Ulcers came from the Latin word ulcus. It is an illness in the digestive system where a sore, an open painful wound, is seen on the lining of the digestive tract. Kinds of ulcers Peptic ulcers or stomach ulcers are described as the small erosions or hole in the gastrointestinal tract that is sometimes caused by a bacterial infection called Helibacter pylori (H. pylori). H. pylori happen to thrive, live and grow in the stomach. Peptic ulcers are sometimes diagnosed as the destruction of the gastric or intestinal mucosal lining of the stomach caused by the hydrochloric acid normally present in the digestive juice of the stomach.
Stomach ulcers causes the nerves surrounding it to become agitated and cause the erosion of a major blood vessel resulting to hemorrhage or pain of higher intensity. This also causes obstruction of the gastrointestinal tract as a result of spasm or swelling in the affected area. Peptic ulcers are common but in some cases this may be caused by cancerous tumors in the stomach or pancreas. People with blood type A are also more likely to develop cancerous stomach ulcers. Reasons still unknown as of this writing. Gastric ulcer injures the gastric mucosal lining and weakens its mucous defenses (Falvo 282-283).
If the pain continues and the illness is unattended this may become malignant and may lead to cancer. Duodenal ulcers are almost always benign. The affected area is located in the duodenum occurring in the first twelve inches of the small intestine beyond the location of the stomach. Esophageal ulcers are those that are found in the esophagus. Esophageal ulcers are very rare but are often the result of alcohol abuse. Special feature: pressure ulcers Pressure ulcers are sores that occur on the skin also affecting the tissues underneath it.
It is observed to be an area of the skin that naturally breaks down when a patient stays in one position for too long without literally shifting position. This often occurs to people who are bedridden or tied to a wheelchair even for a short period of time. It normally starts as a reddened skin then progresses to a blister. Then it continues to progress as an open sore and to its worse form as a crater. The most common affected areas are the elbows, hips, back and the back of the head. Other names for pressure ulcers are bed sores and decubitus ulcers. Causes of ulcers
Some people may naturally secrete more stomach acid than others. It is understood then that the stress they were in and exposed to do not matter at this time, even the kind of food they eat since they are really prone to develop ulcers in their lifetimes. Ulcers occur because of the uncontrolled increased production of acid in the stomach which seems to change a person’s immune system and burns the lining of their digestive tracts. Smoking is associated with peptic ulcers because of its nicotine content that causes the stomach to produce more acid and commends cycle for destruction of stomach walls lining.
Long term use of anti-inflammatory medicines causes ulcer because of the damage being done at the stomach lining. Stress referred to as severe emotional and physical stress may not necessarily cause the illness but it sure serves to aggravate the condition of the patient. Spicy foods, improper diet or skipped meals also causes ulcer. Excessive alcohol consumption in time wears down the lining of the stomach and intestines leading to ulcer. Zollinger-Ellison syndrome, chronic disorders such as liver disease, emphysema, and rheumatoid arthritis increased vulnerability to the disorder because of their type of medication (Brown 344).
Gastrinomas excess acid production and tumor cells produces acid in the stomach contributing to its increased acid output like the Zollinger-Ellison syndrome. Type O blood is seen to be a common cause for duodenal ulcers. Duodenal ulcers are usually common to people with blood type O because they do not produce the substance on the surface of blood cells that protects the lining of the duodenum. Lots of people that have H. pylori bacterial infections aggravated with the level of acid in the stomach produces peptic ulcers. Research show that 2 out of every 10 people were infected with H.
pylori bacteria. The bacteria though do not cause ulcers in every person it infects. The reason is not known yet and still is to be discovered. One thing for sure the bacteria have the ability to spread through mouth-to-mouth contact such as kissing. H. pylori allow the acid to get through to the sensitive lining beneath the stomach and the duodenum since it is capable of weakening their protective mucous coating. It’s characteristic to secrete enzymes somehow neutralizes the acid making it able to survive the environment.
H. pylori then makes its way to the safe area of the protective mucous lining where the bacterium’s spiral shape helps it burrow through the lining. Pressure ulcers were results of the constant pressure being exerted against the skin for longer period of times which reduces the blood supply to that area and causes the affected tissue to die. Pressure ulcers develop in such a rapid state if the patient is unable to move even for a short time. They do damage to the skin and to the deeper layers of tissue under the skin.
Pressure ulcers causes a lot of pain and may destroy the muscle or bone underneath the skin making it longer for them to heal. Signs and symptoms The stomach pain felt by the patient is usually described as a sharp pain between the breastbone and the belly button and was noted to be the common symptom for ulcers. This may occur a few hours after eating or during the night. Sometimes it occurs early morning when the stomach is still empty. It only feels better when one gets to eat or drink but then begins to get worse again one or two hours later in cases of duodenal ulcers.
The same process is also exhibited by gastric ulcers. It feels worse at a later time after one eats or drinks. The stomach pains may wake up the patient during the night. He also feels full fast whenever he eats. Untreated ulcers grow larger and deeper in time which is the main cause of bleeding in the digestive system and makes a hole in the walls of the stomach or the duodenum. Vomiting and unexpected weight loss, frequent burping or hiccupping were some manifestations of a person who is medically confirmed ill with ulcer.
Other major symptoms are heavy feeling, bloating, or a burning or gnawing feeling in the stomach area that last between 30 minutes and 3 hours. Anemia is also believed to aggravate ulcer. Weight gain can be seen with people who are suffering from duodenal ulcers because they tend to eat more in their attempts to ease discomfort. Pressure ulcers have red patches on the skin or bluish and purplish patches on the skin that may not seem to heal. Blisters or damage on the skin may appear with patches of hot skin. Swelling is most likely to progress from earlier symptoms.
Signs of worse ulcers Worse conditions of ulcers need immediate medical attention. They are usually detected by vomiting blood that looks like coffee grounds. This is caused by the bleeding and perforation in the stomach wherein the ulcer eats through the walls of the digestive tract. It can also be associated by the obstruction in the stomach where the digestive tract is blocked and the food taken may find difficulty leaving the stomach because of the obstruction. The patient also feels full after eating and has the greatest probability to lose weight.
Vomiting can be an alarming sign for the patient who usually vomits food eaten within hours or days before the aggravated situation. The nausea seems to be unstoppable coupled with repeated vomiting. The patient is observed to feel weak and dizzy, cold or clammy, and keeps losing weight. The sudden pangs of severe pains are uncontrollable and unbearable at times that reaches even to the back. Medicines at the house may not serve to ease the pain anymore. The patient may show blood in his feces that looks black like tar. The irritated sore of pressure ulcers may breakdown and look like a crater.
The pressure ulcer may become so deep that it induces damage to the muscle and bone or tendons and joints. When infected, it causes blood poisoning or bone infections and qualifies the label as life threatening. An occurrence of thick yellow or green pus may be seen accompanied by a bad smell. Some may experience fever and chills, weakness, rapid heartbeat, and difficulty concentrating. Diagnostic test A patient is usually tested for the H. pylori bacteria by the following methods: breath, blood test, and bowel movement. An upper gastrointestinal series (GI) may be performed.
This is a sort of an xray in the stomach, duodenum and esophagus where the patient is made to drink the whitish liquid called barium which is used while getting the xray. Endoscopy is performed using an endoscope. The skinny, lighted tube with a special camera on its end is gently guided into the throat of the patient down to the esophagus and finally into the stomach and upper intestines in order to see the inner lining of the organs from the camera on a television screen. Tissues may be removed during the Endoscopy for H. pylori bacteria testing.
Healthcare professionals examine the affected area repetitively at regular intervals. They may use photographs or tracings to record location, size and description of appearance. It will also be graded according to its depth of wound, the discoloration and the swelling. Interventions and medications Triple therapy helps eliminate the H. pylori bacteria. It is being done with a combination of two antibiotics and a bismuth subsalicylate most common prescribed brand name Pepto-Bismol. Antibiotics are prescribed to kill the H. pylori bacteria. The treatment of to get rid of H.
pylori usually takes about two to three weeks maximum of eight weeks. Most ulcers also heal within this time. H2 blockers and proton pump inhibitors reduces and controls the presence and manufacture of acid in the stomach. Acid blockers or proton pump inhibitors aims to protect the lining of the stomach so the ulcer may heal. The patient may start to feel the relief within three days of continued medication. Prilosec (omeprazole) is noted to be the only approved acid pump inhibitor at this time in U. S. H2 blockers blocks histamine which stimulates acid secretion.
They help reduced the pain in a matter of few weeks continued medication. There are four approved ulcer drugs: Zantac (ranitidine) (Critser 71), Tagamet (cimetidine), Pepcid (famotidine), and Axid (nizatidine). They act to block H2 receptors thwarting signals to secrete acids. When either drug is used alone, they do not effectively eradicate the presence of H. pylori and may not succeed in curing H. pylori related ulcers. A combination of both is seen to be effective and is advisable during the course of the treatment. Antacids were proven medications aimed to neutralize the acid that the stomach makes.
Best known brand prescription is Carafate. Antacids coat the ulcer and protect it from the acid to give it time to heal under continued medication. A medicine called misoprostol with commonly prescribed brand Cytotec is given to reduce the amount of acid and sustain protection for the lining of the stomach. This usually is the prescribed medication for people who needs to take anti-inflammatory drugs in order to prevent the occurrence of gastric ulcer. This is also used for those patients who once had ulcers or stomach irritations in their respective past medical history.
This treatment also requires a change in the lifestyle of the patient like stopping smoking and drinking of alcohol. The doctor may be asked for any substitute of NSAIDS to prevent the occurrence of ulcers. Sometimes when the condition is really that worse, the patient needs to have a surgery or an operation when there are serious forms of bleeding disorders and presence of holes in the walls of the stomach. Patients with pressure ulcers must be shifted and moved in a correct sitting and lying positions keeping good posture. Regular repositioning allows the ulcer to heal and prevents further damage.
The mattress must also be studied to help relieve pressure and stop ulcers from developing. Treatments of pressure ulcers include dressings, removing damaged skin and treat it with antibiotics to kill bacteria and help the wound get better quicker. Dressings may be administered in three forms: hydrocolloids, hydrogels, and foams. Hydrocolloids is an adhesive dressing that gels over the wound but sticks to the surrounding skin while hydrogels helps clean the wound while its gel keeps it moist. Foams are ultimately designed to absorb and retain fluid.
Sometimes one needs to administer treatments like electrical stimulation which uses electrical current to promote healing. The negative pressure therapy applies suction to the wound. Debridement which is the process used to remove dead tissue cuts away areas of dead tissues. In worse conditions when pressure ulcers do not heal properly, surgery is already advisable to help close the wound. Prevention H. pylori bacteria are transmissible from person to person through food, water, or contact with food that has vomit particles in it. In order to get rid or prevent H.
pylori infection, one must follow the basic rules of washing hands after using the bathroom and before eating. Regular exercise is also advised among other things of not smoking and not drinking. The patient may be encouraged to keep a balanced diet and to try eating small, frequent meals when they are experiencing pain. Pressure ulcers may be prevented by shifting position in at least two hours intervals (US 3-4). The patient must not be permitted to lie on the affected pressure sores. He shall be advised to buy a special mattress and a seat cushion to help reduce pressure.
When lying on one’s side, the patient must avoid resting directly on the hip bone but instead used a pillow under it so the weight may rest on the fleshy part of the buttocks and not on the hip bone. Pillows are also designed to keep the knees and ankles apart. Proper nutrition and hydration is needed to heal the wounds fast. The bed shall not be lifted for more than 300 to reduce shearing over the lower back and tailbone. Daily exercise must also be encouraged.
Works Cited
Page Brown, Earl J. Pathology: Pretest self-assessment and review. USA: The McGraw-Hill Companies, Inc. , 2005. Critser, Greg.Generation RX: How prescription drugs are altering American lives, minds, and bodies. New York: Houghton Mifflin Books, 2005. Falvo, Donna R. Medical and psychosocial aspects of chronic illness and disability. Sudbury, MA: Jones and Bartlett Publishers, 2005. Family doctor. org editorial staff. “Ulcers: What you can do to heal your ulcer?. ” American Academy of Family Physicians. 2006. Familydoctor. org. December 2006. <http://familydoctor. org/online/famdocen/home/common/digestive/disorders/186. html> U. S. Department of Health. Pressure ulcers in adults: Prediction & prevention. USA: Dianne Publishing, 1992.