Peptic Ulcer Disease

Peptic Ulcer Disease (PUD) is a condition characterised by ulcers that develop on the inside lining of the stomach and the upper portion of the small intestine. The most common causes are infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen.

Peptic ulcers occur when the protective mucus layer in the digestive tract is reduced, allowing stomach acid to damage the underlying tissue. Symptoms can include burning stomach pain, feeling of fullness, bloating, heartburn, nausea, and intolerance to fatty foods. In severe cases, ulcers can lead to serious complications such as bleeding or perforation of the stomach or intestinal wall.

Management 

• Medications:
  • Proton pump inhibitors (PPIs) to reduce stomach acid
  • H2 receptor blockers as an alternative to PPIs
  • Antacids for quick relief of symptoms
  • Cytoprotective agents like sucralfate to protect the lining of stomach and small intestine
• Eradication of H. pylori: Typically involves a combination of antibiotics and acid suppressants
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• Discontinuation of NSAIDs:
  • If possible, stop or reduce the use of NSAIDs
  • If NSAIDs are necessary, use the lowest effective dose
• Lifestyle modifications:
  • Avoid foods that trigger discomfort
  • Quit smoking
  • Limit alcohol consumption
  • Manage stress through relaxation techniques or counselling
• Follow-up endoscopy: To ensure healing of the ulcer, especially if it was large or complicated

Prevention 

• Limit use of NSAIDs:
  • If regular use is necessary, take with food and use the lowest effective dose
  • Consider alternative pain relievers when possible
• Protect against H. pylori:
  • Practice good hygiene, especially handwashing
  • Avoid food or water that may be contaminated
• Don't smoke: Smoking can increase stomach acid and impair the protective lining of the stomach
• Limit alcohol intake: Excessive alcohol can irritate and erode the mucous lining of the stomach
• Manage stress: While stress doesn't cause ulcers, it can exacerbate symptoms
• Eat a healthy diet: Include fruits, vegetables, and whole grains. Avoid foods that trigger discomfort
• Stay hydrated: Drink plenty of water throughout the day
• Regular check-ups: If you have a history of ulcers, regular medical check-ups can help catch and treat recurrences early
• Probiotics: Studies suggest probiotics may help prevent H. pylori infection