Many people believe that an ulcer is an added value: growths on the skin or mucosa. This is how stomach ulcers also imagine. Meanwhile, they are not growths, but depressions in the mucosa, which is eaten, among others, by by hydrochloric acid contained in gastric juice. However, ulcers are said to burst, and how can a dimple burst? This is not the only myth about ulcers that needs to be dispelled.
Nobel prize for bacteria
For years, stomach ulcers were believed to be an occupational disease of CEOs and executives: heavy smoking, non-alcohol consumption, late and fat eating, and to the point of protein congestion at inept employees. In a word, ulcers were blamed for an unhygienic lifestyle.
This view changed once and for all in 1992, when two Australian researchers, JR Warren and BJ Marshall, discovered a bacterium that, after several unsuccessful baptisms, was eventually named Helicobacter pylori. They were awarded the Nobel Prize in 2005 for this discovery. So while cigarettes, alcohol, poor diet and stress are still not good for health and good shape, bacteria are responsible for ulcers and are easily treated with antibiotics. The discovery of Warren and Marshall gave doctors an effective tool in fighting ulcers and almost eliminated the need for surgery.
Krzysztof Bartosz, MD, PhD, gastroenterologist from NZOZ “Gastrolog” in Kielce, has detailed data:
– In the 60s and 70s, over 100 stomach operations were performed annually in an average surgical ward in Poland due to complications of peptic ulcer disease, mainly perforation and haemorrhage. Today, a few of them are performed every year. Then about 15% of patients suffered from peptic ulcer disease, today less than 5%. Thanks to eradication therapy (eliminating the bacteria with a set of two antibiotics and a drug that inhibits gastric acid secretion), gastric and duodenal ulcers are observed less and less frequently.
Helicobacter resistant
Averaging the statistics, it can be assumed that every second adult Pole is a carrier of the Helicobacter pylori bacteria. It’s just that roughly 80% of them will never know about it, because the bacteria will not become active. Others may suffer upper abdominal pain, sometimes at night and usually resolving after a meal. In addition, classic signals from the digestive system: nausea, sometimes vomiting. Interestingly, the severity of symptoms depends on many factors, including from the season. Everything is caused by infection with a bacterium that has developed highly specialized mechanisms that enable it to stay, often for many years, in an environment that is extremely unfavorable for all microorganisms, which is filled with caustic hydrochloric acid and pepsin – an enzyme digesting protein – the stomach. Helicobacter produces urease, a special enzyme protein that converts urea into ammonia. Ammonia is alkaline and by increasing the pH level around the bacteria, it neutralizes the acidic environment. Thanks to this, Helicobacter in the ammonia “cloud” exists unscathed at the center of this caustic antibacterial crucible.
Dagger thrust
What’s more, when the conditions become unfavorable even for him, it can temporarily fall into the equivalent of hibernation, i.e. turn into an endospore form. Then there are periods of remission, misinterpreted by patients as healing and the end of trouble. On the other hand, active Helicobacter can cause excessive secretion of gastric juice, which, with additional irritating factors, such as painkillers, cigarettes, general stress or irregular eating, increases damage to the gastric and duodenal mucosa, leading to the formation of initially point, and over time, more and more serious damage to the mucosa, called erosions or ulcers depending on their size and depth. Erosions and ulcers may cause bleeding, and in rare cases, a more serious complication may occur, such as perforation, i.e. perforation through the stomach or duodenum wall, which is commonly called ulcer rupture.
– Fortunately, ulcer perforation occurs less and less frequently – explains Dr. Krzysztof Bartosz. – The pain of a perforated ulcer is severe and sharp, which is why it is called “dagger pain”. Gastric juice is poured out through the opening into the peritoneal cavity, causing the “acute abdomen” syndrome. Very severe pain causes that the patient usually goes to the emergency surgery quickly and after confirming the diagnosis on the basis of physical examination (severe general condition, peritoneal symptoms) and additional examinations (the abdominal examination shows air under the diaphragm domes), the patient undergoes surgery.
Watch out for pain medications
Fighting ulcers and preventing complications is now easier than ever.
A gradual reduction in the number of cases of peptic ulcer disease is also observed. However, symptoms such as pain in the middle epigastrium, especially at night, waking the patient from sleep, and hunger pains (occurring on an empty stomach), decreasing after a meal, suggest peptic ulcer disease. In people up to 45 years of age, a serological test (blood test) for antibodies to the Helicobacter pylori bacterium or a stool test for the presence of bacteria can be performed. Confirmation of the presence of Helicobacter in the presence of peptic ulcer disease may be the basis for an eradication treatment lasting 7-14 days. The effectiveness of the treatment is estimated at over 80%, i.e. for 100 people treated, the elimination of bacteria is achieved in 80 patients. Helicobacter pylori is already present in young children and usually the mother is the source of transmission. In general, peptic ulcer disease is considered to be transmitted in families, although it should rather be specified that the bacterium itself is transmitted, not a ready-made disease. It is easy to get infected, just lack of hygiene after leaving the toilet or sharing bites of food.
Doctor Bartosz also warns against the abuse of over-the-counter painkillers. Most of them damage the gastrointestinal mucosa and cause ailments of various sizes: from mild discomfort to severe pain, with the possibility of bleeding into the gastrointestinal tract. One of the alarm symptoms may be the appearance of tarry stools. So in order to avoid unnecessary complications, avoid the use of painkillers and always consider whether the head really hurts so much that ingesting the painkiller from outside the recipe is necessary.
Text: Julia Wolin
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