What is Acute Peptic Disease?
Acute peptic disease is characterized by the sudden development of ulcers or erosions in the stomach or duodenum. It occurs due to an imbalance between aggressive factors like stomach acid and protective mechanisms such as mucus and bicarbonate.
Common Types of Acute Peptic Disease
- Acute Gastritis: Inflammation of the stomach lining, which may result from infections (e.g., Helicobacter pylori), alcohol use, medications, or stress.
- Peptic Ulcer Disease (PUD): Ulcers form in the stomach or duodenum as the mucosal lining erodes, often caused by H. pylori infection or prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs).
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Causes of Acute Peptic Disease
The primary factors contributing to acute peptic disease include:
Helicobacter pylori Infection:
This bacterium weakens the stomach's protective lining, increasing vulnerability to damage from stomach acid.
NSAIDs and Aspirin Use:
Long-term use of these drugs irritates the stomach lining, leading to ulcer formation.
Excessive Alcohol Consumption:
Alcohol erodes the stomach lining and can promote ulcer development.
Smoking:
Smoking delays the healing process and enhances acid production
Stress:
Physical stress from surgery, trauma, or severe illness can trigger stress ulcers.
Excessive Gastric Acid Production:
Conditions like Zollinger-Ellison syndrome lead to increased stomach acid, causing ulcers.
Symptoms of Acute Peptic Disease
- Abdominal pain: Typically felt as a burning or gnawing discomfort in the upper abdomen, particularly on an empty stomach.
- Bloating: A sensation of fullness or tightness.
- Nausea and vomiting: Often occurring after meals or at night.
- Indigestion (dyspepsia): Pain or discomfort in the upper abdomen.
- Loss of appetite: Frequently due to eating-related discomfort.
- Heartburn: A burning feeling in the chest caused by acid reflux.
- Black or tarry stools: A potential sign of gastrointestinal bleeding from ulcers.
Diagnosis of Acute Peptic Disease
- Medical History and Examination: Detailed history of symptoms, lifestyle factors, and family history is taken.
- Endoscopy (EGD): A flexible camera is used to visually inspect the stomach and duodenum for ulcers, inflammation, or other abnormalities.
- Helicobacter pylori Testing:
- Breathe Test: A non-invasive method to detect pylori.
- Blood Test: Identifies antibodies against pylori.
- Stool Antigen Test: Detects pylori antigens in stool samples.
- Biopsy: Performed during an endoscopy to confirm infection.
- Barium Swallow X-ray: Used occasionally for imaging but is less preferred compared to endoscopy.
Treatment for Acute Peptic Disease
- Antibiotics for H. pylori: A combination of antibiotics (amoxicillin, clarithromycin) and a proton pump inhibitor (PPI) eradicates the infection and aids healing.
- Proton Pump Inhibitors (PPIs): Medications like omeprazole or pantoprazole reduce acid production, promoting healing.
- H2-Receptor Antagonists: Drugs such as ranitidine or famotidine lower acid levels and complement PPIs.
- Antacids and Protective Medications:
- Sucralfate forms a protective coating over ulcers.
- Antacids neutralize acid, providing relief.
- Discontinuing NSAIDs or Alcohol: Essential to stop or reduce the use of these irritants to allow healing.
- Smoking Cessation: Quitting smoking improves recovery and reduces recurrence risk.
- Surgical Intervention: Rarely required but may be necessary for severe complications such as bleeding, perforation, or obstruction.
Lifestyle Modifications for Healing
- Eat smaller, more frequent meals to minimize gastric acid secretion.
- Avoid irritants like alcohol, caffeine, and spicy foods.
- Reduce stress by using relaxation methods like yoga, meditation, or deep breathing.
- Quit smoking to enhance healing and prevent recurrence.
- Follow medical advice on using antacids and other prescribed medications.
Complications of Acute Peptic Disease
If left untreated, acute peptic disease can lead to:
Bleeding:
Resulting in anemia, black stools, or vomiting blood.
Perforation:
Ulcers may create a hole in the stomach or intestinal wall, leading to a critical condition called peritonitis.
Gastric Outlet Obstruction:
Ulcer-related swelling or scarring can block food passage from the stomach, causing nausea and vomiting.
Chronic Peptic Ulcer Disease:
Persistent or recurrent ulcers may cause long-term damage to the stomach lining.
