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Letters to the Editor

Stomach ulcer

- Dr. Tranquilino Elicaño Jr. -

This is a broken inflamed portion of the lining or mucosal membrane of the stomach. It is usually small, about 15 to 25 mm. across and is round or oval in shape. In most cases, the ulcer is situated near the point where the stomach opens into the duodenum which is the first part of the small intestine on the lower posterior wall. The victim may feel pain either at the front or in the back, which maybe more severe before a meal.

 Also, there may be nausea and a feeling of bloatedness after meals. Sometimes, instead of pain, there is discomfort felt as a feeling of emptiness or hunger or of an aching nature. A person with symptoms of gastric ulcer should seek medical advice. There are several examinations to detect gastric ulcer. These are endoscopy, analysis of gastric secretions and X-ray studies using barium. Treatment is by means of a number of different drugs including antacids, carbenoxolene and histamine H2 receptor antagonists (cimetidine, famotidine, rantidine and nisatidine).

Most gastric ulcers respond fairly well to treatment, although there is a tendency for healing and relapse to occur. The person should eat a light diet and irritant foods or drinks should be avoided. These include spicy foods containing pepper, fatty foods, coffee and alcohol. He should also avoid smoking and stress. Complications can arise in the form of blockage of the stomach outlet (pylorus), due to the formation of the scar tissue, perforation through to an adjacent space or organ and hemorrhage (indicated by the vomiting of blood and passing black, tarry feces containing blood). In cases like this, the patient should be brought to the hospital for surgery to remove the ulcer and a part of the stomach.

The exact cause of stomach ulcer is not known but is believed to be linked with changes in the mucous membrane lining of the stomach, mucus secretion and acid and pepsin (an enzyme) production. Some drugs, particularly aspirin and other non-steroidal anti-inflammatory drugs and corticosteroids, encourage the formation of an ulcer.

The risk of developing a stomach ulcer increases with age whereas a duodenal ulcer may occur in young adults. If after receiving proper management there is still no good response, undergo further examinations or tests because one may unfortunately have a cancerous ulcer which will require a different management.

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BLOOD

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CONTAINING

DRUGS

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GASTRIC

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ULCER

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