Nearly 25 % of people in our community suffer from dyspepsia, which means symptoms of bad digestion like abdominal pain or burning, fullness and gas. These symptoms are commonly referred to as those of "acidity " and most people resort to self medication. It is important to remember that any new dyspepsia of more than one month duration should be investigated. Further, at age above 45 years and the presence of "alarm" symptoms like loss of appetite, weight loss and difficulty in swallowing investigations are mandatory.
Peptic ulcer is responsible for about 10 % of these symptoms. It is important for patients suffering from dyspepsia to be evaluated by their physician as apart from ulcers, cancer of stomach may also present in the same way.
Peptic ulcer implies the development of a breach in the lining of stomach or upper small intestine called duodenum and to the naked eye it looks like a wound. This illness effects nearly 10% of people in our country. It is commonly found in young people at the prime of their age and has been said to be associated with "hurry, worry and curry". The factors responsible for causing ulcers include:
However recent research has shown that the most important factor is the presence of a spiral shaped bacteria in the stomach called Helicobacter pylori. This bacterium enters the stomach by the oral route and is usually acquired at a young age. The organism may be present in about 40 % of healthy people but transformation into disease like peptic ulcer and stomach cancer occurs only in few.
Peptic ulcer and stomach cancer is easily diagnosed by an endoscopic procedure. Flexible fibreoptic endoscope is easily and safely introduced through the mouth to directly examine the food pipe, stomach and upper intestines. This does not require any anaesthesia and takes only 5 minutes. The chemical test for the bacteria can also be carried out at the same time.
Once diagnosis is reached it is half the battle won. Treatment of duodenal (small intestine) ulcer is simple and includes anti bacterial and ulcer healing medicines. It is important to realize that strict diet restrictions are no longer necessary with modern medicines. However all analgesic medication and cigarette smoking must be stopped. Once treatment is complete only 5 % people will have a recurrence, rest of them will be cured. Stomach ulcers must be biopsied at the time of endoscopy to rule out cancer that presents in a similar way. These ulcers take at least 6 weeks to heal and healing must be confirmed by a repeat endoscopy. Non healing stomach ulcer may require surgery. Duodenal ulcers heal by medicines only and surgery is required only for complications like bleeding, intestinal obstruction or perforation. "Once an ulcer always an ulcer" an old dictum is no longer true and if early diagnosis is made they can be cured.Dr. Sharat C Misra
Vardaan Hospital is a New Delhi based multi-speciality hospital