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Stomach ulcer

Stomach ulcers are erosions of the stomach’s mucosa and open surface inside the stomach cavity.

Causes:

Gastric ulcer is a very common problem, but its incidence is decreasing. Common causes are medications (NSAIDs like ibuprofen, aspirin, steroids), H. pylori infection, Alcohol, smoking, Zollinger Ellision syndrome, stress, massive burns, trauma, and critically ill patients can experience stomach ulcers.

Symptoms:

Usually presents as upper abdominal pain after eating. Gastric ulcer complications present with a more profound clinical picture. Recurrent ulcers at the pylorus can result in stricture formation and which can result in a gastric outlet obstruction. Gastric ulcers can bleed, especially when a blood vessel is visible in the base of the ulcer on endoscopy. While many of these ulcers can be injected and cauterized endoscopically, some require surgical resection. Before the bleeding lesion is identified endoscopically, patients often present with either bloody vomiting or passage of blood in the stool . Perforation will present with acute epigastric pain and tenderness with guarding and rigidity of abdominal muscles. Obstruction will present with persistent nausea and vomiting.

Diagnosis:

H. pylori by antibody detection tests. Upper endoscopy with biopsy.

Management:

Stopping alcohol, smoking, drugs and medicines which are common offenders can help relieve the symptoms of ulcers. Treatment for H pylori. Change in diet. Proton pump inhibitors like omeprazole, lansoprazole, pantoprazole, esmoprazole. Surgery by removing part of the stomach. Management of perforation with surgery is most of the cases, very uncommonly patient can be managed by just watching and conservative management if they are stable and perforation is very small.

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