Duodenal ulcer

Duodenal ulcer ( Ulcus duodeni ) is a lesion of the mucous membrane of the duodenum. In this case, both the upper or outer layer and the entire mucous membrane can be damaged. Statistics show that men most often suffer from this disease and that duodenal ulcers are more common than stomach ulcers. Both types are characterized by pain with food intake, but with duodenal ulcers, symptoms often occur with an empty stomach or at night and decrease with food intake. The ulcer is usually found in the upper part of the duodenum. An exacerbation of the disease is observed in spring and autumn.

Symptoms

The main symptom of the disease is pain in the upper abdomen. But often, loss of appetite, nausea, vomiting, and a feeling of fullness indicate the first signs of an ulcer. The burning pain typical of an ulcer occurs about two hours after eating in the middle of the upper abdomen or in the navel.

Causes and risks

The appearance of an ulcer can have many reasons, but one of the most common is a chronic infection with the pathogen - the bacteria Helicobacter pylori. An ulcer is caused by an imbalance between protective factors (mucus, bicarbonate, prostaglandin) and aggressive elements like stomach acid, proteases and inflammation. In addition, an ulcer can be caused by circulatory disorders of the intestinal wall, taking medications (primarily painkillers and antirheumatic drugs), as well as psychosomatic factors. A duodenal ulcer can cause many complications. The most common are bleeding (dark colored stools, vomiting of blood) and ulcer breakout (perforation), which can cause inflammation of the peritoneum (peritonitis).

Examination and diagnostics

If the complaints are long-term, then esophagogastroduodenoscopy (EGDS) should be performed to clarify the problem. In this case, a biopsy of samples of suspicious areas of tissue is performed, which are then carefully examined and may indicate the presence of Helicobacter pylori bacteria or other causes of the disease. With the so-called. rapid urease test tissue samples are combined with a liquid containing urea. If the biopsy contains bacteria, then urease breaks down urea and the fluid changes color. Another way to prove the presence of Helicobacter pylori bacteria is the 13C breath test. In this case, the patient drinks a liquid labeled with 13C-urea. Thus, 13C-labeled bicarbonate produced after digestion by bacterial urease is present in the exhaled air and indicates the presence of H. pylori.

Treatment

In the presence of Helicobacter pylori bacteria, it is necessary to carry out the so-called. eradication therapy. We are talking about the combined use of two antibiotics and an acidity blocker. The medication should be taken for at least 7 days or you can buy aciphex. The selection of the appropriate medication depends on many factors (history of antibiotic intake, expected resistance). Eradication therapy usually leads to the successful elimination of bacteria and protects the body from the formation of new ulcers in the intestine.

An ulcer not caused by Helicobacter bacteria can be treated symptomatically. At the same time, it is necessary to minimize or completely eliminate the factors causing the disease, such as stress, alcohol consumption, smoking. At the same time, medications that regulate stomach acid should be used to speed up the healing process of the ulcer. Surgical intervention in our time is usually not required, but possible complications (for example, a break in the intestinal wall) can lead to urgent surgery.

Current and projections

After drug treatment, relapse of the disease and re-infection with Helicobacter bacteria are extremely rare. The eradication therapy efficacy rate is about 90%. As part of a long-term conservative treatment that promotes good therapy results, it is recommended to follow a diet, quit smoking and alcohol consumption, avoid stress and take acid-inhibiting drugs.