A little brother and Hanako said that because of busy work, irregular eating, lately always feel abdominal pain, what should be done to check?
Huazi told him that it was likely to be a peptic ulcer, which is a common disease in gastroenterology, an inflammatory ulcer caused by stomach acid and pepsin digestion of the digestive tract mucosa itself, with gastric ulcers and duodenal ulcers being the most common. Gastric ulcers are common in the elderly, duodenal ulcers are common in young adults, and some people will have compound ulcers that coexist with duodenal ulcers.
First, why does peptic ulcer occur?
The main reason for the occurrence of peptic ulcer is that the digestive juices in the digestive tract have their own digestive effect on the digestive tract.
Gastric parietal cells secrete two distinct factors, namely attacking factors (stomach acid, pepsin) and protective factors (mucus, bicarbonate).
Normally, the attack factor and protective factor in the digestive tract are in equilibrium. However, under the causative factors, it will lead to an imbalance between the two, when the attack factor increases, or the protective factor decreases, it will make the stomach acid, pepsin and the stomach, duodenal tissue direct contact, self-digestion and ulceration.
The mechanism of gastric ulcer is mainly the decrease in the secretion of protective factors such as mucus and bicarbonate, resulting in damage to the gastric mucosal barrier.
The mechanism of duodenal ulcer is mainly the entry of a large number of attack factors such as gastric acid and pepsin into the duodenum without mucosal barrier protection.
Second, pre-meal pain is not the same as post-meal pain
Symptoms of peptic ulcer, mainly epigastric pain or discomfort as the main symptoms, can show dull pain, burning pain, swelling pain, severe pain and other uncomfortable symptoms. And the disease has a chronic course, with a medical history of up to several years or more than a decade.
Pain and discomfort caused by peptic ulcers are mostly associated with eating, and there will be repeated episodes of periodic epigastric pain. From the correlation between pain and eating, it is possible to roughly determine whether the patient is suffering from a stomach ulcer or a duodenal ulcer.
The pain caused by stomach ulcers is mainly "satiety pain". The pain will occur within 1 hour after eating and then gradually resolve. The cause of occurrence is that food rubs against the stomach ulcer surface, which can cause pain, and eating will stimulate gastric acid secretion, which will also aggravate the stimulation of the ulcer surface.
The pain caused by the duodenum is mainly "hunger pain". Pain appears 2 to 4 hours after eating and is relieved after eating. The cause of occurrence is that on an empty stomach, the stomach acid directly enters the duodenum to stimulate the ulcer surface, producing a painful sensation. After eating, after the food is mixed with stomach acid, it slows down the stomach acid into the duodenum and relieves the pain.
Third, gastroscopy is the best way to diagnose
Peptic ulcers have more typical gastrointestinal symptoms. When seeking medical treatment, the doctor will make a preliminary diagnosis through symptoms, but to confirm the diagnosis, a gastroscopy is required.
Gastroscopy is the main method of diagnosing peptic ulcer, using a fiber gastroscope or an electronic gastroscope, you can visually see the ulcer.
Gastric ulcers are mostly located in small gastric curvatures, especially in the antrums, usually single,round, oval or linear, sharp edges, usually less than 2 cm in diameter, basically smooth, the central part of the ulcer is an inflammatory layer, covered by gray-white or gray-yellow moss membrane, and the surrounding mucous membrane is hyperemia and edema.
Due to inflammatory stimulation at the bottom of gastric ulcers, there is often proliferative endarteritis, which thickens the arterial wall, narrows the lumen, and thrombosis, resulting in insufficient local blood supply to the gastric mucosa, making the ulcer difficult to heal, but helping to prevent blood vessel rupture and bleeding at the ulcer.
Duodenal ulcers occur most often in the anterior or posterior wall of the bulb, and the ulcers are generally smaller and less than 1 cm in diameter. Duodenal ulcers are shallow and heal easily compared to gastric ulcers.
If gastroscopy is not available, a barium X-ray examination may be performed. After taking barium, barium adheres to the ulcer and appears on X-rays. However, barium X-ray fluoroscopy is not intuitive as gastroscopy, and gastroscopy can also be directly taken from a sample in the lesion for pathological examination, so people suspected of having peptic ulcers, as long as the body is acceptable, are recommended for gastroscopy.
To sum up, peptic ulcers are a common cause of recurrent abdominal pain, which may be a stomach ulcer if it is always painful after meals, or duodenal ulcer if it is painful when hungry. If you suspect that you have a peptic ulcer, a gastroscope is the best choice for diagnosis. I am a pharmacist Huazi, welcome to follow me and share more health knowledge.