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Lifestyle changes key to treating peptic ulcer

Peptic ulcer is a mucosal break of more than 3 mm in size with depth, breach in the continuity of the inner lining of the stomach (gastric ulcer) or the duodenum (first part of the small intestine - duodenal ulcer).

A state of ‘hyperacidity’ occurs in the stomach, which affects the inner lining of the stomach or duodenum. The inner lining initially becomes red, later develops multiple small erosions and ultimately breaks down to form an ‘ulcer’. Ulcers that develop in the stomach following H.pylori infection need to be treated aggressively. If left untreated, they could develop into cancer.

Although peptic ulcers produce a variety of symptoms, none is specific for the disease. The usual symptoms are discomfort in upper part of abdomen, belching, bloating (sense of fullness) and nausea. Indeed, peptic ulcers are the most common cause of acute upper Gastro Intestinal bleeding which may manifest as blood in vomiting (haemetemesis) or dark-tarry stool (melena). Severe pain or a rapid increase in pain suggests a peptic ulcer complication.

Stressful life, irregular meals, consumption of spicy foods, nicotine and alcohol are some of the causes of the disease.

In the early phase, patient complains of burning sensation in the upper abdomen and nausea &/or vomiting, bloating, belching etc. The patient’s pain varies in intensity depending on the severity of hyperacidity. The pain often increases after food. When the pain becomes intense, the patient is unable to tolerate anything orally i.e. he/she vomits following eating or drinking anything sometimes even water.

The person, who suffers from any of the above mentioned symptoms, should visit a doctor who will identify his disease and counsel him on lifestyle and diet. These patients require upper GI scopy (a procedure in which a tube is passed through mouth to visualise the stomach and duodenum) and biopsy at the same time or blood test to screen for helicobacter pylori infection.

Treatment for this disease depends upon cause of the disease in the individual which may vary from the life style modification, removal of the contributory factors, medicine to eradicate the helicobacter pylori infection. H.pylori infection if detected needs to be treated aggressively with antibiotics. In severe conditions, the patient needs to be hospitalised.

The role of surgery in this disease is limited to patients with one of complications of peptic ulcer like perforation leading to acute severe pain, bleeding and obstruction manifesting as vomiting after meal.

Dr Uday Shankar & Dr Phanipriya Garikapati, Specialist surgeons, Zulekha Hospital, Dubai.