Ulcers (Ulcussygdommen)

Definition and causes

Ulcer is a relatively common condition and is localized to the stomach or more frequently to the upper part of the gut. Usually there is only one wound. It is round or oval, is well-defined and is usually half to one and a half centimeters wide. It is seen as a defect in the mucous membranes. Eros ions (see mavekatar) is more superficial.

There are around. 8,500 new cases of stomach ulcers per. years in Denmark. Wounds in the gut (duodenal ulcers) are three times more frequently than ulcers of the stomach (ventrikelsår). Ulcers seen twice as often in men as in women, and the average debutalder is 55 years. It is estimated that 10% of the population in the Western world at some point in their lives will have had stomach ulcers.

The precise mechanism by which the wound is formed, is still controversial, but there are a number of factors that increase risk. Notwithstanding any other circumstances requiring the formation of a wound presence of acid. The main causes are infection with the bacteriumHelicobactorpyloriand ingestion of certain medications, aspirin (painkillers) and NSAIDs (gout preparations).

The most common cause of stomach ulcers is bacteriumHelicobactorpyloriThat can survive in the acidic environment of the stomach. In Denmark, around 10-20% of 30-year-olds and 50-60% of 60-year-old infected with the bacterium. Most (up to 95%) with duodenal ulcers and up to 75% with ventrikelsår infected with the bacterium. By contrast, only 15-20% of the bacterium that develops ulcussygdom.
The second most common cause of stomach ulcers are ingestion of aspirin and NSAIDs. These substances weaken the mucous membranes of the stomach and gives a 4-5 times greater risk of ventrikelsår (and possibly duodenal ulcers).
Smoking doubles risk of stomach ulcers.
If a close relative has an ulcer, has been around. three times higher risk for stomach ulcers (particularly if you are male).
Alcohol may increase the risk.
It is widely acknowledged in public that coffee and stress increases the risk of stomach ulcers, but studies have shown that this is NOT true. But stress and coffee is possibly together with other problems in the upper abdominal region.

Symptoms of peptic ulcer

Ulcer may cause many different symptoms and the symptoms are dependent on the location of the wound. Sometimes ulcer symptoms resolve, and in other cases it is only at the ulcer complications (see these). The pains of ventrikelsår is more than uncharacteristically by duodenal ulcers. The most common symptoms are:

Duodenal ulcer

Pain in upper abdominal region. Frequently, there is hunger pains with relief by food. In some cases, radiation of pain to his back. There may also be a searing or burning sensation in the upper abdominal region.
Heartburn and acid regurgitation.
Vomiting (may be due to narrowing the bottom of the stomach and thus fully or partially blocking the passage of food (see pyloric stenosis)).

Ventrikelsår

Pain in upper abdominal region.
Nausea and vomiting.
Decreased appetite.

Precautions and diagnosis

Suspect Monday ulcer should seek medical attention when the diagnosis is made easy, and reading in most cases is effective and short.

The diagnosis made by a kikkertundersøgelse (gastroscopy) combined with the removal of the minimum five tissue samples (biopsies) to exclude the possibility that the wound caused by cancer.

Helicobactorpylorican be detected easily because the bacterium using an enzyme, urease, etc. urea to ammonia and hydrogenkarbonat. It uses a "breath test", where after taking a small amount of radioactive urea can measure the degradation products of breath testing.

Treatment of ulcers

Previously, stomach ulcers a chronic condition that often ended with the removal of part or all of the stomach. But after the discovery ofHelicobactorpylorireading has changed radically. Discover the presence of the bacterium, is reading out to eradicate this. Current treatments are so-called combination therapies with three or more drugs. Usually given a substance that either reduce acid production or protect the mucous membranes, as well as two different types of antibiotics to effectively eradicate the bacteria. In many cases a week sufficient, but sometimes you need to treat over a longer period.

Is abdominal years ingestion of aspirin or NSAIDs, can we stop them. Possibly combined with an acid-reducing or mucosal protective agent. If there is no suspicion of simultaneous presence ofHelicobactorpylori, Continued there with acid-reducing therapy in 2-8 weeks.

Select and complications

Earlier got over 80% after treatment for stomach ulcers a new ulcer within a year. Following the introduction of treatment against Helicobactor, get less than 10% a new wounds, and this can often also be addressed effectively.

There may be some complications associated with stomach ulcers. The most common is bleeding. Usually, this merely småblødninger, either seen by bloody vomiting or black extremely smelly stools (due digested blood). But bleeding ulcer should be taken seriously and requires urgent hospitalization, as it may shock and threatening. Longer term småblødninger can give anemia.

Abdominal year to get all the way through the wall (perforation) of the stomach or gut and create gaps between the stomach and intestinal channel and abdominal cavity. This manifests itself as sudden strong pain and can quickly develop into peritonitis.

If the wound is located near the transition between the stomach and gut, it can lead to a further narrowing of the already narrow transition (see pyloric stenosis). This is indicated by nausea and vomiting.

Helicobactor pylori is associated with increased risk of cancer of the stomach.

Prevention of ulcer

You can do several things to prevent stomach ulcers. First and foremost, you can avoid taking aspirin (Magnyl, Aspirin, etc.) and NSAIDs (Ipren, ibuprofen and others). If you put in therapy with one of these and get symptoms, you should talk to their doctor. Often it is possible to find another type of medication with the same effect and without a stomach as a side effect. Smoker Monday, it should stop. Additionally, you can try to eat many small meals because food neutralize stomach acid.