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ESOPHAGEAL ULCER (PEPTIC ULCER)

Esophageal ulcers are also called as peptic ulcers. Peptic ulcers are the ulcers that develop in the inner lining of the stomach, lower esophagus and also in the duodenum. It is the most common type of ulcer which causes burning and pain in the abdomen. This condition is developed due to an inflammation caused by bacteria called H.pylori and also due to acid reflux from the stomach.

Peptic ulcers are the holes that are created in the inner lining of the stomach and therefore they come in contact with the acids in the stomach. More than 4 percent of the population suffers from peptic ulcers. If this condition is left untreated more and more health complications may develop.

TYPES OF PEPTIC ULCERS

There are three types of peptic ulcers. They are:

Gastric ulcers are the ulcers that develop inside the stomach.

Esophageal ulcers are the ulcers that develop inside the esophagus.

Duodenal ulcers are the ulcers that develop in the duodenum.

SIGNS AND SYMPTOMS

The most common symptom of peptic ulcer is pain. A person suffering from peptic ulcer may usually experience pain in the upper abdomen, just below the chest. The pain may last for a few minutes or several hours. The pain may increase during the night as the stomach is empty and the wall of the stomach is directly exposed to acid for a long period of time.

 

The other symptoms of peptic ulcer include:

  • Bloating
  • Vomiting
  • Stomach upset
  • Poor appetite
  • Indigestion
  • Loss of weight
  • Constant burping

CAUSES

There are various causes for the ulcers to form on the inner lining of the stomach, esophagus and duodenum. They are:

  • Tobacco smoking
  • Excess consumption of alcohol
  • Tumor in the stomach
  • Radiation therapy
  • Infection in the stomach caused by bacteria H. pylori

DIAGNOSIS

The following are the tests performed to diagnose peptic ulcer:

  • Physical examination is performed by the doctor to check for abnormalities in the body. He may require a medical history of the patient. The doctor may then examine the abdomen and may ask the patient about drinking and smoking habits.
  • Blood test is performed to determine the levels of white blood cells as an increase in the level of white blood cells may result in the development of an infection in the body.
  • Barium meal is a test in which series of X-rays are taken after drinking a white solution, called a barium meal. This helps in delineating the stomach and intestines clearly to observe the presence of an ulcer in the stomach.
  • Endoscopy is also performed which is a process in which a flexible tube is mounted with a camera that is inserted through the mouth into the stomach to take a direct look at the ulcer.
  • Biopsy may be done, i.e. a piece of tissue may be snipped off the ulcers to enable examination under the microscope in the laboratory.

TREATMENT

The doctor may decide an appropriate treatment for peptic ulcer based o the condition of the patient. The treatment involves the elimination of H. pylori bacterium from the body and the reduction of acid secretion in the stomach. The following medications and treatments are provided to treat the condition.

  • To kill the bacteria, antibiotics like amoxicillin, clarithromycin, and metronidazole are used.
  • To reduce acid production in the stomach, H2 blockers are used. These include drugs like ranitidine, famotidine, or cimetidine. These medicines block histamine, a chemical signal that triggers acid production in the stomach.
  • The pumps that secrete acid in the stomach can be blocked by medicines called proton pump inhibitors (PPIs). These include omeprazole, pantoprazole, rabeprazole, or lansoprazole.
  • The excess production of acid can be neutralized by medicines called antacids. These include salts like sodium bicarbonate (baking soda) and calcium carbonate. A combination of these agents may be used depending upon the condition and severity of the disease.
  • Triple therapy is a trio of antibiotics, PPIs, and H2 blockers used to treat ulcers due to H. pylori. Antibiotics like clarithromycin, amoxicillin or metronidazole, and a PPI are used for 10 to 14 days to treat the condition.

Some other medicines which may help are sucralfate that forms a coating on the lining and protects it, and misoprostol, a drug that prevents ulcers in people who take regular NSAIDs. These are called cytoprotective agents.

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