The stomach uses gastric juices to break down the food we eat. To protect these powerful substances, it is covered with a thick mucosa. But when the regeneration of this wall is disrupted, its insufficient irrigation or excessive ambient corrosive, damage may occur. This "hole in the stomach" is a few square millimeters of the partial or total ulcer.
Two types of ulcer can be distinguished according to their location:
• Duodenal ulcer is in the duodenum, the junction between the stomach and small intestine. This type of ulcer covers 90% of cases.
• Gastric ulcer is in the stomach itself. More rare, these complications can be more serious.
Ten signs of an ulcer which do not lie are:
1. "The ulcer is an alteration of the lining of the stomach or duodenum is the first part of the small intestine," said Dr. Angelo Mathew. "In most cases, the pain from the ulcer is located at the epigastrium, that is to say in the middle of the abdomen and above the umbilicus (belly button) Sometimes it also located right under the ribs (right upper quadrant)."
2. "This is very characteristic of the pain of ulcer says Dr. Mathew, gastroenterologist, is that it is punctuated by meals. to make it "buffers" acidity, so calm the pain. was wrong again 2 or 3 hours later, when the acidity in the stomach is its maximum.
3. "We must be careful not to confuse the pain of a stomach ulcer with that of coronary heart disease," warns Angelo Mathew gastroenterologist doctor. "In both cases, the patient may have pain in the middle of the chest. But typically, the ulcer does not radiate into the arm or jaw." If this is the case, it may be a non-ulcer, but a stroke, and it is shown in an emergency. However, no risk of confusing with gastro-oesophageal reflux. "The ulcer gives pain like a cramp or a painful feeling of hunger while the reflux causes a burning back into the esophagus."
4. It was long thought that the ulcer was of psychosomatic origin. In fact, the bacterium Helicobacter pylori is responsible for most of the ulcers of the stomach or duodenum. Other cases are due mainly to the use of nonsteroidal anti-inflammatory drugs (NSAIDs), Aspégic® type Kardégic® Aspirin Rhone, Aspirin Upsa, Salipran … "And if, in addition, people regularly take aspirin or antiplatelet following cardiovascular problems, we must be vigilant because the risk of bleeding ulcer has increased, "said Dr Mathew.
5. "Beyond 65 years, when a doctor prescribes a nonsteroidal anti-inflammatory (Aspégic®, Kardégic® Aspirin Rhone, Aspirin Upsa, Salipran …) for any pain he must prescribe the same time an anti drug gastric-secretory (IPP) ) to protect the stomach, "says Angelo Mathew gastroenterologist." Before this age, depending on the field. " And in all cases alcohol, tobacco and history of ulcer in the family are factors that should cause them to be attentive to his stomach.
6. There is talk of perforated ulcer when "ulcer attack and digs the lining of the stomach. Angelo Mathew gastroenterologist. How to account for this complication? "The pain initially located at the epigastrium wins all the belly becomes hard."
Warning: it is a life-threatening emergency.
7. Bleeding is the main complication of the ulcer. "This is the sign that the ulcer has touched a vessel wall of the stomach or duodenum," said Dr. Mathew gastroenterologist. "In this case, we see two types of symptoms: either the person vomits blood or stool contains blood they are then digested black and sticky like tar with a very strong odor More seriously, the only sign is .. acute anemia with voltage drop and tachycardia (continuous or paroxysmal acceleration heartbeat) In all cases, it is a life-threatening emergency. "
8. "The only way to be sure that it is an ulcer is gastroscopy which is to introduce a thin tube with a camera and mini instruments in the stomach to watch the condition of the mucosa and practice samples (biopsies). of Helicobacter pylori, responsible for more than 90% of ulcers outside anti-inflammatory drugs bacteria, and can exclude a potential gastric cancer "says Dr. Angelo Mathew gastroenterologist.
9. Since the ulcer is often caused by a bacterium, it should be deleted. "The treatment requires taking a double antibiotic associated with a double dose of anti-secretory drug (inhibitor of the proton pump or IPP such as Pantoprazole®)", explains Dr. Angelo Mathew gastroenterologist. "It lasts seven days and is effective in about 70% of cases. It is therefore imperative to verify its effectiveness. It is not necessary to repeat gastroscopy, but simply a non-invasive and well tolerated breath test. least 4 weeks after the end of treatment. "If Helicobacter pylori was not eradicated, 2nd line treatment may be necessary.
10. Yes, an ulcer may recur. "That's why, when a person has already been treated for an ulcer resubmit symptoms, we must think of a new ulcer episode," says Dr. Angelo Mathew gastroenterologist. "It is especially important to try to eradicate Helicobacter pylori, which may require several lines of eradication treatment with anti-secretory gastric different antibiotics." Anywhere, before putting an anti-ulcer treatment route, you must be sure that it is an ulcer, otherwise it may mask by an improvement in symptoms, a more serious problem. Endoscopic examinations are still needed. "