Trophic local education, resulting from destruction of the mucous layer of the stomach or duodenum bile and corrosive substances the digestive juice, in medicine called peptic ulcers (pus, PUD).
As a rule, the ulceration is sporadic and rarely reaches a size greater than 15 mm.
However, there are cases when there are multiple ulcers, able as convergence with each other to merge into one giant.
The symptoms at different stages
Since the symptoms of ulcer necessarily depend on the severity of the pathological state, it is advisable to highlight them and give each a detailed description of the clinical picture.
1. Fresh ulceration – the first symptom of formation of pus is the appearance of pain in the epigastric area, the intensity of which increases when people are hungry. Here are marked and dyspepsia: nausea, burning sensation behind the breastbone, belching, abdominal discomfort, obstipation (constipation) or diarrhea.
2. Epithelialization of the defect in this phase, pain usually subside (there are only day and are quickly eliminated after ingestion) as well as symptoms of dyspepsia. However, due to additional symptoms (severe swelling and congestion of the right of the diaphragm to the air mass, dryness in the mouth, slightly elevated temperature and fast pulse) becomes quite possible to recognize the disease of the stomach and 12 duodenal ulcer.
3. Healing ulcers – pain occurs on an empty stomach. Flatulence, vomiting and other signs of disorders of the digestive system do not exist.
4. Remission – the patient expressed complaints, and even when palpation abdominal pain syndrome it does not occur.
To develop pus and PUD can in people of different age categories, but more often the pathology is still diagnosed in adults in the area of 30-40 years. The ulcers of the gastrointestinal tract is characteristic of a fluctuating course, there are periods of calm alternate with phases of aggravation and therefore the symptoms of the disease at each stage of its development a few distinctive.
In acute ulcer 12 duodenal ulcer and the body of the stomach characterized by the appearance of pain in the epigastric region possibly extending to the lumbar, thoracic, spine, shoulder, hand. In addition to the pain from ulcer occur halitosis (bad breath), coated tongue, and marked dyspeptic symptoms: instability stool, excessive gas, heartburn, nausea, ending in the release of vomit out that the patient brings obvious relief.
It is worth noting that all of these symptoms are characteristic of uncomplicated forms, so in the event of progression of the clinical picture can be quite different. So, when penetration of ulcers (the spread of the pathological process in the adjacent stomach and duodenum organs) suffering from pain attack occurs, characterized by constancy and over time increase the intensity. In addition to pain increased body temperature, possible presence of edema of the lower back. Also symptoms will depend on which organ was defeated: if the pancreas, there will be a clinic of acute pancreatitis; biliary tract – symptoms of cholangitis; segments of the intestine – the symptoms of colitis or duodenitis; liver symptoms of hepatitis.
In the case of such complications of duodenal ulcer and/or stomach bleeding, caused by exposure of the vessel wall, a person says such clinical condition:
- sharp fall in blood pressure;
- vomiting with admixture of scarlet or coagulated blood;
- sudden weakness;
- syncope or presyncope symptoms (dizziness, tinnitus, feeling of faintness, the protrusion of sweat, rabena in the eyes);
- disorder chair: it became liquid and tarry.
It is also crucial to know and recognize the signs of gastric ulcers in adults with perforation (perforation), since this complex form of disease can lead to peritonitis – inflammation of the lining of the abdominal cavity.
Symptoms of perforated pus and PUD:
- pain in the epigastrium, like a knife;
- gradual development of pain in one side of the abdomen;
- pale skin + cold sweat;
- possible clouding of consciousness;
- the increase in body temperature;
- dryness of the tongue;
- muscle tension of the peritoneum.
The only point to bear pain attack when gastric ulcer with perforation to the arrival of an ambulance is the fetal position.
How to understand that it’s time to see a gastroenterologist?
To the doctor, of course, it is better to apply with the first symptoms of gastric ulcer and 12 duodenal ulcer, that is, the aggregate of phenomena such as dyspepsia, pain, heaviness and discomfort in the abdomen, flatulence. However, there are the symptoms of pus and PUD, in the case of the presence of even one of which the doctor on call at home or an independent visit to the hospital urgent.
- vomiting “coffee grounds”;
- stool with blood and pus;
- stabbing pain in the stomach;
- faint on the background of hypotension.
To recognize erosive-ulcerous disease of stomach and 12 duodenal ulcer in adults allow the following diagnostic methods:
1. questioning the patient and studying the medical history;
2. x-ray examination is necessary to detect functional and morphological changes in the organs;
3. gastroscopy helps to determine the level of gastric acidity, to assess the condition of the mucosal surface to establish the nature of the ulceration;
4. laboratory techniques (blood, feces, gastric secretions, and serology, histological, bacteriological studies conducted for the detection of the pathogenic microorganism Helicobacter Pylori – cause of the ulcerative process in the stomach);
5. the differentiation is carried out with such diseases as hernia of the diaphragm, and diffuse atrophic gastritis, pancreatitis, cholecystitis, cholelithiasis, appendicitis, cancer, stroke, tabid, gastroptosis;
6. physical examination – palpation, percussion of the abdomen, examination of the oral cavity and other events also play a significant role in determining gastric ulcer.
Therapy and diet
Treatment pus and PUD should conduct a comprehensive and phased manner.
For example, in the acute phase of duodenal ulcer or stomach, the patient can be assigned:
- enveloping and adsorbing means;
- cytoprotective drugs;
- reparants (to improve the regenerative abilities of the mucosa);
- medication protivokleshchevogo action (when stomach trouble developed because of harmful bacteria);
- drugs, relaxing muscles and accelerating bowel movements;
In the absence of effect from conservative therapy may be a routine operation. Emergency surgery is indicated in case of gastric bleeding, penetration and perforation of ulcerated defect. Regardless of the shape and complexity of current ulcer 12 duodenal ulcer and/or stomach, all patients (adults and children) mandatory assigned diet, which is able not only to cure a pathology, but also to prevent or reduce the number of relapses.
The principles of diet with pus and PUD:
1. meals should be frequent (about every 4 hours) and small portions;
2. meals are prepared only in the form of mashed and liquid form, serves moderately heated (so as not to cause mechanical and thermal irritation);
3. caloric intake needs to reach 3000 kcal per day;
4. excludes products with a strong sokogonnym action;
5. banned the use of fried, salty, fatty, muffin, mushrooms of any kinds, canned goods, pickles, coffee, soda, alcohol and other food and beverages that have a negative impact on the condition of the digestive system.
If gastric ulcer or duodenal ulcer was diagnosed in time, the probability of full recovery of the patient is very high. Unfavorable prognosis is possible with the development of complications. Especially dangerous perforation of ulcers in the free abdominal cavity, because without urgent surgical intervention comes death.