Thursday, 15 December 2011

Peptic ulcer – Burning volcano in abdomen


Peptic ulcer

DIGESTIVE DISORDERS Peptic ulcer – Burning volcano in abdomen

“Eat to live and don’t live to eat” – We have to follow this principle for a healthy life. Nowadays fast foods, carbonated drinks and tin-packed foods, containing preservatives, add fuel to the hurried, tension-filled life to form peptic ulcer. Also, people now take a lot of medicines like a small meal for their ailments (mostly after 40), which irritate the stomach and induce peptic ulcer.
The stomach secretes digestive juices which help in digestion of food. Digestive juices contain gastric acid (hydrochloric acid) and the enzyme Pepsin. The stomach and the duodenum digest every food item which passes through them to absorb nutrients from it, but the duration and digestion quality differs from person to person. For example – water passes immediately within 10 minutes as no digestion is needed. A pressed potato will be digested within 20 minutes in the stomach. Vegetable meal takes nearly 45 minutes to one hour.
But non-vegetarian diet like meat, chicken, fish, etc., will take nearly 1½ hours for digestion. Cold weather and taking ice-cream after food, delays the process of digestion for some more time. So only parties serving ice-creams finally as deserts, will give a satisfied feeling for a long time as if a heavy diet is taken. If digestion cannot be performed due to toxicity, irritation or overload, then the stomach and intestine emits everything as diarrhoea or vomiting. If irritation is more, diarrhoea sets in whereas in the case of chronic infection or long-standing worries, the intestines will become dull which in turn produces constipation. If there is excessive secretion of digestive juice, it will erode the surface of the stomach or duodenum to form ulcers.
Peptic (pertaining to digestion) ulcer is small sores in the lining of the stomach or the duodenum (first part of intestine) due to irritants (may be allergic, chemical or mechanical or drugs) or infection. It can also occur in the oesophagus and other parts of small intestine.
Types of ulcer
If the stomach is ulcerated, it is called gastric ulcer and if the duodenum is involved, it is duodenal ulcer. Commonly people say “gastritis” for generalised ulcer and gas trouble.
Incidence – Incidence of gastric ulcer peaks in the age group of 50-60. The male, female ratio is almost equal. Incidence of duodenal ulcers peaks in the age group of 20-50 years. But the male, female ratio is 2:1. Also occurrence of peptic ulcer is more common in people who have ‘O’ blood group. The incidence of ulcer is also more in urban than in rural areas, may be due to eating and sleeping habits and the hurried, tense life.
Causes of ulcer are as follows:
Genetic – ulcer has been identified to run in families
Mind – Stress and strain also cause ulcer. Its incidence is more in sensitive, anxious, emotional people and who think a lot because of which acid secretion will be continuous
Foods – Spicy and chilly foods can cause ulcers
Toxic – Chemicals or decayed foods may produce ulcer formation.
Mechanical – Any hard food substance or any investigative procedures.
Habits – Smoking cigarettes, drinking alcohol and irregular dietary habit
Neurological – Peptic ulcer may be due to return of foods. In-coordination of nerves may lead to relaxation of pylorus which may permit bile (secretion of liver) into the stomach, causing gastric ulcer. Also relaxation on oesophageal end may produce gastro oesophageal reflux and produce ulcer in oesophagus, which is felt as heartburn. If the digestive tract obeys the rule of one way, then there won’t be any ulcer formation. Also Vagus nerve, which innervates the stomach, stimulates excessive acid secretion when we are anxious, and this may cause ulcers
Increased acid (hydrochloric acid) secretion – It is noticed in many people with duodenal ulcers, where there is abundance of digestive juices secretion from the stomach, that it may be due to nerve stimulation or local factors (diseases of the stomach or diets) or hormonal factors (tumors of thyroid, pancreas & adrenal glands)
Infectious diseases which cause increased urea and bacteria level in blood
Drugs – long-term use of Non Steroidal Anti-Inflammatory Drugs (NSAIDs) such as aspirin and ibuprofen which are the main culprits of ulcers. Infection – gram negative bacteria – Helicobacter pylori – has been identified in all cases of ulcers. But not all people infected by H. Pylori develop ulcers. So there is no certain answer for the cause of ulcer.
Symptoms – The symptoms and pain of both types of ulcer tend to differ. The ulcer size may vary and may be multiple. But, usually, it is superficial and if persistent, erodes the muscle layer to perforate. Clinically, dyspepsia, nausea, vomiting, headache, blood vomiting, pain in abdomen, constipation or diarrhea are the symptoms.
Gastric ulcer
Usually sufferers are above age 40
Periodical pain occurs immediately after food and finally pain persists
Pain is felt over the umbilicus and left to midline and no radiation of pain is felt
Pain is relieved by vomiting or alkali foods
Fear of eating due to pain
Weight loss will be there due to reduced intake
Nausea and vomit that looks like coffee grounds
Hametemesis (blood vomiting) may be present
Sensation of feeling fullness, indigestion and heartburn may be noticed immediately after eating. Patient often complains about gas trouble or belching
Duodenal ulcer
Usually sufferers are between age group of 20-50.
Periodicity of pain is very marked
Pain is felt above umbilicus and right to the midline and it may radiate to back
Pain appears 1-2 hours after food i.e. Pain is felt when the stomach gets empty, so the pain is often felt during middle of the night or sleep which disturbs sleep
Pain is usually better after taking food
No weight loss will be there since patient feels better with eating and goes on eating
Bloated feeling of intestinal gas
Black or bloody stools (malena) may be present
Diagnosis of an ulcer can be easily made only with endoscopy.
Examination of the tender abdomen will also guide us for diagnosis
X-Rays of stomach and duodenum and series of Barium meal X-rays are to be taken to rule out obstruction or strictures
Biopsy can be done through endoscope – to rule out serious disease like cancer and for presence of H. pylori
Complications
  • Bleeding (hematemesis or malena) may occur when the mucosa gets irritated and opened with erosions
  • Perforation causing peritonitis and septic conditions may occur in the case of chronic inflammatory ulcers when the infection deepens
  • Obstruction may occur due to stricture formation caused by chronic peptic ulcer
Treatment – should aim for relief the symptoms with healing and preventing from further recurrences. Usually, an ulcer will take 3-6 weeks to heal and it won’t produce any scar. Mostly, many people do not care about their stomach disorders. They temporarily manage their complaints such as gas trouble, poor appetite and pain with antacids. There is a study which shows antacids will produce more sodium in blood which in turn gives risk to heart attack or heart disorders. When suffering is constant, some people give no importance to chest burn or heartburn. Also, everyone should be aware that the same set of symptoms may occur in the case of ischaemic heart disease – heart attack – so regular check-up of BP and ECG is a must.
Prevention is the first care than cure to reduce gastric irritation and acid secretion.
DO
  • Masticate well and swallow the food.
  • Have the diet in a relaxed manner, without any hurry
TAKE
  • Easily digestible, oil free diet to reduce work load of stomach and intestine
  • Diet not more than 3/4th of the stomach
  • Small meals often to utilise the acid load in the stomach
  • Water before and after meal
  • Nutritious diet at regular interval or at regular time
AVOID
  • Tension and hurried life
  • Habits of smoking, drinking alcohol, chewing tobacco and overeating which increases acid secretion of the stomach
  • Hunger – which denotes acid load, avoid it by taking small meals often.
  • Full meal, oily diet, pickles and fatty snacks before bed time
  • Food containing high spices, chilies, pepper, sausages
  • Dry bread, cakes and cookies
  • High fat content nuts and biscuits
  • Aerated drinks, coffee and tea
  • Milk products
  • Cabbage, onions, garlic, cauliflower, tomatoes – if not tolerated
  • Drugs like NSAIDs – pain killers (for example. – aspirin)
There are lots of theories and research about diet, milk products, citrus fruit drinks like lemon, grapes, oranges, pineapples and antacids. Milk and cream feedings should not be used as antacid therapy. Some will be better with one and some may get worsened with the same. But it is better to avoid those things which bother one much. Likewise some say that betel nut chewing improves digestion, but if the calcium content increases, that will itself produce more ulceration. Generally, a fibre content diet like greens, vegetables and fruits are good for digestion and also for the general health.
Medicines
Peptic ulcers will get worse if they are not cared for by taking the right food, and sticking to the timings and treated well. In Allopathy, they depend mainly on antacids which give very temporary relief.
Antibiotics are prescribed to kill the bacteria H pylori. But recurrence is common.
Acid-suppressing drugs like H2 blockers (which block histamine) and proton pump (which suppresses the acid production) are used.
Surgery – In coordination with diet regimen management and medications most of the ulcers get healed. If they don’t respond and have other complications, surgery is advised as a last resort where they remove the area of ulceration.
Homeopathic approach – Peptic ulcers can be treated successfully in Homeopathy without any side-effects. First right medicine for ulcer is right food at a regular time. The second thing is a relaxed, tensionless life. The third thing is only the so-called medicines. If we depend only on the third one (medicines), then we have to permanently depend on it and also have to suffer with the disease always or recurrently, I.e. we have to change the tension life with correct, timely meal or otherwise cure is impossible.
Treating peptic ulcer is tough, since the digestive tract cannot take rest for healing and is also often exposed to irritants which hinder the healing process. In Homeopathy, besides treating the disease, it also improves general resistance, to avoid recurrences. For selecting the right drug, Homeopathy gives importance to the character of onset of symptoms, aggravating or precipitating factors, and characteristic symptoms of patients, relieving factors and associated symptoms.
Homeopathic treatment can give permanent relief from peptic ulcer. The earlier you treat, you get speedier and complete cure. Ulcers take time to heal, so medicines should be continued for long time, even if the pain goes away.
Medicines commonly used for peptic ulcers are – Belladonna, Borax, Colocynth, Bryonia, Dulcamara, Nux Vom, Symphytum, Hydrastis, Arg Nit, Acid nit, Aethusa, Pulsatilla, Sulphur, Kali Bich, Lycopodium, Carbo Veg, Anti crud, Calc carb, Nat mur, Nat phos, China, etc. These Medicines should be taken under the advice and diagnosis of a qualified Homeopath.

for new hope

Dr. S. Chidambaranathan, BHMS, MD (Homeo)
Laxmi Homeo Clinic
24 E. New Mahalipatti Road
Madurai, TN 625 001
India

Tel:  +91-452-233-8833 | +91-984-319-1011 (Mob)
Fax: +91-452-233-0196
E-mail:  drcheena@yahoo.com
www.drcheena.com / www.drcheena.in



(Disclaimer: The contents of this column are for informational purpose only. The content is not intended to be a substitute for professional healthcare advice, diagnosis, or treatment. Always seek the advice of healthcare professional for any health problem or medical condition.)

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