A peptic ulcer is a sore that develops on the lining of the stomach, small intestine or oesophagus. A peptic ulcer when developed in the stomach is called a gastric ulcer. A duodenal ulcer when it develops in the first part of the small intestine (duodenum). An oesophageal ulcer when it is manifested in the lower part of the oesophagus. Ulcers develop when stomach acid damages the lining of the digestive tract. Common causes are the bacteria H. Pylori and anti-inflammatory pain relievers including aspirin. Upper abdominal pain is the main sign. Treatment options include medication to decrease stomach acid production. If it is caused by bacteria, antibiotics may be beneficial.
Signs & Symptoms
The most common symptom is a burning sensation or pain in the middle of the abdomen between your chest and belly button. Typically, the pain will be more intense when the stomach is empty, and it can last for a few minutes to several hours.
Other common signs and symptoms of ulcers include:
- dull pain in the stomach
- Trouble breathing.
- Feeling faint.
- Nausea or vomiting.
- Unexplained weight loss.
- Appetite changes.
- Vomiting or vomiting blood — which may appear red or black.
- Dark blood in stools, or stools that are black or tarry.
Causes
Stomach ulcers are mostly caused by any one of the following:
H.pylori infection
long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, or naproxen
Zollinger-Ellison syndrome (a rare medical condition)
Physiopathologie
Peptic ulcer disease (PUD) shows a discontinuation in the inner lining of the gastrointestinal tract because of excessive gastric acid secretion or pepsin. It can reach upto the muscularis propria of the gastric epithelium. In short, peptic ulcers are defects in the mucosa that extend through the muscularis mucosa.
Normally, a physiological balance is there between gastric acid secretion and gastroduodenal mucosal defence. Ulcer develops when this balance is disrupted. Aggressive factors, such as nonsteroidal anti-inflammatory drugs (NSAIDs), H pylori infection, alcohol, bile salts, acid, and pepsin, can alter the mucosal defence by allowing back diffusion of hydrogen ions and subsequent epithelial cell injury. The defensive mechanisms are tight intercellular junctions, mucus, bicarbonate, mucosal blood flow, cellular restitution, and epithelial renewal mechanism.
Diagnostic
- Medical history
- Blood test, stool test, or a breath test to rule out H.pylori infection
- Barium swallow test
- Endoscopy (EGD)
- Endoscopic biopsy
Traitements
It’s important to promptly treat an ulcer. Treatment can be chosen considering the cause of the ulcer. Most ulcers can be treated with medicines but in rare cases, surgery may be required. In an actively bleeding ulcer, hospitalisation and intensive treatment including endoscopy, IV ulcer medications or blood transfusion is needed.
- Nonsurgical treatment
Antibiotics and proton pump inhibitors (PPIs) are used to treat H. pylori infection. PPIs block the functioning of stomach cells that produce acid.
In addition to these following therapies are also advised in some cases:
- H2 receptor blockers
- stopping use of all NSAIDs
- follow-up endoscopy
- probiotics
- bismuth supplement
- Surgical treatment
In very rare cases, a non-healing or recurring and complicated stomach ulcer will require surgery.
Surgery may include:
- removal of the entire ulcer
- taking tissue from another part of the intestines and patching it over the ulcer site
- repairing a bleeding artery
- cutting off the nerve supply to the stomach to reduce the production of stomach acid
Pronostic
In most cases, the prognosis is excellent. It is successful with clearing of H pylori infection, not using nonsteroidal anti-inflammatory agents (NSAIDs), and the appropriate use of antisecretory therapy.
Complications
Ignored and untreated, peptic ulcers can lead to:
- Internal bleeding
- A hole (perforation) in the stomach wall
- Obstruction in the digestive tract
- Gastric cancer
Maladies et Ayurveda
In Ayurveda, abdominal pain and colic comes uder shola and peptic ulcer can be compared with parinama soola or annadravasoola in chronic stage. The word parinama means transformation and here it implies digestion. Abdominal pain which is related with the stages of digestion is called parinaama soola. Anna means solid foods and drava means liquids. Abdominal pain developing while the intake of solid or liquid diet (regardless of food intake) is called annadravasoolawhich is said to be incurable.
Nidana
- Causative factors for the vitiation of Vaata dosha
- Unwholesome diet
- Untimely diet
- Unhealthy eating habits
- Sleeping disorders
Purvaaroopa
Non mentionné
Samprapti
Due to the causative factors, gets covered with the misplaced or aggravated Kapha or Pitta or both and produce pain in the abdomen. When the Kapha is moved from its normal site, along with Pitta blocks the Vaayu and causes pain during the digestion process.
Lakshana
- Pain during the digestion of the food
- Pain in the abdomen
- Pain in the flanks and sides of abdomen
- Pain in the navel region
- Pain in the area of urinary bladder
- Pain in between the breasts
- Pain in the sacral area
Divisions
Parinaama soola
Annadrava soola
Pronostic
Kashtasaadhya/Asaadhya when 3 doshas are involved, with complications or when the strength, muscles and digestive power of individual is deteriorated.
Chikithsa
The Ayurveda treatment of this disease is primarily langhanam(weight reducing therapies like fasting). Also vamana(therapeutic emesis), virechana(therapeutic purgation)and vasti(therapeutic medicated enema) are recommended for a detoxified body and a well-balanced agni(metabolism)
Samana
- Aamapaachanam
- Agnideepanam
- Pathya aaharam
Sodhana
- Vamana
- Virechana
- Vasti
Médicaments couramment utilisés
- Dadicmashtakachoornam
- Kapitthashtakachoornam
- Guduchyadi kashayam
- Dadimadi ghrutam
- Dhanwantaram gulika
- Avipatti choornam
- Guggulutiktam Kwatham
Marques disponibles
- AVS Kottakal
- AVP Coimbatore
- SNA oushadhasala
- Vaidyaratnam oushadhasala
Home Remedies
There is no proven home cure for peptic ulcer but as it is directly related with digestion, some changes in diet regimen are believed to be beneficial like including the following into daily diet:
- Coconut
- Virgin coconut oil
- Curcuma
- Tulsi leaves
- Carrot juice
- Raisins secs
- Bananas
Régime alimentaire
- À éviter
Les repas lourds et les aliments difficiles à digérer provoquent des indigestions.
Hot, spicy and pungent items like pickle
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Boissons gazeuses - rendent l'estomac plus acide et perturbent la digestion
Aliments réfrigérés et congelés - provoquent une digestion faible et paresseuse en affaiblissant Agni (le feu digestif).
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Caillé - provoque le vidaaha et, par conséquent, de nombreuses autres maladies
- A ajouter
Des repas légers et des aliments faciles à digérer
Green gram, soups, fresh vegetables and fruits, raisins, pome granate
Aliments fraîchement cuits et chauds traités avec des graines de cumin, du gingembre, du poivre noir, de l'ajwain, etc.
Comportement :
- Protect yourself from cold climate.
- Il est préférable d'éviter une exposition excessive à la lumière du soleil, au vent, à la pluie ou à la poussière.
- Maintenir une alimentation et un sommeil réguliers.
- Évitez de retenir ou de forcer les envies comme l'urine, les selles, la toux, les éternuements, etc.
- Avoid a sedentary lifestyle.
postures de Yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
L'exercice régulier contribue à améliorer la biodisponibilité des médicaments et des aliments ingérés et favorise la santé.
Le yoga permet de maintenir l'harmonie à l'intérieur du corps et avec le système environnant.
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Exercices simples pour la santé des poumons et du cœur
Tous les exercices et les efforts physiques doivent être décidés et effectués uniquement sous la supervision d'un expert médical.
Research Articles
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6140150/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3952291/
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