Peptic Ulcer: Causes, Symptoms, and Treatment.... pharmacyteach

 Peptic Ulcer: Causes, Symptoms, and Treatment

Contents

What is a peptic ulcer?. 1

Formation of HCL in the stomach:-. 1

What causes peptic ulcers?. 2

Why Peptic ulcer occurs?. 3

What are the symptoms of peptic ulcers?. 3

How are peptic ulcers diagnosed?. 4

What are the treatment options for peptic ulcers?. 5

Drugs that inhibit gastric acid  secretion. 5

Drugs that neutralize gastric acid  (Antacids). 5

Ulcer protectives. 6

Anti-H. pylori drugs. 6

How can gastric ulcers be prevented?. 6

When should I see a doctor?. 7

Conclusion. 7

FAQs. 8

References. 9

 

Peptic ulcers are painful sores that develop on the lining of the stomach (stomach ulcer ) or the first part of the small intestine(small intestinal ulcer ). These ulcers can cause discomfort and can be a cause of serious health problems if left untreated. In this article, we will discuss the causes, symptoms, and treatment options for peptic ulcers.

 

What is a peptic ulcer?

A peptic ulcer is a sore that develops in the lining of the stomach or the duodenum, the first part of the small intestine. Peptic ulcers can be classified as gastric ulcers or duodenal ulcers.

1.  Gastric ulcers develop in the stomach (also called stomach ulcers),
2.  While duodenal ulcers develop in the duodenum.

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The complete classification of GIT drugs

Formation of HCL in the stomach:-

Secretion of HCL into the gastric cavity is the responsibility of the parietal cell of gastric glands of the stomach. Here we'll explain the whole process of the formation of gastric acid /HCL.

So CO2 is formed in the parietal cells by metabolic process and CO2 also inter into the cell from blood. H2O is already present in cells which ionizes into H+ and OH⁻ ions. CO2 reacts with OH to form HCO3 and H+ remains as an ion. figure 01.

CO2 +   OH⁻ ……… HCO3

 H+ ions enter the lumen of the canaliculus by proton pump inhibitor on the luminal membrane side of parietal cells. With the exchange of H+ ions k+ ions are inter into the cells by the same proton pump.

Conversely, CL⁻ ions are inter into the cell from an extravascular fluid by exchanging HCO3 on the basolateral side of parietal cells. After the inter of CL into the cells due to high concentration, it will exit into the lumen of canaliculus by CL channels.

Now in canaliculus high concentrations of H+ and CL⁻ are present which react to form HCL also called gastric acid.

For bitter understanding see the figure below;

 

Formation of HCL in the stomach..pharmacyteach

What causes peptic ulcers?

The most common cause of peptic ulcers is an infection with a bacterium called Helicobacter pylori (H. pylori). H. pylori bacteria can damage the protective lining of the stomach and duodenum, leading to the development of ulcers. Other factors that can contribute to the development of peptic ulcers include:

 

1. Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen.
2. Smoking cigarettes or using other tobacco products.
3. Excessive alcohol consumption.
4. Stress and anxiety.
5. Genetic factors.

Why Peptic ulcer occurs?

l  When there is primarily an Imbalance between Aggressive and Defensive factors, peptic ulcer can occur.

l  Imbalance means an increase or decrease level of these factors.

Aggressive factors (acid, pepsin, bile, H.pylori)

Defensive factors (mucus, HCO3, PG)

 

What are the symptoms of peptic ulcers?

The sign of peptic ulcers can vary depending on the location and severity of the ulcer. Some common symptoms of peptic ulcers include:

 

1. A burning or gnawing pain in the stomach or upper abdomen that may worsen at night or when the stomach is empty.
2. Nausea and vomiting.
3. Loss of appetite and weight loss.
4. Bloating and belching.
5. Feeling full after eating only a small amount of food.
6. Bloody or black stools.

 

 

How are peptic ulcers diagnosed?

To diagnose peptic ulcers, your doctor will perform a physical exam and ask about your symptoms and medical history. They may also recommend one or more of the following tests:

Upper endoscopy: A procedure in which a flexible tube with a camera is inserted into the esophagus, stomach, and duodenum to look for signs of ulcers.

Upper GI series: A procedure in which you drink a liquid that contains barium, which coats the lining of the digestive tract and makes it easier to see on X-rays.

H. pylori test: A blood, stool, or breath test to detect the presence of H. pylori bacteria.

 

What are the treatment options for peptic ulcers?

The treatment for peptic ulcers depends on the cause of the ulcer. Treatment options may include:

1. Antibiotics to kill H. pylori bacteria.
2. Proton pump inhibitors (PPIs)
3. Histamine receptor blockers (H2 blockers) reduce stomach acid production.
4. Antacids neutralize stomach acid.
5. Cytoprotective agents protect the lining of the stomach and duodenum.
6. Surgery in rare cases.

What are the treatment options for peptic ulcers?..pharmacyteach

Drugs that inhibit gastric acid  secretion

1.     H2 receptor blockers: Cimetidine,  Ranitidine, Famotidine

2.     Proton pump inhibitors: Omeprazole,  Pantoprazole, esomeprazole

3.     Anticholinergics : Pirenzepine

4.     Prostaglandin analogs: Misoprostol

Drugs that inhibit gastric acid secretion

Drugs that neutralize gastric acid  (Antacids)

1.     Systemic:

Sodium bicarbonate, sodium citrate

2.     Non-systemic:

                                                  i.      m hydroxide, Mag. Trisilicate,  Aluminium hydroxide gel, Magaldrate

Drugs that neutralize gastric acid (antacids)

Ulcer protective

b.     Sucralfat

c.      Colloidal Bismuth Sulfate (CBS)

Anti-H. pylori drugs

d.     Amoxicillin, Clarithromycin,  Metronidazole, Tinidazole, Tetracycline

 

 

How can gastric ulcers be prevented?

You can reduce your risk of developing peptic ulcers by:

• Avoiding or limiting your use of NSAIDs.
• Quitting smoking or using other tobacco products.
• Reducing your alcohol consumption.
• Managing stress and anxiety.
• Eating a healthy diet.

 

When should I see a doctor?

You should see a doctor if you experience any symptoms of peptic ulcers, especially if the pain is severe or if you vomit blood or have black, tarry stools. Prompt treatment can help prevent complications and improve your overall health.

 

Conclusion

Peptic ulcers are a common medical most common cause of peptic ulcers is an infection with H. pylori bacteria, Signs and Symptoms of peptic ulcers can vary depending on the location and severity of the ulcer. To diagnose peptic ulcers, your doctor may recommend one or more tests, including upper endoscopy, upper GI series, or an H. pylori test.

Treatment options for peptic ulcers can include antibiotics, PPIs, and H2 blockers to reduce stomach acid production, antacids to neutralize stomach acid, cytoprotective agents to protect the lining of the stomach and duodenum, and surgery in rare cases.

Preventing peptic ulcers involves avoiding or limiting the use of NSAIDs, quitting smoking or using other tobacco products, reducing alcohol consumption, managing stress and anxiety, and eating a healthy diet. If you experience any symptoms of peptic ulcers, you should see a doctor as soon as possible to prevent complications and improve your overall health.

However, with prompt diagnosis and appropriate treatment, most peptic ulcers can be successfully treated. If you have any concerns about your digestive health, be sure to speak with your doctor.

 

FAQs

Can stress cause peptic ulcers?

Stress can contribute to developing peptic ulcers, but it is not a direct cause.

 

Can stomach ulcers be cured?

Yes, most stomach ulcers can be cured with appropriate treatment.

 

How long does it take for a gastric ulcer to heal?

The healing time for a peptic ulcer depends on the cause and severity of the ulcer. With appropriate treatment, most ulcers will heal within a few weeks.

 

Can peptic ulcers lead to cancer?

In rare cases, peptic ulcers can lead to stomach cancer if left untreated.

 

Can I still eat spicy food if I have a stomach ulcer?

It is best to avoid spicy foods if you have a peptic ulcer, as they can worsen symptoms. However, every individual is different, and your doctor may be able to recommend specific dietary changes based on your unique situation.

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References

1.      Malfertheiner, P., Chan, F. K., & McColl, K. E. (2009). Peptic ulcer disease. The Lancet, 374(9699), 1449-1461.
2.      Chan, F. K., & Leung, W. K. (2002). Peptic-ulcer disease. The Lancet, 360(9337), 933-941.
3.      Sverdén, E., Agréus, L., Dunn, J. M., & Lagergren, J. (2019). Peptic ulcer disease. Bmj, 367.
4.      KURATA, J. H., & HAILE, B. M. (1984). Epidemiology of peptic ulcer disease. Clinics in gastroenterology, 13(2), 289-307.
5.      Peterson, W. L. (1991). Helicobacter pylori and peptic ulcer disease. New England Journal of Medicine, 324(15), 1043-1048.