Peptic Ulcer

Peptic ulcer is ulceration of the mucosa coming in contact with acid and pepsin. The most common location of peptic ulcers is the first part of the duodenum; this is followed by gastric, lower esophageal and anastomotic jejunal ulcers after gastrojejunostomy.

The highest prevalence of peptic ulcer in India is in Kerala and Tamil Nadu. In India duodenal ulcers are far more common than gastric ulcers (8:1 to 20:1); in the Western countries, the ratio is approximately 4:1.

Causative factors of peptic ulcer:

  • Increased parietal cell mass with increased hydrochloric acid and pepsin.
  • Bile acids
  • Helicobacter pylori infection
  • Tea, coffee in excess
  • Irritant foods, chillies
  • Smoking
  • Alcohol
  • Stress
  • Corticosteroids
  • NSAIDs (Pain Killers)

Duodenal ulcer patients have a tendency to higher gastric acid secretion; gastric ulcer patients have lower acid secretion perhaps due to associated gastritis.

Mucosal injury and ulcerations occur with alcohol, chillies, bile salts, corticosteroids and non-steroid anti-inflammatory drugs (NSAIDs) such as aspirin, salicylates, indomethacin, butazolidine, ibuprofen, naproxen, etc. These agents produce acute ulcers and may have a role in the causation of chronic ulcer.

NSAID decrease the perception of ulcer pain, thus producing a ‘silent ulcer’ with complications of haemorrhage and perforation as the initial symptom. In the elderly arthritic, NSAIDs are one of the most common causes of peptic ulcer, especially gastric ulcers; this is more so in women.

Symptoms:

Duodenal ulcers usually occur in the age group 20-40 years and gastric ulcers, a decade later. Duodenal ulcer may occur for the first time after the age of 50 after rigid diet restrictions for weight reduction or ingestion of steroids or NSAIDs for arthritis. Children may also suffer from duodenal ulcers.

Symptoms of gastric and duodenal ulcers are almost identical. Since the diagnosis is essentially on the symptom of ‘pain’, ‘discomfort’, ‘heartburn’ or ‘gas bloat’ it is necessary to elicit the history in detail.

The onset of symptoms is insidious and usually imperceptible over months or even years. The site is commonly epigastric, occasionally umbilical or even a little below. There is usually no radiation, but there is local spread from epigastrium to the retrosternal region. Pain radiating to the back is assumed to be from a posterior duodenal ulcer eroding the pancreas. The character is usually described as burning. The intensity is usually mild but may be moderately severe.

A daily clock-like recurrence of the pain is diagnostic; it is usually on an empty stomach, before a meal or 3-4 hours after a meal. The duration is 1-2 hours or till the next meal. In patients with associated gastritis, ingestion of chillies, sour foods or fruits leads to discomfort immediately. Aggravating factors are long periods between meals; excessive consumption of chillies, tea or coffee; smoking; tobacco chewing and mental stress. Relieving factors are bland food, milk. Exacerbation of pain occurs for a few days, weeks or months with remissions for weeks, months or even several years.

The appetite is usually very good. Occasionally, there is no previous history and the presenting symptom is an acute complication like perforation or haemorrhage.

Complications:

The major complications of peptic ulcer are:

1) Hhaematemesis(Blood Vomiting) and melaena(Black, tarry stools)

2) Perforation

3) Gastric outlet obstruction.

It is worth remembering that

  1. A benign duodenal ulcer does not turn malignant
  2. A person with confirmed duodenal ulcer seldom develops malignancy of the stomach.

Milk neutralises gastric acid for up to 20 minutes, and provides good symptom relief. However, it cannot be used as long-term therapy because its calcium content may stimulate acid secretion and thus impair ulcer healing.

Treatment at Homeocare International:

In general, the Homeopathic therapy of gastric or duodenal ulcer and non-ulcer dyspepsia is similar. The principles of Homeopathic treatment are

(i) Withdrawal of ulcerogenic drugs – aspirin, phenylbutazone, corticosteroids, etc.

(ii) Stop smoking and alcohol, and restrict intake of tea or coffee to two cups a day

(iii) Adequate physical and mental rest

(iv) Take bland diet

(v) Homeopathic treatment

Diet: Since ulcer pain typically occurs on an empty stomach, small feeds every 4 hours during the waking period is important. Meat soups and extractives increase gastric secretion and are best avoided. Smoking, tobacco chewing, sour fruits and foods and alcohol perpetuate the symptoms. Chillies are best avoided. The effective principle of chillies, capsaicin, causes shedding of gastric surface epithelial cells, damages the protective barrier, and increases acid secretion.

Milk neutralises gastric acid for up to 20 minutes, and provides good symptom relief. However, it cannot be used as long-term therapy because its calcium content may stimulate acid secretion and thus impair ulcer healing.

Since duodenal ulcer is now recognised as a life-long predisposition in conventional method of treatment, and ulcers recur in 60%-70% within one year of healing with conventional treatment, Homeocare International offers a permanent, non-recurring cure without any side effects through its individualistic and advanced Homeopathic treatment.