Aphthous - Ulcer

Ulcers are small, open craters or sores that develop in the lining of the stomach or the duodenum, the first section of the small intestine. It is a hole or break in the protective lining of the esophagus, the stomach or the duodenum. An ulcer is classified as gastric, if present in the stomach, and duodenal, if present in the duodenum. The term peptic ulcer is generally used to describe both types of ulcers. During normal digestion, food passes from the mouth and esophagus, entering into the stomach. The stomach produces hydrochloric acid (HCL) and an enzyme called pepsin to digest the food. From the stomach, food passes into the upper part of the small intestine, called the duodenum, where digestion and nutrients absorption continue. An ulcer is a sore or lesion that forms in the lining of the stomach or duodenum where HCL acid and pepsin are present. Gastric ulcers are somewhat less common but more significant because they may occasion, indicate an underlying cancer of the stomach. Duodenal ulcers, on the other hand, are very common and almost always benign. Ulcers can develop at any age, but they are rare among teenagers and most uncommon among the children. It is between the ages of 30 and 50 that duodenal ulcers occur for the first time. Gastric ulcers are more likely to develop in people over age 60. Duodenal ulcers occur more frequently in men than women, whereas stomach ulcers develop more often in women than men.

• Heartburn
• Intense pain
•  Dark stools
•  Vomiting
•  Nausea
•  Pain between breastbone and navel.
•  Bloated feeling immediately after eating 
•  Feeling full
•  Indigestion
•  Gastrointestinal bleeding 
•  Hemorrhage
• Weakness
•  Fatigue
•  Loss of consciousness
  
  

• Keep your immune system healthy by eating nutritiously and supplementing your diet with garlic capsules, which fights both bacterial and viral infection.
• Taking daily supplements of zinc brings a protective effect against the formation of ulcers
• Stress in all its forms is unquestionably a contributing factor to ulcers. Reduce stress through daily relaxation methods, using music therapy, stretching, yoga, biofeedback, exercise, etc. Change jobs or locations if stress is severe.
• Don’t smoke. Smoking greatly increases your risk for developing ulcers as well as a whole other host of serious diseases. Smoking constricts the blood vessels that supply nourishment to the stomach lining.
• Eat regular meals and do not overeat.
• Avoid alcohol. It can result in stomach lining irritation.
• Avoid taking corticosteroids, ibuprofen, aspirin, indomethacin, prioxicam and naproxen for longer periods of time.
  

Most ulcers (80 percent of gastric ulcers and 90 percent of duodenal ulcers) develop as a result of infection with a bacterium called Helicobacter pylori (H. pylori). The bacterium causes an increased acid production. Along with this, it produces substances that weaken the stomach's protective mucus and make it more susceptible to the damaging effects of acid and pepsin. Smoking increases the chances of getting an ulcer, slows the healing process of existing ulcers, and contributes to ulcer recurrence. Caffeine seems to stimulate acid secretion in the stomach, which can aggravate the pain of an existing ulcer. However, the stimulation of stomach acid cannot be attributed solely to caffeine. Physical stress may increase the risk of developing ulcers, particularly in the stomach. For example, people with injuries such as severe burns and people undergoing major surgery often require rigorous treatment to prevent ulcers and related complications. Some drugs may be responsible for the weakening of the stomach wall, eventually leading to ulcer formation. Drugs such as aspirin, ibuprofen, and naproxen sodium may make the stomach vulnerable to the harmful effects of HCL acid and pepsin. These are mostly non-prescription medications used to treat fever, headaches, and minor aches and pains. The consumption of these articles should therefore be limited as a precaution to peptic ulcers.

Diagnostic procedures include: 

Upper GI (gastrointestinal) series: X-ray of the esophagus, stomach, and duodenum 

Endoscopy: In this procedure a small flexible instrument with a camera on its one end is inserted through the mouth into the esophagus, stomach, and duodenum to view the entire upper gastrointestinal tract. 

Blood, breath, and stomach tissue tests: To detect the presence of H. pylori.

• Eating smaller and more frequent meals is highly recommended. The presence of food can help neutralize stomach acid. It is therefore recommended not to go for long periods of time without food.
• High fiber diets are recommended for their therapeutic use. Fiber promotes mucin secretion and delays gastric emptying.
• Potatoes and almond milk are recommended for their acid neutralizing properties
• Barley helps rebuild the lining of the stomach.
• Foods that are recommended include low-fat yogurt, avocados, bananas, squash, yams, steamed broccoli, and carrots.
• Blue grapes are widely used in Europe to treat ulcers.
• Okra powder acts as a demulcent to stop inflammation.
• Papaya fruit contains enzymes that promote good digestion and heal the stomach lining.
• Persimmons help to facilitate healing of the stomach lining and whey powder contains compounds that help heal ulcerated tissue.
• Dairy products, fatty foods, soda pop, caffeine and alcohol should be avoided.
• Coffee, in any form, should be completely removed from the diet.
• As iron is a gastric irritant, it is not recommended to take iron supplements in the presence of an ulcer.
• Large doses of vitamin C can create more stomach acid; therefore it is not advisable to take Vitamin C supplementation.
  

• Administrations of over the counter antacids help provide relief and promote healing. Their use must be limited, however, as they can cause diarrhea or constipation.
• The majority of ulcers will heal on their own with proper bed rest and diet
• The immune system should be strengthened with proper supplementation, stress and diet control.
• Calcium carbonate antacids may actually produce a rebound effect of gastric acid secretion and should be avoided. In a similar fashion, the prolonged use of sodium bicarbonate antacids should be avoided as they may cause metabolic imbalances.
• The types of antacids most commonly prescribed for ulcers are aluminum-magnesium compounds. These may cause a depletion of calcium and phosphorus and contain aluminum, which may be toxic.
  
• While skepticism abounds about the contribution of stress to ulcer formation, there is enough credible evidence that the connection is a valid one. People who live in high stress cities have a greater incidence of ulcers. Keep stress levels controlled through biofeedback, visualization therapy, yoga, controlled breathing, exercise, etc. 
• Pepto-bismol contains bismuth, which can kill bacteria that invade the stomach and are thought to cause ulcers. If the theory that bacteria cause stomach-lining vulnerability to ulcers is valid, this approach may be worth trying.
• Slow down your pace of living, including the speed in which you eat and drink. Don’t eat under stress.
• Stop smoking, as smokers are twice as likely to get ulcers as nonsmokers. Smoking also inhibits ulcer healing and increases the chances of ulcer recurrence.
• Avoid taking aspirin and ipobrufen. These medications along with other nonsteroidal anti-inflammatory drugs should not be taken by anyone suffering from an ulcer. They can cause further deterioration of the stomach lining.
• Acetaminophen is recommended.
  

While skepticism abounds about the contribution of stress to ulcer formation, there is enough credible evidence that the connection is a valid one. High-stress jobs, relationships and certain personality traits do increase the risk for developing ulcers. This association may be due to the lowering of immunity, and susceptibility, which can cause vulnerability in the stomach lining leading to ulceration, rather than an increase of stomach acid, which can result under times of stress. Now that we know a possible bacterium may be causing ulcers, the role of immunity is even more crucial. Learning to relax and cope with every day stressors is vital to decreasing one’s risk of developing ulcers.