Peptic ulcer and surgical treatment

Ulcer in the stomach is called gastric ulcer, in the duodenum is called duodenal ulcer. Peptic ulcers viewed in the gastroscopy appear as little mouth ulcers of 1-2cm in diameter. Gastric ulcer causes a sharp pain in the stomach soon after eating, in duodenal ulcer the pain is relieved by drinking milk. Other symptoms are: loss of appetite, belching, sensation of discomfort in the stomach, nausea, loss of weight.

Diagnosis

It is important to diagnose ulcers with specific tests in order not to be mistaken with stomach cancer. One is the breath test you are given a substance and if there is infection with H. Pylori in your stomach then a gas is produced and detected in the breath. Barium meal X-ray is also helpfull in detecting ulcers. Gastroscopy uses a
fibre-optic cable which is passed through the stomach and shows the lining of the stomach, a biopsy may be taken in the same time.

Treatment

Comprises a change in the life style, to reduce the symptoms and help healing the ulcers. Although no study has proved the direct implication of spicy foods, coffee and possibly alcohol in the producing of ulcer you???d better avoid them and stop smoking and lose weight. Use paracetamol instead of non steroids anti-inflammatory drugs and ask youGP for advice.

Drugs that reduce the acid in the stomach are: H2-antagonists such as ranitidine and cimetidine, proton pump inhibitors that have a more powerful effect in reducing the protection of the stomach acid.

How to eradicate H. Pylori

The best treatment in eradicating the infection with H. Pylori is a combination of antibiotics and a proton pump inhibitor. Only after curing the infection with H. Pylori you may be sure that the ulcer won???t re-appear. Sometime further tests such as: gastroscopy or barium swallow are necessary.

Complications

Some of the peptic ulcers may heal without treatment, spontaneously. But if they complicate the whole situation is severe, there may appear ulcer bleeding, ulcer perforation, and gastric obstruction. Ulcer bleeding manifests as: melena or black stools, weakness, orthostatic syncope, hematemesis meaning blood vomiting.

If the ulcer is perforated the gastric contents are leaked in the peritoneal cavity and results in acute peritonitis. Those cases are very severe and surgery is required immediately, because the abdomen muscles become rigid and any motion determines extreme abdominal pain.

If gastric obstruction occurs near the pyloric canal which joins the stomach to the duodenum the patient reports increasing abdominal pain, diminished appetite, vomiting of undigested or partially digested food and weight loss.
Surgery was very used in the past in the treatment of the peptic ulcers, complications such as: severe bleeding or perforation may require surgery. Because peritonitis is probable to develop you need to address the emergency as soon as possible. Surgery is performed under a sedative and through a gastroscope.