Stomach Ulcer: Causes, Symptoms, and Diagnosis - Research Paper Example

Stomach Ulcer: Causes, Symptoms, and Diagnosis Introduction Stomach ulcers, or gastric ulcers, are defects in the gastric mucosa, which practically includes the whole gastrointestinal mucosa, that extend from the lining to the muscularis mucosa region (Soll). The problem with stomach ulcers is that they lead to the development of peptic ulcer disease, which is “an important cause of morbidity and health care costs” (Soll). With regards to peptic ulcer disease, the top five countries with the highest number of mortality rates include Cambodia, Philippines, New Guinea, Kiribati, and India (“Peptic Ulcer Disease”). History of Medical Condition According to the journal Nature, the bacteria that is basically responsible for the stomach ulcers of modern man since he migrated from Africa around 60,000 years ago was discovered in 2007 (“Prehistoric Origins”). This bacterial species, known as the Helicobacter pylori, or H. pylori, was investigated by the Max Planck Institute in Berlin, the University of Cambrige and the Hanover Medical School. The conclusion was that H. pylori began its existence in Eastern African populations and finally spread all over the world through migration (“Prehistoric Origins”). Current Medical Information Current medical research conducted in Japan in 2011 suggests that gastric ulcers can lead to cerebral air embolism, especially in patients with esophagectomy, or removal of the esophagus (Suzuki et al.). Associated Physical and Psychological Characteristics Psychosocial factors would most likely contribute to the occurrence of stomach ulcers. According to a research study conducted by the Division of Gastroenterology in Northwestern University in Chicago, “Psychosocial factors [may] play a significant role in…ulcer formation” (Jones). Psychosocial factors, or one’s psychological make-up, may actually play a role in the occurrence and aggravation of stomach ulcers through a number of ways: “…increasing duodenal acid load, altering local circulation or motility, intensifying H. pylori, stimulating corticosteroid secretion, and affecting health risk behaviors” (Levenstein). Causes One of the causes of stomach ulcers is genetic factors. Some strains of H. pylori may contain genes that will further aggravate the risk of the patient for ulcers. The person’s ethnicity oftentimes determines the extent to which these genetic factors cause stomach ulcers (“Peptic Ulcers-Causes”). In fact, genetic factors, such as those for peptic ulcer actually make the individual more susceptible to H. pylori infection (Hein et al.). Nevertheless, previous studies like those of Malaty et al. concluded that “genetic influences for peptide [intestinal and stomach] ulcer are independent of genetic influences for acquiring H. pylori infection” (Malaty et al.). Another cause of stomach ulcers is abnormalities in the patient’s immune system. Certain individuals may in fact be predisposed to stomach ulcers because they have abnormal immune responses pertaining to their intestines and these immune responses are the ones that allow bacteria to injure the intestinal lining (“Peptic Ulcers-Causes”). The bacterium H. pylori is responsible for 80% of gastric ulcers (“Causes of Peptic Ulcers”). Lifestyle factors are a third possible cause of stomach ulcers. The exposure of the individual to chronic stress, smoking and drinking coffee may in fact increase his susceptibility to stomach ulcers with some H. pylori carriers (“Peptic Ulcers-Causes”). A fourth cause of stomach ulcers is shift work and instances of interrupted sleep. People who work during the night may actually have a greater propensity to stomach ulcers compared to those who work during normal day hours. This and frequent interruptions during sleep may actually weaken one’s immunity to harmful bacteria (“Peptic Ulcers-Causes”). A fifth cause of stomach ulcers is the prolonged use of Nonsteroidal Anti-Inflammatory Drugs, or NSAIDs, and is in fact “the second most common cause of ulcers” (“Peptic Ulcers-Causes”). The most common NSAIDs include aspirin, naproxen and ibuprofen, which are the most popular painkillers (“Peptic Ulcers-Causes”). In fact, those who frequently take aspirin are even “more likely” to develop stomach cancers, while duodenal ulcers are attributed to the smokers, and esophageal ulcers are for the heavy drinkers (“Understanding Ulcers”). Other NSAIDs include those drugs used to lower high temperatures and those that alleviate inflammatory conditions – corticosteroids, bisphosphonates, and potassium chloride (“Causes of Peptic Ulcers”). The NSAIDs actually increase the risk of gastrointestinal bleeding and may even persist up to a year even if the medication is stopped (“Peptic Ulcers-Causes”). Other causes of stomach ulcers include other drugs such as warfarin, oral corticosteroids, chemotherapy drugs, and niacin. One particular drug known as Bevacizumab may be used as a treatment for colorectal cancer but it has a potential to increase the risk of the perforation of the gastrointestinal tract (“Peptic Ulcers-Causes”). Still, another possible cause of stomach ulcers is the Zollinger-Ellison Syndrome, or ZES, which is the excessive secretion of gastric acid due to the increase in the substance gastrin as triggered by pancreatic and duodenal tumors (“Peptic Ulcers-Cause”). Another cause of stomach ulcers includes heavy alcohol use, although this often leads to esophageal and not stomach ulcers (“Understanding Ulcers”). Diagnosis The diagnosis of stomach ulcers, as well as duodenal ulcers, may be done most accurately through endoscopy, which is the process of “passing a flexible, thin tube [or endoscope] through the mouth, down the gullet and into the stomach and duodenum” (“Diagnosing a Peptic Ulcer”). It is believed and understood that the views obtained using an endoscope are already “so good” that the doctor does not even have to perform other tests to confirm the presence of an ulcer (“Diagnosing a Peptic Ulcer”). The diagnosis of infection caused by H. pylori is very different. In this case, a sequence of at least three types of tests can possibly be administered to the patient in order to ascertain the presence of H. pylori in the stomach or intestine. First, the urea breath test, is conducted by using a special drink containing a chemical that can be digested by H. pylori, and so a large amount of carbon dioxide on one’s breath may determine if the patient indeed has H. pylori infection. A second test is the stool antigen test, where the patient’s stool sample is tested for the presence of this particular bacterial species. Lastly, a third test is the blood test, where the patient’s blood is tested for antibodies to H. pylori (“Diagnosing a Peptic Ulcer”). Treatment Treatment for stomach ulcers will usually depend on the cause of the disease. If the ulcer is caused by bacterial infection from H. pylori, the recommended treatment involves a course of antibiotics to be administered until bacteria are completely eliminated or reduced to a minimally harmless number. This antibiotic therapy is also known as “eradication therapy” (“Treating a peptic ulcer”). Eradication therapy usually involves taking twice a day for seven days the antibiotics that may include amoxicillin, clarithromycin, and metronidazole. There are, however, side effects that may include diarrhea, vomiting, nausea or a metallic taste in the mouth (“Treating a peptic ulcer”). For stomach ulcers caused by NSAIDs and if there is no infection due to H. pylori, the best solution is a “1-2 month course of proton pump inhibitors or PPI” and one’s choice of NSAIDs will also have to be evaluated or replaced, such as strong painkillers being replaced as paracetamol (“Treating a peptic ulcer”). Proton pump inhibitors work by blocking proton pumps responsible for the production or overproduction of acid in the stomach. There are, however, side effects too such as skin rashes, constipation, dizziness, nausea, diarrhea, and headache (“Treating a peptic ulcer”). However, if the ulcers are caused by both NSAIDs and H. pylori infection, the recommended treatment is a two-month prescription of a dose of PPIs and this must then be followed by eradication therapy. Otherwise, if the PPI treatment fails, H2-receptor antagonists may be employed on the patient (“Treating a peptic ulcer”). The use of antacids and alginates may also prove to be helpful in the treatment of stomach ulcers. Antacids are medications that neutralize acid in the stomach, while alginates are those that produce a protective coating that surrounds the lining of the stomach (“Treating a peptic ulcer”). Prevention Based on the results of a recent study in the University of Gothenburg in Sweden in 2010, “breastfeeding and better hygiene appear to protect against [the stomach ulcer bacterium],” perhaps due to the fact that breast milk contains several kinds of antibodies (“Breastfeeding Protects”). Moreover, according to another research study conducted in Sweden in 2011, the drug “esomeprazole 40 mg and 20 mg once daily reduces the risk of endoscopically proved peptic [ulcers]” (Scheiman et al.). Life Expectancy According to an earlier study in Albuquerque, Mexico, “The benefit of ulcer cure or H. pylori prevention diminishes as age advances” (Inanomi & Sonnenberg). So far, only cure of ulcers and successful primary prevention are needed (Inanomi & Sonenberg). Moreover, according to Yeh et al., endoscopic surveillance of presumed-benign gastric ulcers may improve overall survival” (Yeh et al.) Top of Form Bottom of Form Works Cited “Breastfeeding Protects Children Against Peptic Ulcer bacterium, Study Suggests.” 2012. Science Daily. 11 Apr 2012. “Causes of Peptic Ulcers.” 2012. NHS. 11 Apr 2012. “Diagnosing a Peptic Ulcer.” 2012. NHS. 11 Apr 2012. Hein H. Q., P. Suadacani, & F. Gyntelberg. “Genetic markers for stomach ulcer. A study of 3,387 men aged 54-74 years from the Copenhagen Male Study.” 1998. PubMed. 12 Apr 2012. Inadomi, John M. & Amnon Sonnenberg. “The Impact of Peptic Ulcer Disease and Infection With Helicobacter pylori on Life Expectancy.” American Journal of Gastroenterology 93 (1998): 1286-1290. Nature. 2012. Web. 11 Apr 2012. Jones, M. P. “The Role of Psychosocial Factors in Peptic Ulcer Disease: beyond Helicobacter pylori and NSAIDs.” Journal of Psychosomatic Research 60(4) (2006): 407-412. Nature. 2012. Web. 11 Apr 2012. Levenstein, S. “Psychosocial Factors in Peptic Ulcer and Inflammatory Bowel Disease.” Journal of Consultation and Clinical Psychology 70(3) (1998): 739-750. PubMed. 2012. Web. 11 Apr 2012. Malaty, H. M. & D. Y. Graham, I. Isaksson, L. Engstrand & N. L. Pedersen. “Are genetic influences on peptic ulcer dependent or independent of genetic influences for Helicobacter pylori infection?” Archives of Internal Medicine 160(1) (2000): 105-109. PubMed. 2011. Web. 11 Apr 2012. “Peptic Ulcer Disease.” n.d. World Health Rankings. 12 Apr 2012. “Peptic Ulcers-Causes.” Articles. 2011. University of Maryland. 11 Apr 2012. “Prehistoric Origin of Stomach Ulcers Uncovered.” 2007. Science Daily. 11 Apr 2012. Scarre, Christopher & Brian M. Faggan. Ancient Civilizations. New York: Prentice Hall, 2008. Print. Scheiman, James M. & P. J. Deveraux, Johan Herlitz, Peter H Katelaris, Angel Lanas, Sander Veldhuyzen van Zanten, Emma Naucler, and Lars Erik-Svedberg. “Prevention of peptic ulcers with esomeprazole in patients at risk of ulcer development treated with low-dose acetylsalicylic acid: a randomized, control trial (OBERON).” Journal of Psychosomatic Research 60(4) (2006): 407-412. Heart. 2012. Web. 11 Apr 2012. Soll, Andrew H. “Peptic Ulcer Disease: Genetic, environmental, and psychological risk factors.” 2012. UpToDate. 12 Apr 2012. Suzuki, Takahisa & Takafumi Ando, Akihisa Usami, Masataka Shinoda, Hitomi Takashi, Mutsumi Murayama, Isako Uchiyama, Kazuhiro Morise, Shinya Endo, Nobuhiro Haruki, Kazuhiro Tashiro & Hidemi Goto. “Cerebral air embolism as a complication of peptic ulcer in the gastric tube: case report.” Journal of Negative Results in Biomedicine 11: 139. BMC Gastroenterology. 2011. Web. 11 Apr 2012. “Treating a Peptic Ulcer.” 2012. NHS. 11 Apr 2012. “Understanding Ulcers.” 2012. WebMD.com. 11 Apr 2012. Yeh J. M., Ho W., Hur C. “Cost-effectiveness of endoscopic surveillance of gastric ulcers to improve survival.” Gastrointestinal Endoscopy 72 (1):33-43 (Jul 2010). PubMed. 2012. Web. 10 Apr 2011. Read More