall, one speaks initially of acute gastritis, local inflammation often asymptomatic. Sometimes gastritis becomes chronic, reduces the secretion of protective mucus, increases the secretion of acid in the stomach and changes the lining and can then be complicated by an ulcer of the stomach or duodenum.

Ulcers can also be caused by medications like taking medications like nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin. These alter the defense mechanisms of the intestinal wall and therefore promote its attack by local acidity.

Stress is a real cause of ulcers (stress ulcers) and is observed in special circumstances such as staying in intensive care.

Tobacco is not directly responsible for ulcers but it doubles its risk of occurrence. An acidic or spicy diet or alcohol consumption are also factors favoring the occurrence of ulcers.

What are the complications of stomach and duodenal ulcers?

In 20% of cases, the ulcer is complicated by digestive hemorrhage. It results in bleeding of red blood through the mouth (acute hemorrhage) or black blood in the stool (digested blood = minimal and chronic hemorrhage): this is called melena. If the acute bleeding is profuse, it may be accompanied by signs of shock such as feeling unwell, rapid heartbeat and breathing, and sweating. If it is minimal but chronic, it can be responsible for an iron deficiency anemia (iron deficiency anemia) diagnosed on a blood test and which is linked to the loss of iron contained in the hemoglobin, inside the blood cells. red.

More rarely, ulcers can be complicated by digestive perforation. This corresponds to the occurrence of a complete hole in the digestive wall. A very intense “stab” pain in the stomach is then felt, sometimes associated with nausea or vomiting.

These two complications are medical emergencies and should require urgent medical attention.

In rare cases, the stomach ulcer can turn into cancer, which is why it is monitored at a distance from treatment. The ulcer of the duodenum does not present this risk.