Peptic ulcer is a chronic polyetiological pathology that occurs with the formation of ulcerative lesions in the stomach, a tendency to progression and the formation of complications. The main clinical signs of peptic ulcer disease include pain in the stomach and dyspeptic symptoms. The diagnostic standard is endoscopic examination with biopsy of pathological areas, X-ray of the stomach, detection of H. pylori. Complex treatment: dietary and physiotherapy, eradication of Helicobacter pylori infection, surgical correction of complications of the disease.
Stomach ulcer symptoms
The clinical course of gastric ulcer is characterized by periods of remission and exacerbation. Exacerbation of ulcer is characterized by the appearance and increase of pain in the epigastria region and under the xiphoid process of the sternum. With an ulcer of the body of the stomach, the pain is localized to the left of the central line of the body; in the presence of ulceration of the pyloric region – on the right. Possible irradiation of pain in the left half of the chest, scapula, lower back, and spine. Stomach ulcer is characterized by the occurrence of pain syndrome immediately after eating with an increase in intensity within 30-60 minutes after eating; pylorus ulcer can lead to the development of nocturnal, hungry and late pains (3-4 hours after eating). The pain syndrome is stopped by applying a heating pad to the stomach area, taking antacids, antispasmodics, proton pump inhibitors, H2-histamine receptor blockers.
In addition to pain, YBZH is characterized by lining of the tongue, bad breath, dyspeptic symptoms – nausea, vomiting, heartburn, increased flatulence, instability of the stool. Vomiting occurs predominantly at the height of stomach pain and brings relief. Some patients tend to induce vomiting to improve their condition, which leads to disease progression and complications.
Atypical forms of gastric ulcer can manifest as pain in the right iliac region (appendicular type), in the region of the heart (cardiac type), lower back (radiculitis pain). In exceptional cases, pain syndrome in peptic ulcer may be absent altogether, then the first sign of the disease is bleeding, perforation or cicatricial stenosis of the stomach, due to which the patient seeks medical help.
Prediction and prevention of gastric ulcer
The prognosis for gastric ulcer largely depends on the timeliness of seeking medical help and the effectiveness of anti-Helicobacter pylori therapy. PUD is complicated by gastric bleeding in every fifth patient, from 5 to 15% of patients undergo perforation or penetration of the ulcer, 2% develop cicatricial stenosis of the stomach. In children, the incidence of complications of gastric ulcer is lower – no more than 4%. The likelihood of developing stomach cancer in patients with peptic ulcer is 3-6 times higher than among people without this pathology.
Primary prevention of gastric ulcer includes the prevention of infection with Helicobacter pylori infection, the elimination of risk factors for the development of this pathology (smoking, cramped living conditions, low standard of living). Secondary prevention is aimed at preventing relapses and includes adherence to diet, elimination of stress, and the appointment of an anti-Helicobacter pill regimen when the first symptoms of peptic ulcer appear. Patients with gastric ulcer require lifelong observation, endoscopic examination with mandatory tests for H. pylori once every six months.