Peptic ulcers are open sores or erosions in the mucosal lining of either the duodenum (duodenal ulcers) or the stomach (gastric ulcers) due to irritants (may be allergic, chemical or mechanical or drugs), excessive secretion of digestive juice or infection.


TYPES -

If the stomach is ulcerated, it is known as gastric ulcer and if the duodenum is involved, it is known asduodenal ulcer.


INCIDENCE -

Gastric ulcer peaks in the age group of 50-60. The male, female ratio is almost equal. Duodenal ulcer peaks in the age group of 20-50 years. But the male, female ratio is 2:1. Occurrence of peptic ulcer is more common in people who have 'O' blood group.


CAUSES -  

•    Heredity - this is particularly so with duodenal ulcers.
•    Helicobacter pylori - This is the most important etiological factor in peptic ulcer disease, accounting for 90% of duodenal ulcers and 70% of gastric ulcers.
•    Increased hydrochloric acid secretion causes changes in the wall of duodenum (gastric metaplasia) setting the stage for invasion by H. Pylori.
•    Long term use of Non Steroidal Anti Inflammatory Drugs (NSAIDS) such as aspirin and ibuprofen damage the gastric mucosal barrier.
•    Habits - Smoking cigarettes, drinking alcohol and irregular dietary habit confers an increased risk of ulcer.
•    Mental and physical stress and strain.
•    Foods - Spicy and chilly.
•    Toxic - Chemicals or decayed foods.
•    Mechanical - Any hard food substance or any investigative procedures.
•    Neurological
•    Infectious diseases which cause increased urea and bacteria level in blood.


SIGNS AND SYMPTOMS - Usually runs a chronic course and complaints tend to be episodic in nature; the patient is usually free from symptoms in between these episodes.

•    Abdominal pain - Pain is referred to the epigastrium and is often so sharply localized that the patient can indicate its site with two or three fingers - the 'pointing sign'. Abdominal pain with burning or gnawing sensation.
•    Hunger pain - Pain occurs intermittently during the day, often when the stomach is empty, so that the patient identifies it as 'hunger pain' and obtains relief by eating.
•    Night pain - Pain wakes the patient from sleep and may be relieved by food, drinking milk or antacids.
•    Episodic pain/ Periodicity - Characteristically pain occurs in recurrent episodes.
•    Other symptoms - Waterbrash, Heartburn, Loss of appetite, Vomiting, Nausea, Headache, Constipation or diarrhea, Haematemesis Dyspepsia, Weight loss and Dark or black stools.


DIFFERENCE BETWEEN GASTRIC AND DUODENAL ULCER


   

DIAGNOSIS - Diagnosis of Peptic ulcers is confirmed by:

•    Endoscopy.
•    Double contrast barium meal examination.
•    X-Rays of stomach and duodenum.


COMPLICATIONS -

•    Bleeding (hematemesis or malena).
•    Perforation causes peritonitis and septic conditions in cases of chronic inflammatory ulcers when the infection deepens.
•    Obstruction due to stricture formation caused by chronic peptic ulcer.
•    Risk of stomach cancer.


Homoeopathic Treatment -

Peptic ulcer disease been a constitutional disease finds its local expression at the level of the digestive system. Being a constitutional disorder, it calls for constitutional approach towards treatment. Homoeopathy offers long-term cure instead of temporary relief as the treatment targets the root cause. Treatment is at the deeper level of immunity and it enhances the healing capacity of the body. Homoeopathy also helps prevent complications of Peptic ulcers. They can be treated successfully in Homeopathy without any side-effects. Homoeopathy improves the general resistance and also avoids recurrences.

 These medicines should be taken under the advice and diagnosis of a qualified Homeopath. Nux vomica is a very commonly used drug. The patient of nux vomica is of Type I personality with sedentary life with constant ineffectual urging, passing small quantity at each attempt. lycopodium – intellectually keen but physically weak. Eating very little causes fullness. Mouthful fills the stomach, aggravated in the evening between 4-8 pm. Arsalb – burning in the abdomen, vomiting black blood, pain more in the midnight.

Other medicines are ROBINIA, KALI BICH, BISMUTH, HYDRASTIS.


PREVENTION -

Proper lifestyle modifications, diet and regimen measures shall help in prevention peptic ulcer formation. It also helps in speedy recovery and arrests the further progression of complications. Dietary and regimen measures that should help are as follows:


TO TAKE

•    Easily digestible, oil free diet so that the work load of stomach and intestine can be reduced.
•    Frequent small meals should be encouraged to utilize the acid load in the stomach.
•    Water is to be taken before and after meals.
•    Nutritious diet should be taken at regular intervals or at regular time.
•    Diet rich in fiber, like green vegetables and fruits which are good for digestion and also for the general health should be consumed regularly.
•    Foods containing flavonoids, like apples, celery, cranberries (including cranberry juice), onions, and tea may inhibit the growth of H. pylori.


TO AVOID

•    Stressful and hurried life.
•    Habits of smoking, drinking alcohol, chewing tobacco and overeating which increases acid secretion of the stomach.
•    Hunger - which denotes acid load, avoid it by taking small meals often.
•    Full meal, oily diet, pickles and fatty snacks before bed time.
•    Food containing high spices, chilies and pepper.
•    Dry bread, cakes and cookies.
•    High fat content nuts and biscuits.
•    Aerated drinks, coffee and tea.
•    Milk products.
•    Stress by the regular use of relaxation techniques such as yoga, tai chi, or meditation.
•    Cabbage, onions, garlic, cauliflower, tomatoes - if not tolerated
•    Drugs like NSAIDs - pain killers (for example. - aspirin)


Hence, through Homoeopathic treatment permanent relief from peptic ulcer can be achieved. Ulcers take time to heal, so medicines should be continued for long time, even if the pain goes away. Homoeopathy aids in eradicating the ulcer even without the need of surgery.

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