In this article, I would like to tell you about peptic ulcers (stomach-duodenal ulcers), which are one of the important diseases of our age.
To be more knowledgeable about diseases such as stomach pains, gastritis and ulcers, which we often hear about and most of us experience personally. I believe that being conscious and conscious is absolutely necessary for people who grow up, live and work with urban culture in the 21st century. We use medicines and apply some alternative treatment methods by hearing from those around us.
In this article, I will try to make us more aware of the diseases of the stomach and duodenum (duodenum), which we call peptic diseases.
Ulcer actually originates in the stomach. It is a general medical definition, not specific. Ulcers are wounds that develop on the tissue covering the surfaces of our body or internal organs in contact with air, called skin and mucosa. These wounds can be seen on the skin, in diabetics, in bedridden people, or in any of the organs we call the digestive system, starting with the mouth and ending with the anus.
These wounds in the stomach and duodenum are generally called peptic ulcer disease. This disease is determined by the presence of wounds of different depths formed in the tissue covering the surface of the relevant organ, under the influence of stomach acid and a liquid called pepsin secreted from the stomach.
By the way, let me point out that although the tissues that secrete this secretion are in the stomach, A similar disease can also be seen in neighboring organs (duodenum and esophagus) and in the small intestines where this tissue is located. Each of these diseases is given different names, but I would like to keep them out of our topic for now. (such as Zollinger Ellison - Meckel's diverticulum) The special structure of the inner layer of the stomach and duodenum and the thick protective secretion layer covering this layer protect these organs against the secreted acid.
These wounds and the diseases they cause, which we will generally list under four headings, are as follows:
- Superficial injury and inflammation in the inner surface of the stomach (Gastritis)
- Superficial injury and inflammation in the duodenum (Duodenitis)
- Deep wound in the stomach (Stomach ulcer)
According to the statistics made in the United States, the prevalence of peptic ulcer in the world is 2% in recent publications. It is seen at similar rates in men and women. On the other hand, duodenal ulcers are 5 times more common than stomach ulcers. These ulcers, which are rare in childhood, are still accepted diseases that can be seen at any age.
Peptic ulcers are more common in chronic lung diseases, liver cirrhosis, chronic kidney failure and kidney stones.
This disease is It occurs when the balance between mucosa-aggressive (aggressive) factors and mucosa-protective factors is disrupted in favor of aggressive factors.
We Can Count These Factors as follows
- Aggressive (aggressive) Factors: Acid, pepsin, bile acids, aspirin, antirheumatic drugs and the microbe called helicobacter pylori, stress, smoking and alcohol.
- Protective Factors: Mucus (secretion covering the inner layer), bicarbonate, blood flow, regenerative ability, some active ingredients (such as prostaglandin). )
In gastritis and duodenitis, patients consult a doctor with complaints of fullness, bloating, pain, burning, and sourness in the stomach, while in peptic ulcer disease, the excruciating pain and burning sensation in the stomach area that occasionally hits the back occurs after meals. -They may complain of nausea, weight loss, weakness and loss of appetite, along with severe pain that wakes them up after 3 hours and at night. These patients even say that the pain is relieved with certain foods such as milk and bread or antacids.
In case of bleeding, this can be seen as blackening of the stool color and vomiting in the form of coffee grounds.
In this disease, I would also like to give brief information about the microbe (Helico bacter pylori) that is related and frequently talked about today. This microbe is transmitted to humans through contaminated water and food. The incidence increases with age. The microbe settles in the protective mucus layer of the stomach, and then those with disease-causing properties disrupt this protective layer with the toxin they secrete, creating an environment for disease development. The presence of this microbe has been shown in 90% of duodenal ulcers. We can understand the existence of this microbe from blood, breath and feces, as well as what I call endoscopy. While the scar is entered through the mouth and the stomach and duodenum are examined, we can also investigate its presence from samples taken from these organs. Another important feature for our country is the increasing resistance of this microbe to antibiotics and its treatment becoming increasingly difficult due to the antibiotics that the public uses easily and for different reasons. Because while perhaps no antibiotics are needed for a simple upper respiratory tract infection, the antibiotics we take (e.g. largopen, etc.) may also be effective against this microbe, but resistance may appear due to unnecessary use.
The initial diagnosis of patients presenting with these complaints is based on what the patient tells. can be placed. When the patient's complaints are listened to carefully, if peptic ulcer disease is suspected, x-rays taken by ingesting a white, radiopaque (visible on the film) drug or, for a higher accuracy rate, examinations performed through the mouth with special camera tubes, which we call endoscopy, help us diagnose the disease.
The superiority of endoscopy is that, in addition to its higher success in diagnosis, it also provides additional features such as detecting some additional diseases together or separately with the ulcer, obtaining results under the microscope by taking samples from them, and investigating the presence of helico bacter pylori microbe.
Recently, I can easily say that endoscopies, which are improved in size, smaller in diameter and performed under light anesthesia, are no longer a feared examination for people.
The main thing in treatment is to reduce or eliminate the effects of the aggressive factors we have just mentioned. In short, these are;
- Lowering stomach acid
- Repairing the protective layer
- Destroying the Helicobacter pylori microbe
- Cutting the antirheumatic medication or aspirin used
- Quitting smoking immediately
- The most impossible thing is probably getting rid of stress
We can say that.
I would also like to briefly talk about surgical treatment. Thanks to developing diagnosis and treatment methods, the operation rate in the treatment of this disease has decreased significantly, which is pleasing. Because the side effects of the operations sometimes impair the patient's quality of life, on the other hand, since the necessary explanations are not given to the patient before the surgery, the patient may not be comfortable after the operation due to these effects. becomes horseless. Today, surgery for peptic ulcers is performed under the following conditions.
- Perforation of the ulcer
- Frequently recurring or unstoppable bleeding
- Obstruction in the stomach outlet
- The presence of ulcer wounds that do not heal It causes. The important thing is to have these diseases examined and evaluated in a timely manner and treated in a timely manner, rather than being delayed with the prejudice of "nothing will happen to me".
I tried to explain how important this is even in a peptic ulcer disease.
I hope we all We stay healthy.
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