The ulcer is a defect in the epithelial layer of the skin or the mucous layer of the basal membrane of an inflammatory nature and is quite deep.
An ulcer occurs due to various mechanical, chemical, infectious and radiation injuries. Also, ulcers appear in tissues and organs in violation of their supply of blood and nutrients and as a result of disturbance of innervation, that is, the connection of certain parts of the body with the central nervous system( CNS) through the neural pathways. Thus.the cause of the occurrence of ulcers lies in the damage to the tissues of organs and in the violations of their regulation by the main apparatus of the body's control - the central nervous system.
The main difference of the ulcer from is the erosion of on the mucosa - the depth of the lesion. Erosion is a superficial defect, and an ulcer is deep. The ulcer always heals with scar formation.
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Peptic
disease Under ulcer understoodpathology, in which there is the formation of ulcerative defects in various tissues and organs of the diseased organism. From what kind of tissues and organs ulceration takes place, and such widely known diseases as peptic ulcer and 12 duodenal ulcer take their name. And also some others, which we will consider later.
Stomach Ulcer
Gastric ulcer, or peptic ulcer is a localized defect in its mucosa. If the ulcer is deep enough, it also captures the submucosal layer. An ulcerative defect is formed due to the action of acid, pepsin and bile on that part of the mucous layer, in which the metabolic processes are disturbed.
Stomach ulcer develops as a result of the causes already listed above. It, as a rule, flows relapses, periods of exacerbations and remission alternate more often in the spring and autumn seasons.
Stomach ulcer can be classified according to the following signs: gastric ulcer acute or chronic( i.e., unspecified);it can be complicated by bleeding, perforation or not complicated.
Etiology and pathogenesis of
When the gastric mucosa proceeds normally, it is exposed to 2 factors - protective and aggressive.
Protective factors include the production of the mucous membrane of the stomach mucus, which creates a barrier for the reverse diffusion of protons to the shell.
Aggressive factors are gastric juice, because it contains hydrochloric acid and a protein processing enzyme - pepsin, as well as an infectious substance - Helicobacter. When aggressive factors begin to predominate over the defense, ulceration occurs.
Now, the presence of Helicobacter pylori is the most important factor in the occurrence of gastric ulcer. After all, the bacterium Helicobacter lives quietly in the gastric mucosa and gastric juice. However, not all people infected with Helicobacter pylori get stomach ulcers. The problem of the causes of ulcers is still not fully understood.
Causes of ulcers and peptic ulcer
Worldwide, 38% of gastric ulcers are associated with Helicobacter pylori. The second reason is treatment with nonsteroidal anti-inflammatory drugs and some other drugs. Other causes are tumor diseases, foreign bodies entering the stomach, syphilis, immunodeficiency virus, tuberculosis infection.
For the development of peptic ulcer stomach: tobacco smoking, abuse of ethanol with a high percentage, coffee, stress, anxiety, broken and improper diet, lack of hot food in the food, etc.
Symptoms of gastric ulcer
Clinical signs of ulcers depend on the location of the ulcer, the longitude of the disease and the threshold of the patient's individual sensitivity to pain.
The main symptom of an ulcer is the pain in the upper abdomen in the middle - in the epigastric region. With peptic ulcer of the stomach, pain occurs after eating, when the ulcer is not in the stomach, but in the duodenum - the pain is "hungry", that is, it occurs on an empty stomach. Acceptance of moderate food leads to relief of the patient's condition.
Additional symptoms of gastric ulcer are: heaviness in the abdomen, heartburn, sour eructations, nausea and vomiting after eating. It is necessary to remember the following: let there be no pain, but there is heartburn, remember that heartburn is equivalent to pain.
Diagnosis
- The blood test is usually uninformative( unless, of course, there is bleeding, but there are external signs of bleeding - pallor, fainting, dizziness, weakness, low blood pressure).
- It is necessary to analyze the feces for the presence of hidden blood.
- To investigate the acid-forming function of the stomach.
- To investigate the X-ray of the stomach with radiopaque substance. You can see the cavity on the contour of the mucous membrane.
- Conduct endoscopic examination of the stomach and duodenum. You can visually see the ulcer defect, its shape, size, depth and location.
- Determine the presence of Helicobacter pylori in the gastric juice and stomach.
Treatment of
The main therapy is complete destruction, or eradication of the microbe Helicobacter. Always apply antacid drugs, i.e. enveloping and wound healing. Suppress the secretion of hydrochloric acid in gastric juice with antisecretory drugs, which are selected strictly individually. Treatment of ulcers and gastric ulcer and 12 PCs is strictly necessary under the supervision of a surgeon and therapist.
Prognosis and complications of
With correct and timely treatment of stomach ulcer, the prognosis is favorable. The patient is restored to health and ability to work.
With improper treatment or lack of it, as well as a violation of diet, peptic ulcer disease can be complicated by bleeding from a peptic ulcer, in which the development of a threatening condition for the life of the patient is possible. Another complication is perforation of the ulcer, followed by the development of peritonitis.
In case of any suspicion of bleeding or perforation of the ulcerative defect, the surgeon should be urgently contacted.
Signs and symptoms of bleeding
The main signs of bleeding with peptic ulcer disease are vomiting of crimson color, a feeling of fullness in the stomach, general weakness and dizziness, pale skin, cold sweat, palpitations of frequent and weak filling, feeling of lack of air.
The main symptom of perforation of a ulcerative defect in peptic ulcer is an acute pain in the upper abdomen of the "dagger" type. It can not be confused with anything. The perforated ulcer is treated only by surgical methods.
Duodenal ulcer
Duodenal ulcer occurs under the same conditions under which a stomach ulcer develops. It is also characterized by a recurrent course. But it should be noted that the ulcer 12PK is observed 4 times more often than in the stomach. It also happens that ulcers are formed immediately in the stomach and in the duodenum. This is a combination of ulcers.
Symptoms of duodenal ulcers are pain and indigestion. Three quarters of patients complain of pain in the upper half of the abdomen, more often under the spoon. Half of patients have moderate pain, but one-third have pain syndrome.
Pain appears or worsens with irregular eating habits, alcohol intake, spicy food and physical exertion. When the course of duodenal ulcer is typical, the pain has a very noticeable connection with the diet. After taking baking soda, pain and heartburn quickly disappear or decrease. The pain in the upper part of the abdomen is suppressed after moderate light meals, antacids and antisecretory drugs.
Complications of duodenal ulcer can be the same as in peptic ulcer. Examination of patients, too, as with ulcers of the stomach.
Consider the numerous questions and answers about ulcers and stomach ulcers and duodenal ulcer in questions and answers.
If you want to know more about acidic, perforating and through-going ulcers, about the make-ups and types of stomach ulcers and what is prescribed for them, and what can be treated, flip through the site of Alcostad.ru. Earlier this article was posted on MedVlad.ru, which is currently closed.