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A peptic ulcer is an open sore or raw area in the lining of the stomach or intestine.
A gastric ulcer occurs in the stomach.
A duodenal ulcer occurs in the first part of the small intestine.
Causes: The most common cause of ulcers is infection of the stomach by bacteria called Helicobacter pylori (H.pylori). Most people with peptic ulcers have these bacteria living in their digestive tract. Yet, many people who have these bacteria in their stomach do not develop an ulcer. The following factors raise your risk for peptic ulcers:
Drinking too much alcohol
Regular use of aspirin, ibuprofen, naproxen, or other nonsteroidal anti-inflammatory drugs (NSAIDs). Taking aspirin or NSAIDs once in a while is safe for most people.
Smoking cigarettes or chewing tobacco
Being very ill, such as being on a breathing machine
Having radiation treatments
A rare condition called Zollinger-Ellison syndrome causes stomach and duodenal ulcers.
Many people believe that stress causes ulcers. It is not clear if this is true for normal stress.
Normally, the lining of the stomach and small intestines can protect itself against strong stomach acids. But if the lining breaks down, the result may be:
Swollen and inflamed tissue, called (gastritis)
An ulcer Most ulcers occur in the first layer of the inner lining.
A hole that goes all the way through the stomach or duodenum is called a perforation. A perforation is a medical emergency.
Fig 1. Location of ulcers Fig 2. Symptoms of PUD Fig 3. Complications of PUD
Small ulcers may not cause any symptoms. Some ulcers can cause serious bleeding. Abdominal pain is a common symptom. The pain can differ from person to person, and some people have no pain. Other symptoms include:
Feeling of fullness and problems drinking as much fluid as usual
Hunger and an empty feeling in the stomach, often 1 - 3 hours after a meal
Mild nausea that may go away with vomiting
Pain or discomfort in the upper abdomen
Pain in the upper abdomen that wakes you up at night
Self Care instructions- Since the source of H. pylori infection is not yet known, no definitive recommendations have been made for preventing peptic ulcer disease. However, it is always wise to wash your hands thoroughly, eat food that has been properly prepared and drink water from a clean, safe source. If you have a history of ulcers or if you develop stomach discomfort, you may reduce your risk of NSAID-induced ulcers by:
Knowing your risk-factors.
Trying a different NSAID.
Reading medication labels and following instructions.
Adjusting your dose and frequency.
Substituting alternative pain-relief medications for the NSAID.
Discussing with your doctor ways to protect your stomach while getting pain relief.
Avoiding or limiting your use of alcohol when taking pain medications.
Talking to your doctor about pain that does not go away.
If you smoke, quit. People who smoke are twice as likely to develop ulcers. Ulcers also heal more slowly in people who smoke.
Avoid overindulging in alcohol.
If you have symptoms of an ulcer, contact your doctor.
You may find relief from the pain of a stomach ulcer if you:
Choose a healthy diet. Choose a healthy diet full of fruits, vegetables and whole grains. Not eating vitamin-rich foods may make it difficult for your body to heal your ulcer.
Consider switching pain relievers. If you use pain relievers regularly, ask your doctor whether acetaminophen (Tylenol, others) may be an option for you.
Control stress.Stress may worsen the signs and symptoms of a peptic ulcer. Examine your life to determine the sources of your stress and do what you can to address those causes. Some stress is unavoidable, but you can learn to cope with stress with exercise, spending time with friends or writing in a journal.
Don't smoke. Smoking may interfere with the protective lining of the stomach, making your stomach more susceptible to the development of an ulcer. Smoking also increases stomach acid.
Limit or avoid alcohol. Excessive use of alcohol can irritate and erode the mucous lining in your stomach and intestines, causing inflammation and bleeding.
To treat an ulcer, first eliminate substances that can be causing the ulcers. If you smoke or drink alcohol, stop. If the ulcer is believed to be caused by the use of NSAIDs, they need to be stopped.
Items most frequently associated with gastric discomfort include the following: black pepper, red or hot pepper, chili powder, caffeine, regular and decaffeinated coffee or tea, alcohol, cocoa, chocolate, cola beverages, citrus fruits and juices, fatty and fried foods, tomato products, and peppermint. These should be eliminated from the diet unless specifically allowed by the physician and/or dietitian. Additional adjustments may be made according to individual tolerances.
Chew food thoroughly.
Eat in a leisurely manner in a calm, relaxed atmosphere. Chew and swallow food slowly.
Reduce or stop cigarette smoking. Smoking delays ulcer healing.
Do not eat within two hours of bedtime.
Omit any particular food that causes discomfort.
If there is an ulcer, do not use aspirin, aspirin-containing combination medicines, or certain arthritis medications (non-steroidal anti-inflammatory drugs or NSAIDS). ibuprofen (Motrin), Advil, and Aleve are NSAIDS. These can cause ulcers and delay or prevent ulcer healing.
Use antacids as needed. Keep in mind that magnesium-containing antacids can cause diarrhea.
Sample diet plan 1-
apple juice 1/2 cup
oatmeal 1/2 cup
toast 1 slice
skim milk 1 cup
margarine 1 tsp
sugar 1 tsp
jelly 1 tsp
salt 1/4 tsp
cream of potato soup 3/4 cup
broiled chicken patty 3 oz
mustard 1 tsp
peaches 1/2 cup
skim milk 1 cup
salt 1/4 tsp
apricot nectar 1/2 cup
baked fish 3 oz
green beans 1/2 cup
bread 1 slice
margarine 1 tsp
salt 1/4 tsp
This Sample Diet Provides the Following
Sample diet 2-
- 1 Cup (250ml) lukewarm water with 1 Tbsp. lemon juice and 1/2 tsp. honey
- 5 soaked raisins
- 1 Rava Dal Dosa OR Oats
- forteified low fat Milk (1 cup) or Soy milk
- 1 medium Apple ?OR 1 medium orange
Mid Morning Snack
- 1/2 Cup boiled vegetable bhel, sprinkled with lemon juice OR Semiyan Upama
- 1 Cup Coconut water
- 1 large bowl of Salad (carrots, cucumbers, beets, tomatoes and onions)
(Dressing - mix Olive oil or cream, lemon juice and pepper)