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Millions of people around the world suffer from ulcers. An ulcer is a sore or hole in the lining of the stomach or duodenum (the first part of the small intestine). People of any age can get an ulcer and women are affected just as often as men. With stomach ulcers, H. pylori infection is found in 60 to 80 percent of the cases.
Again, it is still uncertain how the infection acts to cause the ulcer. It probably weakens the protective mucous layer of the stomach. This allows acid to seep in and injure the underlying stomach cells. However, there is still a great deal of research to be done to unravel this relationship. In times past, physicians were taught "no acid, no ulcer. " The medical profession felt the single most important factor causing duodenal ulcers to form was strong stomach acid.
Research has now shown that over 90 % of all patients who develop duodenal ulcers have H. pylori infection in the stomach as well. Medical studies are under way to determine the relationship between the two and how an infection in the stomach can be related to a duodenal ulcer. Acid is still important; patients without acid in the stomach never get duodenal ulcers. However, physicians now accept the fact that the infection is directly related to the development of duodenal ulcers.
It is now rather easy to clear duodenal ulcers with the strong acid-reducing medicines available. But, the ulcers will usually recur unless the H. pylori infection is also cleared from the stomach. Although we use to think that spicy food, acid, and stress were the major causes of ulcers, we now know that nine out of ten ulcers are caused by H. pylori. Helicobacter Pylori is a specific bacteria that can cause infection of the stomach.
This infection can contribute to the development of diseases, such as dyspepsia (heartburn, bloating and nausea), gastritis (inflammation of the stomach), and ulcers in the stomach and duodenum. It will be useful to know some things about the upper digestive tract to understand how and where Helicobacter pylori infection can occur. H. pylori is a fragile bacteria that has found an ideal home in the protective mucous layer of the stomach. These bacteria have long threads protruding from them that attach to the underlying stomach cells. The mucous layer that protects the stomach cells from acid also protects H.
pylori. These bacteria do not actually invade the stomach cells as certain other bacteria can. The infection, however, is very real and it does cause the body to react. Infection-fighting white blood cells move into the area, and the body even develops H. pylori antibodies in the blood. H.
pylori infection probably occurs when an individual swallows the bacteria in food, fluid, or perhaps from contaminated utensils. The infection is likely one of the most common worldwide. The rate of infection increases with age, so it occurs more often in older people. It also occurs frequently in young people in the developing countries of the world, since the infection tends to be more common where sanitation is poor or living quarters are cramped. In many cases it does not produce symptoms.
In other words, the infection can occur without the person knowing it. The infection remains localized to the gastric area, and probably persists unless specific treatment is given. Medicines that reduce stomach acid may make you feel better, but your ulcer may come back. Since most ulcers are caused by this bacterial infection, they can be cured for good with the right antibiotics. The main cause for ulcers in eating disorder patients is the irregular eating habits. When there is no food in the stomach for long periods of time the stomach acid simply starts eating away at the lining.
Similarly when there is too much food in the stomach for long periods of time it will damage the tissues. Those irritations then develop into the open sores known as ulcers. If ulcers are not treated complications such as serious weight lose, leading to malnutrition, the risk of bleeding, which can eventually lead to anemia, and also complete penetration of the stomach lining called perforation. The most common ulcer symptom is a gnawing or burning sensation in the abdomen between the breastbone and the belly button. The pain often occurs when the stomach is empty, between meals and in early morning hours, but can occur at anytime.
It may last anywhere between minutes and hours and may be relieved by either eating or taking antacids. Less common symptoms include nausea, vomiting, or loss of appetite. Sometimes ulcers bleed. If bleeding persists, it may lead to anemia with weakness and fatigue. If bleeding is heavy it may appear in vomit r bowel movements. Complications from stomach ulcers may include serious weight loss leading to malnutrition and the risk of bleeding, which can lead to anemia, (a condition were the body does not have enough red blood cells to carry oxygen).
Another risk is that the ulcer may go through the wall of the stomach causing what is called a perforation. People who are having frequent pain in their stomach should see there doctor for treatment, as ulcers can be serious. People should not attempt to treat themselves with over-the-counter medications because delaying treatment could be dangerous. To determine if you have an ulcer, the doctor may do several tests. An x-ray called a barium swallow or upper GI may be done to see if there is an There are quiet a few other ways for a physician to locate an ulcer. The first test that may be performed is an endoscopy This is a test in which a small tube with a camera inside is inserted through the mouth and into the stomach to look for ulcers.
During the Endoscopy, small samples of the stomach lining can be obtained and tested for H. pylori using the chemical called Pylori Tek. The second test is called the C 13 urea breath test non-invasive and non-radioactive... This a breath test that can determine if you are infected with H. pylori. In this test, you drink a harmless liquid and in half an hour, a sample of your breath is tested for H.
pylori. The last test I will describe is a triple-antibiotic therapy for peptic ulcer disease. Patients who have had two or more ulcer episodes are candidates for antibiotic therapy. Those patients experiencing their first ulcer episode should not be treated with antibiotics, since one third of such patients will not have a recurrence anyway, and antibiotics are not without problems -- they are expensive and inconvenient, they have associated side effects, and they may induce antibiotic resistance in H. pylori. The best regimen to have emerged for eradicating H.
pylori consists of a bismuth compound combined with two other antimicrobial agents -- for example, tetracycline or amoxicillin plus metronidazole -- with all three agents given for 14 - 16 days. Bismuth salts (e. g. , PeptoBismol) are reasonably effective topical antimicrobial agents that penetrate the mucous layer of the stomach and reach the gastric crypts in sufficiently high concentrations to kill H. pylori. Bismuth also helps reduce the development of antibiotic resistance in H. pylori.
Since bismuth compounds are inexpensive and well tolerated, there is no advantage to not using them. Doctors treat stomach and duodenal ulcers with several types of medicines including H 2 -blockers, acid pump inhibitors, and mucosal protective agents. When treating H. pylori, these medications are used in combination with antibiotics.
Most doctors treat ulcers with acid-suppressing drugs known as H 2 -blockers. These drugs reduce the amount of acid the stomach produces by blocking histamine, a powerful stimulant of acid secretion. H 2 -blockers reduce pain significantly after several weeks. For the first few days of treatment, doctors often recommend taking an antacid to relieve pain. Initially, treatment with H 2 -blockers lasts 6 to 8 weeks. However, because ulcers recur in 50 to 80 percent of cases, many people must continue maintenance therapy for years.
This may no longer be the case if H. pylori infection is treated. Most ulcers do not recur following successful eradication. Nizatidine (And) is approved for treatment of duodenal ulcers but is not yet approved for treatment of stomach ulcers. H 2 -blockers that are approved to treat both stomach and duodenal ulcers are: Cimetidine (Tagamet) Ranitidine (Zantac) Famotidine (Pepcid). Like H 2 -blockers, acid pump inhibitors modify the stomach's production of acid.
However, acid pump inhibitors more completely block stomach acid production by stopping the stomach's acid pump -- the final step of acid secretion. The FDA has approved use of omeprazole for short-term treatment of ulcer disease. Similar drugs, including lansoprazole, are currently being studied. Mucosal protective medications protect the stomach's mucous lining from acid. Unlike H 2 -blockers and acid pump inhibitors, protective agents do not inhibit the release of acid. These medications shield the stomach's mucous lining from the It is found that the most effective therapy, according to the NIH Panel, is a 2 -week, triple therapy.
This regimen eradicates the bacteria and reduces the risk of ulcer recurrence in 90 percent of people with duodenal ulcers. People with stomach ulcers that are not associated with NSAIDs also benefit from bacterial eradication. While triple therapy is effective, it is sometimes difficult to follow because the patient must take three different medications four times each day for Typical 2 -week, triple therapy: Typical 2 -week, dual therapy: Metronidazole 4 times a day Amoxicillin 2 to 4 times a day, or Tetracycline (or amoxicillin) 4 times a day Bismuth sub salicylate 4 times a day In the past, doctors advised people with ulcers to avoid spicy, fatty, or acidic foods. However, a bland diet is now known to be ineffective for treating or avoiding ulcers. No particular diet is helpful for most ulcer patients. People who find that certain foods cause irritation should discuss this problem with their doctor.
Smoking has been shown to delay ulcer healing and has been linked to ulcer recurrence; therefore, persons with ulcers should not smoke. Drinking, smoking and caffeine intake should be in moderation. People who take aspirin and ibuprofen may be told to avoid these medications. Jacintha S. Cauffield, Pharm. D.
of Clinical Pharmacy Fellow, University of Florida, Gainesville, Fla. has done research that proves the stomach's inability to defend itself against the powerful digestive fluids, acid and pepsin, contributes to ulcer formation. The stomach defends itself from these fluids in several ways. One way is by producing mucus -- a lubricant-like coating that shields stomach tissues. Another way is by producing a chemical called bicarbonate.
This chemical neutralizes and breaks down digestive fluids into substances less harmful to stomach tissue. Finally, blood circulation to the stomach lining, cell renewal, and cell repair also help protect the stomach. Speaking in a first hand point of view, ulcers are extremely painful and uncomfortable. I first realize that there might be a problem approximately two summers go when a persistent burning sensation overcame my abdomen mostly every day in the early morning. When I first approached my pycisain with my discomfort he asked me to retreat home and return if the problem wasnt to decrease. Since the pain, if anything, increased, my doctor sent me to get what I now know as a urea breath test.
At first, when I swallowed the chalk-like tasting liquid my mouth and throat instantly got dry, leaving after only a few moments. When the breath test appeared positive with the presence of H. Pylori, my doctor gave me a strict set of dietary rules to follow and then I was placed upon a two-week therapy. Though, the constant medication was bothersome, all symptoms lessened and than demolished entirely. The only advice I would give anyone concerning ulcers, is try to eat right, and not to get tormented about petty things. Ulcers, ultimately feel like a burning inferno tucked below your skin.
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