Ulcer comes from the Latin word ulcus. An ulcer is an open sore. Peptic ulcers are those that occur in the gastrointestinal tract. The gastrointestinal tract is a 25-30 ft systemof (Berland 1971) the digestive system is a long tunnel of many twist and turns with an entrance and exit. The prime concern of gastrointestinal system is food. Every organ, every chemical, and every function deals with food. The stomach is a big bag that can hold about a quart of food and liquid. It is shaped like an upside down russet pear. It contains some of 35 million glands that secrete the strong digestive juices. The exit of the stomach is the pylorus sphincter; it acts as a gate that allows the chynces to be forced into the duodenum which is a horse shaped beginning of the small intestine. Helicobacter pylori bacteria are a living cell of the stomach. It causes pain and erosion of the stomach. The case of duodenal ulcers occurs in 40 million American. 40,000 Americans have the surgery to repair the damaged stomach k, in some cases patients don't survive up to 6,000 people die from ulcers.
What is a duodenal ulcer?
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A duodenal ulcer is a sore on the lining of the stomach. The duodenum is the beginning of the small intestine. The duodenum is a round pipe like organ 10-12 inches long. One cause of peptic ulcers is bacterial infections, but some ulcers are caused by over using nonsteroidal anti immflamatory drugs (NSAIDs), like aspirin and ibuprofen. In a few cases, cancerous tumors in the stomach or pancreas can cause ulcers (Judd 2006). Duodenal ulcers are caused helicobacter pylorus acid. An ulcer can occur anywhere in the body. Ulcers of the mouth come from not eating the right foods, and on the body of bed ridden patients. When most people refer to an ulcer it's usually a peptic ulcer or an ulcer of the gastrointestinal system. A peptic ulcer can occur anywhere peptic juices flow. They occur in those regions of the gastrointestinal tract which are bathed by the digestive juices, containing hydrochloric acid and containing the protein digesting enzyme pepsin. (Null 1979) An ulcer will damage the lining of your stomach. An ulcer looks like a red crater on the inside of the stomach. An ulcer can re occur if a patient does not treat as directed.
What is a helicobacter pylori bacterium?
Barry Marshall and J. Robin Warren discovered helicobacter pylori bacteria and its role in gastritis and peptic ulcer disease. Helicobacter pylori cause a chronic inflammation lining of the stomach (gastritis) in humans. This bacterium is the most common cause of ulcers. Helicobacter pylorus infection is most caused by eating contaminated foods. 30% of the United States is infected. One of six patients will be diagnosed with H. pylori; if not treated H. pylori can produce ulcers in the duodenum and even stomach cancer. Researchers believe that h. pylori are responsible for the majority of peptic ulcer cases. H. pylori are a common case in the United States. Researchers are not sure on how people detect h. pylori they seem to think it's by food or water. It has also been detected in saliva so it may come from mouth to mouth contact su
Materials and Methods
Many different medicines and procedures to diagnose some one with duodenal ulcers cause by H. pylori bacteria. Gastroenterologist's use a procedure called upper GI endoscopy is also sometimes called EGD (esophagus gastroduodenscopy) is a visual examination of the upper intestinal tract using a lighted flexible fiber optic video scope. The upper gastrointestinal tract beginning with the mouth and continuing through the esophagus down to the stomach. The stomach looks down into the gastrointestinal tract. Also in some cases during an EGD a balloon is used to open up the duodenum if it's shut off because of ulcers. Your stomach has to be completely empty for this procedure. This is usually an outpatient procedure; the throat is sprayed with a liquid to numb the throat. The patient is also given a sedative to calm and relax them for the procedure. The lighted scope is used to find polyps or ulcers. Another procedure used to find ulcers is the barium x-ray. The patient has to drink a mixture of barium and water to coat the esophagus and stomach to identify ulcers. Different medicines can be prescribed to help secrete the acid. Carafate which is a liquid medicine that coats the stomach, nexium and prevacid are both antacid pills
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If a patient is diagnosed with an ulcer the doctor will test the patient for H. pylori. This test is important because treatment for an ulcer caused by h. pylori is different from that for an ulcer caused by NSAIDS. Test used to detect H. pylori is a pH test. The test monitors the how much acid your stomach produces by the food you eat. A long copper wire tube is inserted through your nose down the esophagus to the stomach. You must record the things you eat by pressing a button on the monitor and recording them on a chart. The doctor will go over the results and let you know at a later date. The blood antibody test requires blood to be drawn and sent to a lab to detect bacteria. Also the breath test known as the urea breathe test. The patient drinks a urea solution that contains a special carbon atom. If h. pylori are present it breaks down the urea, releasing the carbon. The blood carries the carbon to the lungs, where the patient exhales it. The breath test is 96 to 98 percent accurate. In diagnosing H. pylori blood, breath, and stool tests are often done before tissue test. Blood tests are not used to detect H. pylori following treatment because a patient's blood can show positive results even after H. pylori have been eliminated. (Judd 2006)
Observation and results
Duodenal ulcers can be identified from bad eating habits up to stress. Thee highest and deadliest diagnosis is stomach cancer. It begins in the mucus producing cells on the inside lining of the stomach. (Mayo Clinic 2009). Stomach ulcers caused by H. pylori bacteria can start off by feeling gurgling or rumbling in your stomach. Stomach ulcers can be very painful, sometimes acid reflux can be one of the first diagnosis that can be treated with antacids over the counter or prescribed. H. pylori weaken the protective mucous coating of the stomach and duodenum, which allows acid to get through the sensitive lining beneath. Both the acid and bacteria irritate the lining and causes an ulcer. H. pylori are able to survive in stomach acid because it secretes enzymes that neutralize the acid. This mechanism allows H. pylori make its way to the mucous lining. Once there the spiral shape bacteria burrows it way through the lining (Judd 2006).
Symptoms of duodenal ulcers and H. Pylori bacteria
Some people only have mild symptoms or none at all but if any of these symptoms occur please see a physician
Perforation of the intestine
Bowel obstruction-vomiting, abdominal swelling and constipation
Pain below the ribs
Bloody or dark tarry stool
Pain after eating
H. pylori duodenal ulcers are treated with drugs that kill the bacteria reduce stomach acid, and protect the stomach lining. Antibiotics are used to kill the bacteria a liquid antibiotic called sulcarafate it lines the stomach and coats the ulcer to try and heal and block out bacteria. H2 blockers work by blocking histamines which stimulates acid secretion. They help reduce ulcer pain (Judd 2006). Prescribed medicine such as nexium and prevacid help with these conditions if you can not get a prescription over the counter antacids can work as well. The use of only one medicine to treat H. pylori is not recommended. The most proven effective treatment is a two week treatment of called triple therapy. It involves taking two antibiotics to kill the bacteria and either an acid suppressant or stomach lining shield. Two week triple therapy reduces symptoms, kills bacteria, and reduces ulcer reoccurrence. Patients may find triple therapy complicated because it involves taking as many as twenty pills a day. Also the antibiotics have several side effects such as dizziness, headaches, and yeast infections in women. Nonetheless triple therapy is ideal (Judd 2006)
When it is necessary to operate upon the ulcer, the reason usually that there are complications have developed. This occurs in 8-15 percent of duodenal ulcer cases. In most gastric ulcer cases it deals with cancer, the percentage is 60%. A treatment of injecting water and minerals over a period of about a week, this may open up the digestive passage. If this procedure fails surgery may be the last resort. If the case is very serious the whole stomach is removed. This operation is called total gastrectomy. A segment of the small intestine is attached to the esophagus to make a substitute stomach. The most frequently operation is the vagotomy. The cutting of one or more branches of the vagus nerve, in conjunction with the antrectomy the removal of the antrum of the stomach. After the surgery the use of the nerves can no longer secrete acid. Gastroenterostomy is performed for duodenal ulcers in which the upper portion of the intestine is connected to the stomach such a way that gastric juices proceed directly to the intestinal tract. Without coming in contact the diseased part of the duodenum, it's often performed with the vagotomy. All these procedures can be avoided if an ulcer is treated at an early stage.
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No one knows for sure how H. pylori spread so prevention is difficult. Researchers are trying to develop a vaccine to prevent infection (Judd 2006). But it is always wise to wash hands thoroughly, drink pure water, and eat properly cooked foods. People who have a family history of duodenal ulcers are most likely to get the disease. This disease is twice more common in men than women. A major cause in 60% of gastric and up to 90% of duodenal ulcer cases is chronic inflammation in the stomach due to helicobacter pylori bacteria that colonizes the mucosa. The bacteria can cause chronic gastritis. Resulting in a defect in gastric acid production the increase in acid can contribute to the erosion of the mucosa therefore an ulcer is formed. Another cause of ulcers is the use of NSAIDs, such as ibuprofen, aspirin, and naproxen. They interfere with the stomach's ability to produce mucous and bicarbonate. NSAIDs also affect blood flow to the stomach hinder cell repairs and cause the stomach to defense mechanisms to fail. The gastric mucosa protects itself from gastric acid with a layer of mucus. Although some studies have found correlations between smoking and ulcer formation other risks have been more specific, they have found that smoking by itself may not be much of a risk factor unless associated with h. pylori infection. Studies have found that alcohol consumption increases modest in comparison to the primary risk factor. Researchers also continue to look at stress as a possible cause, or at least complication in the development of an ulcer. Helicobacter pylori thrive in an acidic environment and stress has been demonstrated to cause the supported by a study on mice. The best advice to prevent ulcers is to keep your hands clean, wash your hands thoroughly before eating and coming contact with other germs. Changing your eating habits can prevent and heal ulcers. Drinking pure water and food that's cooked properly can prevent h. pylori from occurring Taking fatty foods and high citric acid foods out your diet can prevent them from happening because certain foods irritate the stomach.
Summary and Conclusion
The duodenum is a 10-12 inch pipe like organ in the stomach near the pancreas and jejunum. It breaks down the food to pass through the digestive system into the stomach it also regulates how much food can empty into the stomach. An ulcer is a sore on the lining of the stomach that is similar to a crater. It aggravates the nerves surrounding it and causes serious pain. Helicobacter bacteria are a spiral like bacteria that lives in the stomach. It isn't deadly but if not treated in an early stage it can turn into stomach cancer. Certain methods are used to cure duodenal ulcers antibiotics and antacids to help secrete the acid and help the inflammation of the stomach. Some cases are not cured by the use of antibiotics and antacids so the next step is taken by having surgery. A gastrectomy is a full or partial removal of the stomach. This procedure is used on patients with stomach cancer and secretion of the stomach. This procedure is also done with the vagotomy. If the stomach produces too much acid the vagus nerves are clipped to reduce the secretion of acid. H. pylori weakens the mucous in the stomach, an ulcer is caused by this or a break in the lining of the stomach. Symptoms that occur in some people are indigestion, nausea. Vomiting and constipation. Patients who have these problems go see a gastroenterologist. To prevent these things from happening try and cut back on alcohol consumption, spicy foods, and smoking. Alcohol can cause a burning sensation in the stomach and irritate the ulcer and cause vomiting and pain. Constipation can cause diarrhea and vomiting, this happens because when the ulcer is formed around the duodenum the food has nowhere to go because it shut off to the size of a retractable pen. The backs up and the patient's vomits up everything the texture is foamy and a red color. A patient becomes dehydrated and may need to drink lots of fluids or go see a physician. You can prevent all these things from happening if you seek medical help or change or lifestyle.
Mitchell A. Spellberg, M.D. 1971, "Living with your ulcer"
Nancy Nugent 1978, "How to live with your stomach"
Gary and Steve Null 1976, "Why your stomach hurts"
Judd 2006, Gastrointestinal Disorders and Diseases
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Dr. T. Daniel Iseman, Gastroenterologist
Dr. Roland Craft, Surgical Associates