Peptic ulcers: Symptoms, triggers, and remedies
In the realm of global health, peptic ulcers continue to be a significant concern. According to recent statistics, approximately 8% of the world population, equating to millions of individuals, have experienced at least one peptic ulcer. This number has seen a 25% increase since 1990 [1].
Peptic ulcers can develop due to various factors, with two primary causes being Helicobacter pylori (H. pylori) infection and the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) [2]. However, a myriad of other contributing factors also plays a role.
Smoking, for instance, increases stomach acid production and hinders the healing of ulcers or erosions by impairing mucosal defenses [3]. Excessive alcohol consumption can erode the stomach's protective mucous lining, making it more vulnerable to acid damage [3]. High levels of physical or emotional stress have been shown to disrupt the mucosal barrier, potentially contributing to ulcer formation [1].
Aging can also weaken mucosal defenses and increase susceptibility to ulcers [1]. Irregular eating habits or a poor diet can affect stomach acid regulation and mucosal protection [1]. Genetics may influence individual susceptibility, and rare medical conditions like Zollinger-Ellison syndrome can cause excessive gastric acid secretion, leading to ulcers [5].
Peptic ulcers can lead to complications such as internal bleeding, bowel obstruction, and perforation (when the ulcer bores a hole through the wall of the stomach or small intestine) [2]. It's crucial to seek medical attention promptly if symptoms such as a dull, burning pain in the stomach, nausea, vomiting, feeling bloated or full, or more severe signs like bleeding, vomiting blood, black and tarry stools, or persistent and severe nausea and vomiting, are experienced.
Fortunately, prevention and management strategies are available. A diet rich in fiber, including oats, flax seeds, legumes, nuts, barley, certain fruits and vegetables, may help reduce the risk of ulcers [4]. Limiting or avoiding certain foods such as alcohol, caffeine, citrus fruits, and spicy foods, if they cause discomfort, can also be beneficial [4].
Doctors may recommend avoiding NSAIDs, especially if they are used frequently, to prevent new ulcers from forming [2]. In cases where H. pylori is the culprit, antibiotic treatment is necessary to remove the bacterium from the stomach and prevent them from returning [2]. Quadruple therapy, which involves using two antibiotics, a proton pump inhibitor, and bismuth subsalicylate, is used to eradicate H. pylori [2].
Doctors may also use antisecretory agents, such as H2 receptor antagonists and proton pump inhibitors, to help block stomach acid production [6]. Diagnosis typically involves a physical exam, blood tests, breath tests, stool antigen tests, upper gastrointestinal X-rays, EsophagoGastroDuodenoscopy or upper endoscopy, and biopsies for examination under a microscope [6].
In conclusion, while H. pylori and NSAIDs are primary causes of peptic ulcers, lifestyle factors (smoking, alcohol, stress), physiological changes (age), genetic predisposition, and rare medical conditions are notable contributors. By understanding these factors and adopting preventive measures, individuals can help mitigate their risk of developing peptic ulcers.
References: [1] https://www.ncbi.nlm.nih.gov/books/NBK470368/ [2] https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcer-disease [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3643642/ [4] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5862507/ [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554454/ [6] https://www.ncbi.nlm.nih.gov/books/NBK537000/
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