Peptic Ulcers (Gastric or Duodenal)

Peptic ulcers occur either in the stomach of duodenum where food is digested. They are called peptic ulcers because it is considered that acid and pepsin, secreted in the stomach plays a part in their formation.

Peptic ulcers occurring in the stomach are called gastric ulcers and those occurring in the duodenum are called duodenal ulcers.

Whereas increased acid secretion plays a part in the formation of the crater in the mucus lining of the stomach or duodenum, other factors also play a role.

Genetic makeup seems to have an influence. Some people can live healthy life and develop ulcers while others abuse their gastrointestinal tract in a variety of ways and still not suffer meals, smoking, alcohol and medications particularly aspirin and the non steroid anti-inflammatory tablets all play a part in forming ulcers in the susceptible person.

Most of us experience dyspepsia at some stage of life, which is generally relieved by milk or antacid tablets or mixtures. If symptoms persist for a week or two then you should consult your doctor particularly if there is no obvious cause for the discomfort.

Both types of ulcers cause similar but varied symptoms. Burning, sharp, dull or penetrating pain is the main symptom. It is generally located in the pit of the stomach just under the rib cage. In the case of a gastric ulcer it can be a little over to the left. In the case of duodenal ulcer, perhaps to the right. It can vary in its time of appearance but often has a relationship to meals. It can come on before of after meals, can be relieved by food, milk or antacids, yet at times a good vomit will ease the pain. Duodenal ulcers will often wake you up in the early hours of the morning.

Whilst it is well to remember that peptic ulcers can even occur in childhood, most ulcers occur or at least are diagnosed in adulthood and can produce complications from the mid thirties on. These complications include bleeding, perforation, obstruction and cancer.

Bleeding can often be insidious and only up with black motions. Iron medication can also cause black motions. A sudden acute haemorrhage produces the sudden vomiting of what looks like coffee grounds perhaps intermingled with bright blood. Sudden weakness, dizziness, fainting, a cold moist skin first and the desire to pass a motion may precede or be associated with an acute haemorrhage even without the occurrence of vomiting.

A perforated ulcer can be dangerous as the initial symptoms of intense abdominal pain, nausea and vomiting may suddenly subside for several hours. This can lead to a false sense of relief. Symptoms will then reappear with blood like rigidity of the abdominal wall associated with fever and signs of shock and general collapse. An acute perforation is a possible surgical emergency and needs quick medical or surgical attention.

An obstruction of the passage of food through the gastrointestinal tract due to peptic ulcer can be acute or chronic. Vomiting is the main symptom and in acute cases can be copious, particularly after meals. Surgical treatment is generally necessary in case of obstruction.

It can be impossible to differentiate between a gastric or duodenal ulcer or even cancer on symptoms alone. Cancer can always be present with all of the previous mentioned symptoms but loss of weight may be an additional factor.

Persistent symptoms that donít settle with medical treatment need investigation even in the young person and your doctor should be consulted if you are concerned. Medical treatment of peptic ulceration is very satisfactor

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