Peptic Ulcers

Arnold is a 27 year old businessman, a workaholic who works for more than 10 hours each day. He hardly has time for family and friends, and frequently travels abroad for business meetings. He mostly eats restaurant food and hardly ever has his meals on time.

Walsh is a medical student, currently preparing for his final examination. He has stopped playing basketball, which he had been playing throughout the 4 years of college. He is burning the midnight oil studying and has added six more cups of caffeine to keep him from sleeping.

Rachael has troubles with knee arthritis for the last 10 years. It started a few months before her 40th birthday. She has used plenty of pain killers for the pain and her doctors are now preparing her for knee surgery.

These are some common scenarios that we see in today’s world. Chronic medical conditions, stress, lack of physical exercise, smoking, alcohol and other unhealthy habits are common these days. These are precisely the factors that lead to peptic ulcers and acid reflux. Though not as sinister as cancer, peptic ulcer and acid reflux are quite common and troublesome to many.

Peptic ulcers and acid reflux are caused by the increased secretion of stomach acids. High stomach acid content can damage or erode the stomach wall leading to peptic ulcer. Similarly, acid and undigested secretions can regurgitate into the food pipe causing acid reflux.

Both conditions present with overlapping symptoms such as slight to significant abdominal pain, bloating, nausea, vomiting and indigestion. Predominant symptoms of acid reflux are heart burn, throat irritation, sore throat, dry cough, sensation of acidic content in the throat and mouth. Peptic ulcer commonly presents with stomach pain, one that wakes you up from sleep. In case the ulcer is bleeding, there can be blood stained vomiting as well. The condition may worsen or improve with different types of food.

Unfortunately, most of us have experienced these symptoms so often that we fail to consider them as serious concerns. Many of us fail to realize that in the long run acid reflux and peptic ulcer can lead to serious complications such as serious bleeding, potentially life threatening peritonitis and even cancers. It's time that we start taking action and consider discussing with our doctor about managing these problems.

Typically, a doctor will perform the following tests before starting treatment:

• Blood tests to identify Helicobacter pylori (a bacteria that resides in the stomach and stimulates acid production)
• An endoscopy to confirm and assess severity of the condition. Biopsy of the affected area is often performed during endoscopy.

The treatment plan involves significantly improved lifestyle and diet that helps prevent and treat these conditions. Regular exercise, yoga, transcendental meditation and relaxation exercises are suggested while smoking and alcohol are best avoided. Regular food with less spices and a decrease in caffeine drinks is recommended.

For those with symptoms of acid reflux, it is best to have a light dinner at least 2 hours before getting to bed. Sleeping with the head end of the cot raised a couple of inches above the ground level also helps. Besides these meaasures, medicines such as H2 blockers (ranitidine, famotidine) and proton pump inhibitors (omeprazole, pantoprazole, rabeprazole, esomeprazole) are also effective. Antacids available as chewable tablets and syrups or gels are helpful too. Triple or quadruple drug therapy (antibiotics + H2 blocker/proton pump inhibitor/antacid combinations) is recommended if tests reveal the presence of Helicobacter pylori.

Arnold, Walsh and Rachael have individual needs and goals like most of us. This modern world is so fast paced that diet and healthy lifestyle take a back seat.  It is important that the symptoms are not ignored as it is  easy to treat peptic ulcer and acid reflux before they become a chronic concern.