Peptic ulcer

Peptic ulcer – what is a peptic ulcer

Peptic ulcer (peptic ulcer disease) represents open sores in the mucous membrane of the lower esophagus, stomach or duodenum mainly as a result of bacterial infection caused by Helicobacter pylori. The most common symptom is severe stomach pain that extends from the navel to the sternum. If left untreated over time, sores get worse and can cause serious complications.

Symptoms

Symptoms of peptic ulcer depend on the location of the ulcer and the age of the patient, as many patients, especially the older ones, have few or no symptoms at all.

Pain is the most common symptom of a peptic ulcer, often localized in the epigastrium. It has the character of burning or biting, and can also spread to the back or to the right rib arch, which is usually a sign of complication. Sudden sharp and very severe pain indicates a perforation.

Pain in the duodenal ulcer occurs on an empty stomach and 2 to 3 hours after a meal. It also often occurs during the night. After taking a small amount of food or antacid, the pain stops.

In a gastric ulcer, the pain occurs within one hour of ingestion, and eating out of the desire for relief may further exacerbate the pain.

Difficult discharge of the gastroduodenum may be due to the localization of an acute ulcer or fibro-stenotic anatomical changes after previous ulcers. In these cases, inappetence (lack of appetite), nausea and vomiting may occur. These symptoms result in weight loss.

Heartburn is common in patients with duodenal ulcer. The appearance of melena (stool as black as tar) or hematemesis (vomiting of fresh, red or only minimal liquid mixed with blood or clotting blood, or vomiting of dark blood) indicates a bleeding ulcer.

peptic ulcer

Causes and risk factors

It was once believed that peptic ulcers were caused by spicy foods or a stressful life. Today, the most common causes of stomach ulcers are:

Heliobacter pylori (H. pylori) infection

Although it is not entirely clear how Heliobacter pylori spread, most scientists believe it is most commonly transmitted directly from infected to healthy individuals. It can also enter into the human organism through food and water. This bacterium has several strains and most commonly lives on the gastric mucosa. In most cases, it does not cause problems, but it can cause acute inflammation (gastritis), which then becomes chronic and can cause an ulcer. Studies show that about 15 to 20% of people infected with H. pylori will develop a gastric or duodenal ulcer, and less than 1% will have cancer or gastric lymphoma.

Regular use of certain painkillers

Certain painkillers from the group of NSAIDs make the stomach or duodenal mucosa more susceptible to injury. These are medicines like ketoprofen, ibuprofen, diclofenac, indomethacin and others. Approximately 30% of adults who regularly use these drug groups experience side effects on the digestive system.

Risk factors for gastric ulcer are:

Smoking and alcohol consumption – Both bad habits stimulate the stomach to produce more acid than usual. If a person also has an H. pylori infection, the risk of developing a peptic ulcer is even greater,

Cocaine and methamphetamine intake – These narcotics restrict blood flow to the gastric mucosa, preventing its normal functioning,

Viral diseases – Viruses, such as cytomegalovirus and herpes, especially in the elderly and those whose immunity is already compromised can increase the risk of peptic ulcer development

Emotional stress

Treatment

The type of therapy will certainly depend on the cause of the ulcer. Some of the options are:

Antibiotics

If a peptic ulcer is caused by H. pylori infection, therapy will consist of a combination of two antibiotics and some type of acid-blocking drugs, such as a proton pump inhibitor.

Proton pump inhibitors

Unless a bacterial infection is present, these medicines will regulate the amount of gastric acid and help cure the ulcer.

Recommendations

Reduce the use of non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen. These drugs are used by people of all ages, as they are often prescribed to treat a wide variety of conditions such as fever and pain – and some abuse and rely on these drugs alone to relieve chronic pain (such as headache, arthritis (joint pain). PMS cramps, etc.). This group of drugs has a great impact on the digestive system by reducing the production of mucus, which plays a very important role in the defense of the gastric and intestinal mucous membranes against strong gastric acid and other digestive enzymes. Try to stop using these medicines or at least reduce them. Talk to your doctor about other possible ways to control your pain.

Control stress situations. Although the theory that stress alone can be the cause of peptic ulcer is no longer supported, it is still considered somewhat “psychosomatic”. When one experiences chronic stress, the risk of developing an ulcer goes up a lot because there is a strong connection between the brain and the digestive process.

Balance your diet. Although talking about eating frequently throughout the day is not the best option in this case. Try to skip meals and reduce meals to 3 times a day, but large amounts of food can aggravate the symptoms of an ulcer in the digestive tract, so be careful. Also, avoiding breakfast, in this case, is not the best idea. If you are able, it would be best to seek help with a diet plan with your doctor or fitness trainer.

Crohn‘s disease

Crohn‘s disease

Crohn’s disease is an inflammatory disease of the gastrointestinal tract that can affect any part of the digestive system, from the oral cavity to the end of the colon, and is often difficult to distinguish from ulcerous colitis (inflammation of the colon with ulcerations).

Most commonly, the affected part of the gastrointestinal tract in Crohn’s disease is the terminal part of the small intestine (ileum) and large intestine (colon), although changes can occur on any part of the digestive organ. An intestinal wall can bleed and even lead to perforation of the intestinal wall with leakage of intestinal contents into the abdominal cavity causing numerous complications.

Causes

Various clinical studies have shown that the genetic factor plays a very important role in the onset of this disease. There is a high degree of concordance in the disease of monozygotic twins.

Numerous infective, bacterial and viral agents have been suggested as the cause, but without definitive evidence. M. paratuberculosis causes, in ruminants, Johne’s disease, a chronic inflammatory disease of the ileum, similar to Crohn’s disease.

The predisposing factors of Crohn’s disease include diets containing a lot of refined sugars and the use of contraceptives. Smoking is also one of the possible synergistic triggers for this disease.

Signs and symptoms

Periods of exacerbation and improvement change, besides the ileocecum, the descending colon and other segments can be affected also, so the symptoms mainly depend on the localization. However, three are dominant: diarrhea, abdominal pain, weight loss.

The acute phase goes with fever, loss of appetite, nausea; often the clinical picture is nonspecific and atypical. Palpable mass can be found in the ileocecum, the involvement of the entire small intestine is prognostically unfavorable. Colonic involvement is mainly manifested by diarrhea, rarely by hematochezia, and extra-intestinal symptoms are more common than in the small intestine.

intestines

Perianal involvement is manifested by fissures, ulcerated hemorrhoids, and ulcers. Abscesses, rarely, anovaginal fistulas and strictures are also seen, either as an underlying disease or a complication.

Extra-intestinal complications are, in fact, systemic disease outbreaks, which include: osteoporosis, arthritis, ankylosing spondylitis, erythema nodosum, changes in the eyes – episcleritis, uveitis, aphthous stomatitis, fatty liver, cholangitis, renal calculus, nutritional deficits, and anemia are frequent due to malabsorption defects, loss of appetite and chronic diseases.

Diagnosis

Diagnosis should be considered in all diarrhea patients, with or without blood, and abdominal pain. Atypical manifestations, fever of unexplained origin without intestinal symptoms, or extra-intestinal manifestations, such as arthritis or liver disease, are possible.

As Crohn’s disease can also affect the small intestine, it should be considered in all forms of malabsorption syndromes, intermittent intestinal obstruction, and abdominal fistulas.

Blood tests are nonspecific. They may show moderate anemia (normochromic, normocytic or hypochromic), increased sedimentation, leukocytosis and thrombocytosis, hypoproteinemia. Diarrhea can lead to electrolyte disruption and malabsorption in Crohn’s disease to steatorrhea.

The prevalence of the disease is determined by an X-ray examination of the small intestine with barium and lower gastrointestinal series. These may show changes in mucosal appearance, deep ulceration, and a pathognomonic “ribbon or wire sign.” Changes often affect the ileum and colon continuously. In chronic cases, strictures may occur. Intestinal lesions are usually discontinuous.

Treatment

For the treatment of mild to moderate cases of the disease, anti-inflammatory drugs are mostly used. Corticosteroids (budesonide and prednisone) are used briefly to relieve the symptoms of Crohn’s disease since they suppress the immune system and cause various other side effects.

Immunomodulators such as ciclosporin A and azathioprine help to maintain remission and can also help treat fistulas. Antibiotics are most commonly used when it is necessary to treat abscesses or other bacterial infections that occur as a result of Crohn’s disease.

Surgical methods of treatment for patients are mostly suggested in the case of the need to remove damaged bowel sections to avoid more serious complications, blockages or ruptures. Surgical methods are also resorted to in case the medicines do not show good results.

Crohn's disease

Surgery can bring remarkable improvement, and there is a possibility that the next attack will not occur for many years. However, absorption of vitamins, fats, and other important micronutrients may be reduced after the removal of a portion of the intestine.

When conventional treatments do not work, biological drugs can also be used, but only if the doctor has approved this type of therapy. During the onset of the disease, it is necessary to rest. In order to alleviate the symptoms, it is necessary to follow all the instructions given by your doctor.

Dietary supplements that you can use include supplements of vitamins A, C, E, B12, K, folic acid, minerals – calcium, magnesium, zinc and selenium, amino acid glutamine, essential fatty acids, and probiotics.

Disease activation is often associated with emotional or physical stress, but in some cases, it is not entirely clear why the disease has returned.

Common cold

Common cold

The common cold is the most common of all viral infections of the upper respiratory tract. It usually occurs in the colder periods of the year. The common cold is an acute, usually afebrile, viral infection with inflammation of some or all of the organs of the upper respiratory tract, including the nose, paranasal sinuses, pharynx, larynx, and often the trachea and bronchi.

Epidemiology

The common cold is the most common human disease worldwide, constantly occurring and affecting all age groups. It can be seen throughout the year but is more frequent in winter because of the lower resistance of the respiratory mucosa, more frequent and closer contact between people and non-ventilation of the rooms.

Despite common beliefs and observations, there is no conclusive evidence that cold, draft, fatigue, sleeplessness, or similar conditions are associated with an increased incidence or severity of colds. The disease is particularly common among young children, school kids, students and soldiers, which can also occur epidemically. Generally, the number of colds in one year decreases over a person’s life.

Common cold – causes

In theory, all respiratory viruses can cause the common cold, but the most common causes are naturally occurring viruses of less virulence, such as rhinoviruses, reoviruses, coronaviruses, parainfluenza virus type 4, etc. Other, more virulent, respiratory viruses are prone to cause catarrh, or flu, if we are talking about influenza virus type A and B. However, between 30 and 50% of common colds are caused by some of the more than 100 known rhinovirus serotypes.

common cold

Signs and symptoms

An incubation period of the common cold is one to three days, meaning that the first symptoms will manifest after one to three days after the exposure to the virus. The most prominent symptom is the congested an runny nose. It starts to itch, causing sneezing which is a natural response to stimulation of nasal mucosa. The nasal secretion is watery and transparent at the beginning but over time it may become sticky with a green or yellow color. That change doesn‘t indicate a bacterial infection. On some occasions, epistaxis may occur due to capillary rupture caused by nasal congestion.

Other symptoms

Other symptoms include sore throat, headache, malaise (generally unwell feeling), fatigue, fever (it is not always present but if it is, it doesn‘t exceed 100 °F or 38 °C). Cough is caused by the presence of foreign bodies in the trachea and it could last for more than 2 weeks, especially in people who smoke.

The common cold is a self-healing disease, and it usually vanishes after 4 – 10 days

Treatment

The common cold should never be treated with antibiotics, so the treatment is symptomatic, which involves eliminating and relieving certain symptoms. Because patients are usually not or are low-febrile and have no other general symptoms, antipyretics (medications for lowering body temperature) are usually not required.

It is necessary to take a large amount of fluid and to spare a heavy effort for several days. Nasal decongestants are used to reduce nasal mucosa and secretion. Antibiotics are only used to treat bacterial complications, such as sinus or middle ear infections.