21.04.2019

Endoscopy for acute ulcers of the stomach and duodenum. Can I take aspirin if I have a stomach ulcer?

Mechanism of ulcer occurrence

A stomach ulcer caused by taking Aspirin is no different in symptoms from a disease provoked by other factors. It is characterized by:

pain in epigastric region, especially at night;
abnormal stool, often with signs of hemorrhage;
hiccups, nausea and vomiting after eating.

If these pathological signs appear while taking Aspirin, treatment should be stopped immediately and consult a gastroenterologist for advice.

After introducing ASA or other salicylates into the patient’s body (orally and intravenously), during FGDS, transformations in the gastric mucosa can be seen. Around the particles acetylsalicylic acid swelling, redness, tissue necrosis and hemorrhages into the underlying layers are observed on the gastric mucosa, which indicates the allergic nature of the pathological changes.

Through clinical trials, the ability of aspirin particles to cause inflammatory changes around them has been established. Gastric slime layer coagulates, partially losing its protective ability.

In this case, uncrushed tablets remain in the stomach cavity for a long time without dissolving. The acid corrodes the delicate mucous membrane, damaging the walls of nearby vessels. As a result, there may be hidden bleeding. The situation is complicated by the fact that this process can exist for a long period without symptoms. The patient does not feel pain, heartburn or nausea.

Then obvious symptoms of internal bleeding suddenly appear:

vomiting streaked with blood or “coffee grounds”;
weakness;
black tarry stools;
signs of anemia.

Patients with such symptoms require hospitalization in a hospital. Sometimes there is a need for surgical treatment.

Studies prove the fact that mucosal defects do not occur in all patients receiving salicylates. In the vast majority of people, the lining of the stomach is resistant to the effects of a large dose of aspirin. The risk group for the occurrence of the disease are patients predisposed to gastrointestinal diseases, weakened and elderly people, as well as those who have a history of ulcerative lesions of the stomach and duodenum. In such patients, gastric hemorrhages and perforations sometimes occur even from short-term use of Aspirin.

Dosage forms of Aspirin with a special insoluble coating that protects the gastric mucosa reduce the risk of damage, but do not completely remove it. After all, the very presence of acetylsalicylic acid in the patient’s body provokes pathological reactions.

The harmful effects of aspirin on the gastric lining increase with the simultaneous use of other drugs, especially Prednisolone and Butadione. Inflammation and ulceration of the mucous membrane digestive organ disappear after discontinuation of treatment with salicylates and antiulcer pharmacological therapy.

What can replace aspirin?

The free sale of non-steroidal anti-inflammatory drugs entails their uncontrolled use. However, the vast majority of patients, as well as some pharmacy workers, do not have a complete understanding of side effects, and especially about the ulcerogenic effect of drugs that contain ASA.

Aspirin treatment, and especially long-term treatment, can contribute to the appearance of dangerous complications, such as an ulcer with perforation and bleeding.

At the same time, the drug is widely used to prevent rheumatism. Therapy involves 2–3 months of using the drug in large doses. In general, ASA is well tolerated and does not cause adverse reactions, but still, it is better to use less dangerous drugs.

Aspirin is also an inexpensive and popular antipyretic and analgesic that is used for all colds accompanied by hyperthermia and headache. However, instead of this dangerous drug, it is wiser to use analgesics of different pharmacological groups, which do not have a pronounced ulcerogenic effect, for example:

All over the world, for acute respiratory viral infections or other colds, paracetamol (also known as children's Panadol). In pediatric practice, it is a drug that is used primarily.

The effectiveness of ASA as an antiplatelet agent is beyond doubt. It is still used as a first aid drug to thin the blood for thromboembolism. pulmonary artery and heart attacks. People with pathologies of the cardiovascular system carry it with them in the first aid kit along with Nitroglycerin. If necessary, Aspirin can quickly and effectively improve blood properties.

The most popular antiplatelet drugs are:

Peptic ulcer disease is a contraindication to taking these drugs, so they should be replaced with antiplatelet agents without an ulcerogenic effect (Dipyridamole, Integrilin, Clopidogrel, Ticlopidine).

Therapy for aspirin ulcers

Salicylic and aspirin ulcers of the mucous membrane of the digestive organ have scanty symptoms, but their complications are always sudden and sometimes very severe. Most often, defects are localized in the antrum of the stomach, closer to the pylorus. Manifestations of salicylate damage can vary widely, from erosive gastritis to a true ulcer.

In this case, medicine taken on an empty stomach irritates the mucous membrane more than if drunk after a meal. The damaging effect of Aspirin on the mucous membrane is reduced by ascorbic acid and calcium.

To reduce the irritating effects of ASA, doctors recommend drinking it with plenty of milk. It is contraindicated to take the medicine on an empty stomach or with alcohol.

Treatment of the disease is multicomponent. It begins with stopping the use of Aspirin and prescribing a diet, as well as standard antiulcer therapy, including antisecretory, antacid drugs, PPIs, anticholinergics and antispasmodics.

Thus, uncontrolled treatment with such a popular, inexpensive and effective drug as ASA is dangerous due to its serious complications. First of all, this applies to people with a complicated medical history and predisposition to gastrointestinal diseases, as well as elderly and weakened patients.

Aspirin and peptic ulcers

candidate medical sciences, Head of the All-Union Center for the Study of Side Effects of Medicines of the USSR Ministry of Health

Acetylsalicylic acid was well tolerated by patients and did not seem to cause any side effects. However, the attention of doctors was attracted by the fact that some patients who took aspirin for a long time complained of stomach pain that occurred after eating. Their stool samples showed traces of blood. But only after using gastroscopy, a method that allows one to examine the stomach cavity, was it possible to discover a connection between acute hemorrhagic inflammation of the gastric mucosa and taking aspirin. Doctors saw multiple erosions on the gastric mucosa, at the bottom of which lay particles of acetylsalicylic acid. Relationship long-term use acetylsalicylic acid and gastric microbleeding has been proven. Discontinuation of the drug and prescription special diet quickly improved the condition of the patients, the normal state of the gastric mucosa was restored.

Practice has shown that such disorders do not occur in all patients. Apparently, in most people, the gastric mucosa is resistant to the damaging effects of even large doses

Some drugs, in addition to their therapeutic effect, can cause certain side effects due to the patient’s increased individual sensitivity to the drug or its complete intolerance. Readers should be aware of these undesirable effects of medications, so as not to increase the dose prescribed by the doctor without permission, and especially not to self-medicate.

acetylsalicylic acid. It turned out that the gastric mucosa is damaged more quickly in people who have suffered or are predisposed to peptic ulcer. Gastric bleeding, and in some cases even perforation of a stomach ulcer, sometimes occurs in them after short-term use of acetylsalicylic acid. This is confirmed by many cases. Let's give one of them.

Patient S, 62 years old, who had suffered from peptic ulcer for 30 years, was admitted to the clinic. Having caught a cold, he began to take aspirin, 1 tablet 3 times a day. On the 4th day, the patient developed abdominal pain, hiccups, nausea and vomiting after eating. At x-ray examination A defect in the mucous membrane was discovered - a giant niche in the area of the duodenal bulb and an emerging breakthrough in its wall - the beginning of its perforation. Only emergency surgery saved the patient's life.

An exacerbation of chronic peptic ulcer disease was provoked by taking acetylsalicylic acid.

Scientists have also found that the damaging effect of acetylsalicylic acid on the gastric mucosa is enhanced if other medications are taken along with it, especially butadione and prednisolone. Irritation of the gastric mucosa and exacerbation of peptic ulcer disease disappear after stopping the use of acetylsalicylic acid and under the influence of antiulcer treatment.

Is it possible to reduce to some extent irritant effect aspirin? Yes, if, after taking acetylsalicylic acid, wash it down with plenty of milk or take this medicine immediately after a meal, but under no circumstances on an empty stomach. In no case should you also drink alcohol while taking aspirin, as some do when fighting a cold. Alcohol irritates the gastric mucosa, disrupts its protective barrier function, and the damaging effect of acetylsalicylic acid increases.

I talked about side effect acetylsalicylic acid in order to warn about the dangers of self-medication with a widespread, affordable and, undoubtedly, highly effective drug. This warning applies primarily to people suffering from chronic peptic ulcers of the stomach and duodenum, as well as those who are predisposed to peptic ulcers.

Is it true that aspirin causes stomach ulcers?

Aspirin (ASA) is the main representative of the NSAID group; it is successfully used in the treatment of colds and rheumatic diseases accompanied by fever, and is also used as a blood thinner to prevent blood clots.

However, doctors have discovered the ability of Aspirin to damage the mucous membrane of the stomach and duodenum. In 20–25% of patients taking long-term treatment ASA or combined NSAIDs, an aspirin gastrointestinal ulcer occurs, and in half of the patients erosive gastritis develops.

Mechanism of ulcer occurrence

The process of damage to the gastric mucosa by salicylates does not have a complete explanation. Their local corrosive, chemical and toxic effects are very likely. Aspirin directly affects the lining of the stomach, causing necrosis of areas of the mucous membrane and provoking allergic irritation.

A stomach ulcer caused by taking Aspirin has no symptoms.

There is hardly a person who has not at some point taken aspirin (acetylsalicylic acid), a medicine that is effective for various inflammatory processes. Pharmacologists know that in most cases the drug does not act on the main cause of the disease (bacteria or viruses), but on its individual manifestations. The patient receives relief; sometimes after a few tablets his headache goes away and his temperature drops. Hence the authority of acetylsalicylic acid.

Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

Here is the case of our patient with a corticosteroid ulcer:

I.N.T., and. b. 5646/1955, was ill from the age of 16 bronchial asthma for which he was repeatedly treated in various hospitals. He was never diagnosed with a peptic ulcer. At x-ray examination carried out upon admission to the clinic, established data chronic gastritis. The clinic began treatment with cortansil (30 mg per day) and ACTH (20 units intramuscularly twice a week). A week after treatment, pain appeared in epigastric region, heartburn and belching. On the 10th day from the start of corticosteroid treatment, a secondary X-ray examination revealed a giant gastric ulcer on the upper curvature of the stomach above the gastric angle. I had to stop treatment and start regular anti-ulcer therapy, as a result of which subjective complaints stopped, the ulcer decreased in size and later disappeared completely.

Other hormones. Condition of patients suffering from ulcers.

However, recent studies have established that aspirin is by no means harmless and it is dangerous to get carried away with it. According to doctors, with its regular use, the risk of hemorrhage in the retina increases. Aspirin disrupts the functioning of the liver and kidneys. As a result, you can achieve the opposite effect - instead of cleaning the blood vessels, they will wear out, since both filters - the liver and kidneys - will not cope with the load and remove toxins from the body in a timely manner. In addition, aspirin destroys tooth enamel.

What can replace aspirin? Drink more fluids - not strong tea and coffee, but mineral water, plain water, juices, compotes. Consume foods containing unsaturated fatty acid- fish, seafood. Baked potatoes and rice contain a lot of potassium, which is beneficial for blood circulation. Lemon juice, tomato juice (without salt!), and decoction are good for thinning the blood.

A headache disrupts the usual way of life, changes all plans and causes a lot of inconvenience. Therefore, I want to get rid of it as soon as possible by everyone available means. However, it is strictly not recommended to mindlessly consume large quantities of tablets. In order for treatment to help quickly and for a long time, it is necessary to establish the cause of the ailment.

Causes of headaches

There are a great many conditions that cause headaches, but most often they occur for the following reasons:

Vascular dysfunction, high and low blood pressure; Osteochondrosis, myositis, spondylosis and other diseases of the cervical spine; Predisposition to migraines; Physical and mental overstrain, sedentary work, physical inactivity; Stale air in the room, stuffiness; Stress, disappointment, hyper-responsibility, serious moral shock; Inflammatory and infectious diseases.

The pain can be stabbing and dull.

Aspirin (acetylsalicylic acid) is one of those drugs that is known to literally everyone.

Meanwhile, the effects of aspirin on the human body are very diverse, and not always favorable. It is important to know about this in advance in order to avoid health problems.

Acetylsalicylic acid is included in many antipyretic drugs (“Citramon”, “Askofen”, “Coficil”, “Acelysin”, “Asphen” and others), including “hot drinks” for fever, but there is also pure aspirin in tablets or capsules of various dosages.

Aspirin is a derivative of salicylic acid, in which one hydroxyl group replaced with acetyl, this is how acetylsalicylic acid was obtained. The name of the drug comes from the Latin name of the meadowsweet plant.

Stomach and duodenal ulcers: causes, symptoms, diagnosis, treatment

Gastric and duodenal ulcer video

Mechanism of ulcer formation

Causes of stomach and duodenal ulcers

Factors that cause ulcers in H. Pylori carriers

Symptoms of stomach and duodenal ulcers

Diagnosis of gastric and duodenal ulcers

Treatment of stomach and duodenal ulcers

Antibiotics and combined treatment regimens for gastric and duodenal ulcers

Surgical treatment of gastric and duodenal ulcers

How to replace aspirin for stomach ulcers

Nutrition for stomach ulcers

Complications of stomach ulcers

A peptic ulcer is an open wound or moist area that tends to develop in one of two places:

In the gastric mucosa.

IMPROPER USE OF ANTI-FYRETER MEDICATIONS CAN CAUSE A CHILD. NECROSIS OF LIVER CELLS

The Ministry of Health of Ukraine has issued an order according to which nimesulide-based medications cannot be prescribed to children under 12 years of age. However, not even all pediatricians know about this, so parents should be vigilant

Inna ROGOMAN “FACTS”

Cold and flu season has begun, and children are at greater risk of contracting the infection than others. One of the first signs of illness is high fever. How to deal with it? And is it necessary to shoot it down?

Exists general recommendation“Adults need to lower their temperature if it exceeds 39.5 degrees, and for children under three years old - at 38.5 degrees,” explains Anna Gorban, chief physician and director of the Institute of Child Health, Dr. Bogomolets. - However, in each specific case, a doctor must make a decision, since children tolerate high temperature. One baby lies, unable to move, and the other plays. If you feel strong.

Formed medicinal ulcer differently. Some medications can suppress the production of protective hormones called prostaglandins, resulting in decreased gastric mucus production. Others themselves have a negative effect on the walls of the muscle bag. Still others provoke a significant increase in pH due to increased production of hydrochloric acid by parietal cells. Moreover, under the influence of glucocorticosteroids, secretory levels increase.

There is hardly a person who has never taken aspirin (acetylsalicylic acid), a medicine that is effective in various inflammatory processes. Pharmacologists know that in most cases the drug does not act on the main cause of the disease (bacteria or viruses), but on its individual manifestations. The patient receives relief; sometimes after a few tablets his headache goes away and his temperature drops. Hence the authority of acetylsalicylic acid.

Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

It is also widely used to prevent exacerbations of rheumatism. This requires large doses of the drug, and it is used for a long time, 2-3 months in a row.

Acetylsalicylic acid was well tolerated by patients and did not seem to cause any side effects. However, the attention of doctors was attracted by the fact that some patients took a long time.

There is no main and only reason for stomach ulcers! Nevertheless, modern medicine It is understood that stomach ulcers are the end result of an imbalance between the digestive fluid in the stomach and duodenum. Most ulcers are associated with an infection caused by a type of bacteria called Helicobacter Pylori (H.).

Can I take aspirin if I have a stomach ulcer?

There is hardly a person who has not at some point taken aspirin (acetylsalicylic acid), a medicine effective for various inflammatory...

Can I take aspirin if I have a stomach ulcer?

Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

It is also widely used to prevent exacerbations of rheumatism. This requires large doses of the drug, and it is used for a long time, 2-3 months in a row.

Acetylsalicylic acid was well tolerated by patients and did not seem to cause any side effects. However, the attention of doctors was attracted by the fact that some patients who took aspirin for a long time complained of stomach pain that occurred after eating. Their stool samples showed traces of blood. But only after using gastroscopy, a method that allows one to examine the stomach cavity, was it possible to discover a connection between acute hemorrhagic inflammation of the gastric mucosa and taking aspirin. Doctors saw multiple erosions on the gastric mucosa, at the bottom of which lay particles of acetylsalicylic acid. The relationship between long-term use of acetylsalicylic acid and gastric microbleeding has been proven. Canceling the drug and prescribing a special diet quickly improved the condition of the patients, and the normal state of the gastric mucosa was restored.

Is it possible to reduce the irritant effect of aspirin to some extent? Yes, if you take acetylsalicylic acid, wash it down with plenty of milk or take this medicine immediately after a meal, but under no circumstances on an empty stomach. In no case should you also drink alcohol while taking aspirin, as some do when fighting a cold. Alcohol irritates the gastric mucosa, disrupts its protective barrier function, and the damaging effect of acetylsalicylic acid increases. Self-medication with aspirin is very dangerous. This applies primarily to people suffering from chronic peptic ulcers of the stomach and duodenum, as well as those who are predisposed to peptic ulcers.

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Aspirin and peptic ulcers

Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

It is also widely used to prevent exacerbations of rheumatism. This requires large doses of the drug, and it is used for a long time, 2-3 months in a row. Acetylsalicylic acid was well tolerated by patients and did not seem to cause any side effects. However, the attention of doctors was attracted by the fact that some patients who took aspirin for a long time complained of stomach pain that occurred after eating. Their stool samples showed traces of blood. But only after using gastroscopy, a method that allows one to examine the stomach cavity, was it possible to discover a connection between acute hemorrhagic inflammation of the gastric mucosa and taking aspirin. Doctors saw multiple erosions on the gastric mucosa, at the bottom of which lay particles of acetylsalicylic acid. The relationship between long-term use of acetylsalicylic acid and gastric microbleeding has been proven. Canceling the drug and prescribing a special diet quickly improved the condition of the patients, and the normal state of the gastric mucosa was restored.

Practice has shown that such disorders do not occur in all patients. Apparently, for most, the gastric mucosa is resistant to the damaging effects of even large doses of acetylsalicylic acid. It turned out that the gastric mucosa is damaged more quickly in people who have had or are predisposed to peptic ulcer disease. Gastric bleeding, and in some cases even perforation of a stomach ulcer, sometimes occurs in them after short-term use of acetylsalicylic acid.

Self-medication with aspirin is very dangerous. This applies primarily to people suffering from chronic peptic ulcers of the stomach and duodenum, as well as those who are predisposed to peptic ulcers.

Drug-induced (medicinal) stomach ulcer

Not the last place among pathological lesions The mucous and deep tissues of the stomach are occupied by drug-induced ulcers. They are caused by ulcerogenic drugs, the most common of which are: indomethacin, aspirin, brufen, diclofenc, potassium chloride, non-steroids, sulfonamides and a number of others. Most often, the onset of the disease occurs after long-term use of tablet medications, especially in large dosages.

A medicinal ulcer forms in different ways. Some medications can suppress the production of protective hormones called prostaglandins, resulting in decreased gastric mucus production. Others themselves have a negative effect on the walls of the muscle bag. Still others provoke a significant increase in pH due to increased production of hydrochloric acid by parietal cells. Moreover, under the influence of glucocorticosteroids they increase secretory functions pepsin and gastrin, due to which the aggressiveness of the stomach contents increases several times.

In some cases, drug-induced stomach ulcers heal on their own after stopping the offending medications. But complications often arise. That is why any medications should be taken only on the recommendation of a doctor and after appropriate examinations.

Ulcer and aspirin are mutually exclusive concepts

Since aspirin is one of the most commonly used drugs, cases of aspirin ulcers are very common. Its symptoms are practically no different from those of a disease caused by other causes. Among them:

pain in the epigastric region;
nausea accompanied by vomiting after eating;
hiccups;
diarrhea.

If such negative factors occur, the drug should be discontinued.

As a rule, after stopping the medication, an aspirin stomach ulcer goes away on its own. But also for a speedy recovery, gastroprotective drugs or medications of the PPI group can be prescribed.

Naturally, taking aspirin for a stomach ulcer is strictly prohibited. Acetylsalicylic acid can cause not only painful sensations, but provoke internal bleeding and even perforation of the walls. To reduce the negative effects of aspirin, experts advise drinking plenty of milk with the tablet. But in no case should you take the drug on an empty stomach or in combination with alcohol (alcohol tinctures).

Acetylsalicylic acid was well tolerated by patients and did not seem to cause any side effects. However, the attention of doctors was attracted by the fact that some patients who took aspirin for a long time complained of stomach pain that occurred after eating. Their stool samples showed traces of blood. But only after using gastroscopy, a method that allows one to examine the stomach cavity, was it possible to discover a connection between acute hemorrhagic inflammation of the gastric mucosa and taking aspirin. Doctors saw multiple erosions on the gastric mucosa, at the bottom of which lay particles of acetylsalicylic acid. The relationship between long-term use of acetylsalicylic acid and gastric microbleeding has been proven. Canceling the drug and prescribing a special diet quickly improved the condition of the patients, and the normal state of the gastric mucosa was restored.

Your own doctor

Main menu

Search

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Aspirin and peptic ulcers

Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

Aspirin and peptic ulcers

Mechanism of ulcer occurrence

A stomach ulcer caused by taking Aspirin is no different in symptoms from a disease provoked by other factors. It is characterized by:

pain in the epigastric region, especially at night;
abnormal stool, often with signs of hemorrhage;
hiccups, nausea and vomiting after eating.

If these pathological signs appear while taking Aspirin, treatment should be stopped immediately and consult a gastroenterologist for advice.

After introducing ASA or other salicylates into the patient’s body (orally and intravenously), during FGDS, transformations in the gastric mucosa can be seen. Around the particles of acetylsalicylic acid on the gastric mucosa, swelling, redness, tissue necrosis and hemorrhages into the underlying layers are observed, which indicates the allergic nature of the pathological changes.

Through clinical trials, the ability of aspirin particles to cause inflammatory changes around them has been established. The gastric mucous layer coagulates, partially losing its protective ability.

In this case, uncrushed tablets remain in the stomach cavity for a long time without dissolving. The acid corrodes the delicate mucous membrane, damaging the walls of nearby vessels. As a result, hidden bleeding may occur. The situation is complicated by the fact that this process can exist for a long period without symptoms. The patient does not feel pain, heartburn or nausea.

Then obvious symptoms of internal bleeding suddenly appear:

Patients with such symptoms require hospitalization in a hospital. Sometimes there is a need for surgical treatment.

The harmful effects of aspirin on the gastric lining increase with the simultaneous use of other drugs, especially Prednisolone and Butadione. Inflammation and ulceration of the mucous membrane of the digestive organ disappear after discontinuation of treatment with salicylates and antiulcer pharmacological therapy.

What can replace aspirin?

The free sale of non-steroidal anti-inflammatory drugs entails their uncontrolled use. At the same time, the vast majority of patients, as well as some pharmacy workers, do not have a complete understanding of the side effects, and especially the ulcerogenic effect of drugs that contain ASA.

Aspirin treatment, and especially long-term treatment, can lead to dangerous complications, such as an ulcer with perforation and bleeding.

Aspirin is also an inexpensive and popular antipyretic and analgesic that is used for all colds accompanied by hyperthermia and headache. However, instead of this dangerous drug, it is wiser to use analgesics of different pharmacological groups that do not have a pronounced ulcerogenic effect, for example:

All over the world, for acute respiratory viral infections or other colds, paracetamol (aka children's Panadol) is used instead of ASA. In pediatric practice, it is a drug that is used primarily.

The effectiveness of ASA as an antiplatelet agent is beyond doubt. It is still used as a first aid drug to thin the blood for pulmonary embolism and heart attacks. People with pathologies of the cardiovascular system carry it with them in the first aid kit along with Nitroglycerin. If necessary, Aspirin can quickly and effectively improve blood properties.

The most popular antiplatelet drugs are:

Therapy for aspirin ulcers

Salicylic and aspirin ulcers of the mucous membrane of the digestive organ have scanty symptoms, but their complications are always sudden and sometimes very severe. Most often, defects are localized in the antrum of the stomach, closer to the pylorus. Manifestations of damage by salicylates can be very different, from erosive gastritis to true ulcers.

To reduce the irritating effects of ASA, doctors recommend drinking it with plenty of milk. It is contraindicated to take the medicine on an empty stomach or with alcohol.

Thus, uncontrolled treatment with such a popular, inexpensive and effective drug as ASA is dangerous due to its serious complications. First of all, this applies to people with a complicated medical history and predisposition to gastrointestinal diseases, as well as elderly and weakened patients.

How to take aspirin for stomach ulcers

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pain in the epigastric region;
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Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

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Aspirin and peptic ulcers

There is hardly a person who has never taken aspirin (acetylsalicylic acid) - a medicine that is effective in various inflammatory processes. Pharmacologists know that in most cases the drug does not act on the main cause of the disease (bacteria or viruses), but on its individual manifestations. The patient receives relief; sometimes after a few tablets his headache goes away and his temperature drops. Hence the authority of acetylsalicylic acid.

Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

Practice has shown that such disorders do not occur in all patients. Apparently, for most, the gastric mucosa is resistant to the damaging effects of even large doses of acetylsalicylic acid. Another thing was found out - the gastric mucosa is damaged faster in people who have had or are predisposed to peptic ulcer disease. Gastric bleeding, and in some cases even perforation of a stomach ulcer, sometimes occurs in them after short-term use of acetylsalicylic acid. This is confirmed by many cases. Let's give one of them.

Patient S., 62 years old, who had suffered from peptic ulcer for 30 years, was admitted to the clinic. Having caught a cold, he began to take aspirin, 1 tablet 3 times a day. On the 4th day, the patient developed abdominal pain, hiccups, nausea and vomiting after eating. An X-ray examination revealed a defect in the mucous membrane - a giant niche in the area of the duodenal bulb and an emerging breakthrough in its wall - the beginning of its perforation. Only emergency surgery saved the patient's life.

An exacerbation of chronic peptic ulcer disease was provoked by taking acetylsalicylic acid.

I talked about the side effects of acetylsalicylic acid in order to warn about the dangers of self-medication with a widespread, affordable and, undoubtedly, highly effective drug. This warning applies primarily to people suffering from chronic peptic ulcers of the stomach and duodenum, as well as those who are predisposed to peptic ulcers.

Drug-induced (medicinal) stomach ulcer

Not the least place among pathological lesions of the mucous membrane and deep tissues of the stomach is occupied by drug-induced ulcers. They are caused by ulcerogenic drugs, the most common of which are: indomethacin, aspirin, brufen, diclofenc, potassium chloride, non-steroids, sulfonamides and a number of others. Most often, the onset of the disease occurs after long-term use of tablet medications, especially in large dosages.

A medicinal ulcer forms in different ways. Some medications can suppress the production of protective hormones called prostaglandins, resulting in decreased gastric mucus production. Others themselves have a negative effect on the walls of the muscle bag. Still others provoke a significant increase in pH due to increased production of hydrochloric acid by parietal cells. Moreover, under the influence of glucocorticosteroids, the secretory functions of pepsin and gastrin increase, due to which the aggressiveness of the stomach contents increases several times.

Ulcer and aspirin are mutually exclusive concepts

Since aspirin is one of the most commonly used drugs, cases of aspirin ulcers are very common. Its symptoms are practically no different from those of a disease caused by other causes. Among them:

pain in the epigastric region;
nausea accompanied by vomiting after eating;
hiccups;
diarrhea.

If such negative factors occur, the drug should be discontinued.

As a rule, after stopping the medication, an aspirin stomach ulcer goes away on its own. But also for a speedy recovery, gastroprotective drugs or medications of the PPI group can be prescribed.

Naturally, taking aspirin for a stomach ulcer is strictly prohibited. Acetylsalicylic acid can cause not only pain, but also provoke internal bleeding and even perforation of the walls. To reduce the negative effects of aspirin, experts advise drinking plenty of milk with the tablet. But in no case should you take the drug on an empty stomach or in combination with alcohol (alcohol tinctures).

Can I take aspirin if I have stomach problems?

Aspirin (acetylsalicylic acid) should not be used for gastrointestinal diseases. Yes and healthy people it must be taken with caution. Do not drink on an empty stomach, wash it down with jelly, for example.

And with a stomach ulcer or gastritis, an exacerbation or even bleeding can easily occur when taking aspirin. A long time ago I had a perforated stomach ulcer, I think it was because of aspirin.

No, you cannot take aspirin if you have stomach diseases - it is very dangerous. Internal bleeding is possible due to acid corroding the walls of an already unhealthy stomach.

Acetylsalicylic acid has an extremely negative effect on the stomach; even healthy people should use it with caution. Do not take tablets on an empty stomach or take aspirin better milk. And under no circumstances should it be mixed with alcohol.

Aspirin is acetylsalicylic acid, it is an analgesic, anti-inflammatory and antipyretic agent, often used for headaches; toothache; for neuralgia; at elevated temperature bodies; and also inflames the blood; By the way, aspirin is used to prevent impaired cerebral circulation and other diseases.

But. There are, of course, contraindications; it is not recommended to take aspirin if you have a stomach ulcer; as well as diseases associated with the gastrointestinal tract; and of course, aspirin is contraindicated in case of kidney disease; liver and bronchial asthma.

As you can see, it is not recommended to drink aspirin for stomach diseases, because the acid partially corrodes the lining of the stomach itself, which not only doctors know about, but the patient himself should know.

Is it true that aspirin causes stomach ulcers?

However, doctors have discovered the ability of Aspirin to damage the mucous membrane of the stomach and duodenum. In 20–25% of patients taking long-term treatment with ASA or combined NSAIDs, an aspirin gastrointestinal ulcer occurs, and half of the patients develop erosive gastritis.

Mechanism of ulcer occurrence

A stomach ulcer caused by taking Aspirin has no symptoms.

Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

Here is the case of our patient with a corticosteroid ulcer:

I.N.T., and. b. 5646/1955, from the age of 16 he suffered from bronchial asthma for which he was repeatedly treated in various hospitals. He was never diagnosed with a peptic ulcer. An X-ray examination performed upon admission to the clinic revealed evidence of chronic gastritis. The clinic began treatment with cortansil (30 mg per day) and ACTH (20 units intramuscularly twice a week). A week after treatment, pain in the epigastric region, heartburn and belching appeared. On the 10th day from the start of corticosteroid treatment, a secondary X-ray examination revealed a giant gastric ulcer on the upper curvature of the stomach above the gastric angle. I had to stop treatment and start regular anti-ulcer therapy, as a result of which subjective complaints stopped, the ulcer decreased in size and later disappeared completely.

Other hormones. Condition of patients suffering from ulcers.

What can replace aspirin? Drink more liquid - not strong tea and coffee, but mineral water, plain water, juices, compotes. Eat foods containing unsaturated fatty acids - fish, seafood. Baked potatoes and rice contain a lot of potassium, which is beneficial for blood circulation. Lemon juice, tomato juice (without salt!), and decoction are good for thinning the blood.

A headache disrupts the usual way of life, changes all plans and causes a lot of inconvenience. Therefore, I want to get rid of it as soon as possible by all available means. However, it is strictly not recommended to mindlessly consume large quantities of tablets. In order for treatment to help quickly and for a long time, it is necessary to establish the cause of the ailment.

Causes of headaches

There are a great many conditions that cause headaches, but most often they occur for the following reasons:

The pain can be stabbing and dull.

Aspirin (acetylsalicylic acid) is one of those drugs that is known to literally everyone.

Meanwhile, the effects of aspirin on the human body are very diverse, and not always favorable. It is important to know about this in advance in order to avoid health problems.

Aspirin is a derivative of salicylic acid in which one hydroxyl group is replaced by acetyl, which is how acetylsalicylic acid is obtained. The name of the drug comes from the Latin name of the meadowsweet plant.

Mechanism of ulcer formation

Antibiotics and combined treatment regimens for gastric and duodenal ulcers

Nutrition for stomach ulcers

Complications of stomach ulcers

In the gastric mucosa.

IMPROPER USE OF ANTI-FYRETER MEDICATIONS CAN CAUSE A CHILD. NECROSIS OF LIVER CELLS

Inna ROGOMAN “FACTS”

There is a general recommendation: adults should lower their temperature if it exceeds 39.5 degrees, and children under three years old - at 38.5 degrees, explains Anna Gorban, chief physician and director of the Institute of Child Health, Dr. Bogomolets. “However, in each specific case, a doctor must make a decision, since children tolerate high fever differently. One baby lies, unable to move, and the other plays. If you feel strong.

Can I take aspirin if I have a stomach ulcer?

Aspirin is also popular among patients because it has a reputation for being absolutely harmless.

It is also widely used to prevent exacerbations of rheumatism. This requires large doses of the drug, and it is used for a long time, 2-3 months in a row.

Acetylsalicylic acid was well tolerated by patients and did not seem to cause any side effects. However, the attention of doctors was attracted by the fact that some patients took a long time.

There is no main and only reason for stomach ulcers! However, modern medicine understands that stomach ulcers are the end result of an imbalance between the digestive fluid in the stomach and duodenum. Most ulcers are associated with an infection caused by a type of bacteria called Helicobacter Pylori (H.).

Aspirin for heartburn

Action and application

The pharmacological group that aspirin belongs to is non-steroidal anti-inflammatory drugs. The main advantage of acetylsalicylic acid is its ability to block the production of prostaglandins (hormones involved in inflammatory processes that cause platelet fusion). It has the following properties:

antipyretic (dilates blood vessels and increases sweat production, which lowers temperature);
anti-inflammatory (reduces the permeability of small vessels at the site of inflammation);
pain reliever;
antiplatelet (thins the blood by affecting platelets).

Due to this versatile action, the medicine is used for the following symptoms:

elevated temperature;
mild to moderate headaches;
prevention of heart disease;
prevention of circulatory disorders, blood clots;
rheumatoid arthritis and rheumatism.

Aspirin should be used for up to 7 days as a pain reliever and for up to 3 days as an antipyretic; for long-term treatment, the medicine is prescribed by a doctor. Doses are also selected individually for each patient. Adult patients take the drug 2-6 times a day with a glass of water or milk. Acid for treatment is prohibited for children under 15 years of age.

Harm to the stomach

ASA negatively affects the functioning of the stomach. If consumed daily, the tablets cause ulcers. To reduce the negative effect on the stomach, the medicine should be crushed into powder and taken after meals. Tablets that dissolve in a glass of water will cause less harm to the body. For diseases gastrointestinal tract aspirin is contraindicated. It is forbidden to combine aspirin with alcohol, as this will lead to gastric bleeding.

Using Aspirin for Heartburn

One of the side effects of the medicine is heartburn. To avoid this side effect, aspirin should be taken only after meals. Take the tablets crushed with 300 ml of liquid. As an alternative, tablets in a special coating or water-soluble tablets are used. They cause less harm to the gastric mucosa. If you suffer from heartburn, consult your doctor before regularly using acetylsalicylic acid.

Stomach and duodenal ulcers: causes, symptoms, diagnosis, treatment

Gastric and duodenal ulcer video

A peptic ulcer is an open wound or moist area that tends to develop in one of two places:

In the lining of the stomach (stomach ulcer);

In the upper part of the small intestine - the duodenum (duodenal ulcer).

Duodenal ulcers are three times more common than gastric ulcers.

Ulcers develop when ulcers appear in the stomach, intestines, and digestive glands. digestive juices, and the mucous membrane of the stomach or duodenum is damaged.

Ulcers can average from 0.62 cm to 1.25 cm in diameter. Helicobacter Pylori bacteria are the main cause of peptic ulcers. Long-term use Nonsteroidal anti-inflammatory drugs (NSAIDs) are the second most common cause.

Peptic ulcer disease affects all age groups, but rarely occurs in children. Men are twice as likely to get ulcers as women. The risk of duodenal disease tends to increase starting at age 25 and continuing until age 75. The risk of its greatest peak is from 55 to 65 years.

Mechanism of ulcer formation

Two important components digestive juices - hydrochloric acid and the enzyme pepsin. Both substances are critical in breaking down and digesting starches, fats and proteins in food. They play different roles in ulcers.

Hydrochloric acid. It is a common misconception that excess hydrochloric acid, which is secreted in the stomach, is solely responsible for the production of ulcers. Patients with duodenal ulcers tend to have higher than normal levels of hydrochloric acid, but most patients with peptic ulcers have normal or lower than normal acid levels. Having stomach acid is actually important for protecting against H. Pylori, the bacterium that causes peptic ulcers in most cases. The exception is ulcers that occur from Zollinger-Ellison syndrome, a rare genetic condition in which a tumor in the pancreas or duodenum secretes very high levels of gastrin, a hormone that stimulates the secretion of hydrochloric acid.

Pepsin. This enzyme breaks down proteins in food. It is also an important factor in the formation of ulcers. Since the stomach and duodenum are composed of proteins, they are sensitive to the action of pepsin. However, the body has a defense system to protect the stomach and intestines against these two potent substances:

A layer of mucus that covers the stomach and duodenum (the first line of defense);

Bicarbonate, which produces a mucus layer that neutralizes digestive acids;

Hormone-like substances prostaglandins that help expand blood vessels in the stomach to ensure good blood flow and to protect against injury. Prostaglandins can also stimulate the action of bicarbonate and mucus.

The destruction of these defense mechanisms makes the mucous membrane of the stomach and intestines susceptible to the action of acid and pepsin, increasing the risk of ulcers.

Causes of stomach and duodenal ulcers

In 1982, two Australian scientists identified Helicobacter Pylori (or H. Pylori) as the main cause of stomach ulcers. They showed that stomach inflammation and the result of stomach ulcers from a stomach infection are caused by H. Pylori bacteria.

The bacteria appear to cause ulcers in this way: the corkscrew shape of Helicobacter Pylori allows them to penetrate the mucous layer of the stomach or duodenum so that they can attach to the lining. The surfaces of the cells lining the stomach contain protein. The protein breakdown accelerating factor acts as a receptor for bacteria.

H. pylori survives in highly acidic environments. H. Pylori stimulates the increase and release of gastrin. Higher gastrin levels promote increased acid secretion. The increase in acid damages the intestinal lining, leading to ulcers in certain individuals. H. Pylori also modifies certain immune factors that allow this bacteria to evade detection by others. immune system and lead to frequent inflammations, even without invading the mucous membrane. Even if ulcers do not develop as is believed, the bacteria Helicobacter pylori is the main cause of active chronic inflammation in the stomach - gastritis, and in the upper part of the small intestine - duodenitis. H. Pylori is also strongly associated with stomach cancer and possibly other extraintestinal problems. H. Pylori bacteria are most likely transmitted directly from person to person. However, little is known about exactly how these bacteria are transmitted.

About 50% of the world's population is infected with H. Pylori. The bacteria are almost always acquired in childhood and persist throughout life if the person is not treated. The prevalence of this bacterium in children is about 0.5% in industrialized countries. However, even there, in regions with critically unsanitary conditions, the conditions for infection are equal to those in developing countries.

It is not yet entirely clear how these bacteria are transmitted. Possible transmission methods include:

Intimate contact, including contact with liquid by mouth;

Diseases of the gastrointestinal tract (especially with vomiting);

Contact with feces (feces);

Contaminated wastewater.

Although Helicobacter pylori are quite common, ulcers in children are very rare - only 5-10% of H. Pylori-infected adults. Several factors may explain why some infected patients get ulcers:

Presence of relatives with peptic ulcer disease;

Infection with a bacterial strain that contains a cytotoxin-related gene.

When the bacteria Helicobacter Pylori was first identified as the main cause of peptic ulcers, it was found in 90% of people with duodenal ulcers and about 80% of people with stomach ulcers. Because everything more people Now tested and treated for the bacteria, the rate of H. Pylori-induced ulcers has decreased. Currently, H. Pylori is found in about 50% of people with peptic ulcers;

Factors that cause ulcers in H. Pylori carriers

Certain factors may increase the risk for ulcers in NSAIDs:

Age 65 or older;

History of peptic ulcer or gastrointestinal bleeding;

Other serious illnesses– such as congestive heart failure;

Use of medications such as: anticoagulant Warfarin (Coumadin), corticosteroids, osteoporosis drug Alendronate (Fosamax), etc.;

Helicobacter pylori infections;

Other risk factors for ulcers from H. Pylori or NSAIDs;

Stress and psychological factors;

Bacterial or viral infections;

Smoking. Smoking increases acid secretion, decreases prostaglandins and bicarbonate, and decreases blood flow. However, research results on the actual effect of smoking on ulcers vary.

Only 10-15% of people infected with Helicobacter Pylori develop peptic ulcers. H. Pylori infections, especially in older people, may not always lead to peptic ulcers. Other factors must also be present to actually cause ulcers:

Genetic factors. Some people have strains of H. Pylori with genes that make the bacteria more dangerous and increase the risk of ulcers;

Immune disorders. Some people have a disorder of the intestinal immune response that allows bacteria to injure the intestinal lining;

Lifestyle factors. Although lifestyle factors such as chronic stress, coffee and smoking have long been considered the main causes of ulcers, they are now thought to only increase susceptibility to ulcers in some H. Pylori carriers - and nothing more;

Stress. Although stress is no longer thought to be a cause of ulcers, some research suggests that stress may predispose a person to ulcers or prevent healing existing ulcers;

Shift work and interrupted sleep. People who work night shifts have a significantly higher incidence of ulcers than day workers. Researchers suspect that frequent sleep interruptions may weaken the immune system's ability to defend against harmful bacteria.

Non-steroidal anti-inflammatory drugs (NSAIDs). Long-term use of NSAIDs such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) is the second most common cause of ulcers. NSAIDs also increase the risk gastrointestinal bleeding. The risk of bleeding continues as long as the patient takes these drugs, and it may continue for about 1 year after the break. Short courses of NSAIDs for temporary pain relief should not cause serious problems because the stomach has time to recover and repair any damage that has occurred.

Patients with ulcers from NSAIDs should stop taking these medications immediately. However, patients who require these medications on a long-term basis can reduce the risk of developing ulcers by taking proton pump inhibitor PPI drugs such as Omeprazole (Prilosec), Famotidine (H2 blocker Pepcid), and others.

15-25% of patients taking NSAIDs regularly will have evidence of one or more ulcers, but in most cases these ulcers are very small. Long-term use of NSAIDs may cause harm, possibly small intestine. Even low doses of aspirin (81 mg) may pose some risk, although the risk is lower than with higher doses. The greatest risk is for people who use very high doses NSAIDs for a long period of time, especially in patients with rheumatoid arthritis.

Medications. Some medications other than NSAIDs can also make ulcers worse. These include: Warfarin (Coumadin) - an anticoagulant that increases the risk of bleeding, oral corticosteroids, some chemotherapy drugs - Spironolactone and Niacin. Bevacizumab, a drug used to treat colorectal cancer, may increase the risk of gastrointestinal perforation (perforation or ulcer perforation is when an ulcer breaks beyond the stomach or duodenum and releases its contents). Although the benefits of Bevacizumab outweigh the risks, gastrointestinal perforations are very serious. If they occur, patients should stop taking the drug.

Ulcers associated with ZES are usually persistent and difficult to treat. Treatment consists of removing the tumor and suppressing the acid with special medicines. In the past, gastric removal was the only treatment option.

Experts don't know what factors actually increase the risk of developing ulcers.

Symptoms of stomach and duodenal ulcers

Dyspepsia. The most common symptoms of peptic ulcer disease are known as common name"dyspepsia". However, peptic ulcers can occur without dyspepsia or any other GI symptoms, especially if they are caused by NSAIDs.

Main symptoms of dyspepsia:

Hunger and feeling of emptiness in the stomach, often 1-3 hours after eating;

Heartburn and belching. The most common symptoms of a peptic ulcer are abdominal pain, heartburn, belching, and possibly a sour throat sensation.

Many patients with these symptoms do not have a peptic ulcer. Most of them have what is called "functional dyspepsia." Older patients are less likely to have these symptoms than younger ones. Lack of symptoms can delay diagnosis, which can put older patients at greater risk of severe complications.

Periodic abdominal pain. Recurrent abdominal pain and other gastrointestinal symptoms are common in children. This becomes the norm for pediatricians when identifying Helicobacter Pylori infection in children with these symptoms. However, researchers were unable to confirm a clear link between regular abdominal pain and Helicobacter pylori infection in children.

Ulcer pain. Pain from ulcers can be localized in one place, or can be throughout abdominal cavity. The pain may be a burning or aching sensation in the upper abdomen, or stabbing pain, penetrating through the intestines.

Symptoms may vary depending on the location of the ulcer:

There is often aching pain in the duodenum several hours after eating, and patients may then be able to relieve the pain by eating. Many people also experience heartburn;

Dull, aching pain in the stomach, often immediately after eating. Eating does not relieve the pain and may even make it worse. The pain can also come at night;

Ulcer pain can be especially confusing when it radiates to the back or chest, behind the breastbone. In such cases, it can be confused with other diseases such as a heart attack;

Because the ulcer can cause hidden bleeding, patients may experience symptoms of anemia, including fatigue and shortness of breath.

Extremely dangerous symptoms. Severe symptoms symptoms that begin suddenly may indicate a blockage in the intestine, perforation, or bleeding, all of which are emergencies. Symptoms may include:

Black or bloody stools;

Severe vomiting, which may include coffee grounds-like substances in the blood (a sign of serious hemorrhage) or the entire contents of the stomach (a sign of intestinal obstruction);

Severe abdominal pain, with or without vomiting, with blood.

An ulcer can lead to emergencies. Severe abdominal pain, sometimes with signs of bleeding, may mean that the ulcer is perforating from the stomach or duodenum. Vomiting substances that resemble coffee grounds or having black, tarry stools may indicate serious gastrointestinal bleeding.

Diagnosis of gastric and duodenal ulcers

An ulcer is always suspected in patients with persistent dyspepsia. Symptoms of dyspepsia occur in 20-25% of people who live in industrialized countries, but only about 15-25% of patients with dyspepsia actually have ulcers. There are several steps you need to take to accurately diagnose ulcers:

Medical and family history. The doctor will ask questions about dyspepsia for a detailed answer from the patient, and will also check:

Other important symptoms– such as weight loss or fatigue;

Current and past use of medications (especially long-term use of NSAIDs);

Family members with ulcers;

Drinking and smoking habits;

Rule out other diseases and disorders. Dyspepsia is caused by many other diseases. Symptoms of stomach ulcers—particularly abdominal and chest pain—can be similar to symptoms of other illnesses, including:

Gastroesophageal reflux disease. About half of patients with GERD also have dyspepsia. For GERD or other esophageal problems, the main symptoms are: heartburn, burning pain up to the throat. It usually develops after eating and goes away with antacids. The patient may have difficulty swallowing and may experience belching or heartburn. Older patients with GERD are less likely to have these symptoms, but may instead have: loss of appetite, weight loss, anemia, vomiting, or dysphagia (difficulty or painful swallowing);

Heart problems. Heart pain, such as from angina or heart attack, most likely comes from exercise and can be transmitted to the neck, jaw, etc. In addition, patients typically have cardiovascular risk factors;

Gallstones. The main symptom is a persistent attack or corrosive pain on the right side under chest. This pain can be severe and may radiate to the upper back. Some patients experience chest pain. Pain often occurs after fatty or heavy meals, but stones in gallbladder almost never cause dyspepsia;

Irritable bowel syndrome - can cause upset stomach, abdominal pain, nausea, vomiting, bloating. It occurs more often in women than in men;

Side effects of medications. Dyspepsia can also occur from gastritis, stomach cancer, or as a side effect of certain medications, including NSAIDs, antibiotics, iron, corticosteroids (Theophylline), and calcium blockers;

Noninvasive GI tests to detect bleeding. If a peptic ulcer is suspected, the doctor will order tests to detect bleeding. These may include: rectal examination, clinical blood and stool tests for occult blood. These are tests for hidden (occult) blood in the stool;

Tests for determining Helicobacter Pylori. Blood and stool tests can detect Helicobacter Pylori with sufficient high degree accuracy. Experts recommend testing all patients with peptic ulcers for H. Pylori because it is a common cause of the condition. Testing can be done after treatment to ensure that bacteria are completely eliminated.

Smokers and those who experience regular and persistent fasting pain may also be good candidates for screening tests.

The following tests are used to diagnose Helicobacter pylori infection:

Breath test. This is a simple, carbon isotope-urease breath test (MDT) that can identify up to 99% of people who have H. Pylori;

Blood tests - to measure antibodies to Helicobacter pylori - results are available in minutes. Diagnostic accuracy%. One of the important ones here is the solid-phase test enzyme immunoassay, as well as urine ELISA test;

Stool tests - to determine the genetic trace of H. Pylori in feces;

Biopsy or esophagogastroscopy. The most accurate way to determine the presence of Helicobacter Pylori is a tissue biopsy of the gastric mucosa using endoscopy;

Endoscopy. Endoscopy (esophagogastroduodenoscopy, or EGD) is a procedure to evaluate the esophagus, stomach, and duodenum using an endoscope, a long, thin tube equipped with a tiny video camera. When combined with biopsy, endoscopy is the most accurate procedure for detecting the presence of peptic ulcers, bleeding and gastric cancer, and for confirming Helicobacter pylori. Endoscopies are typically reserved primarily for patients with dyspepsia who also have risk factors for stomach ulcers, cancer, or both.

Patients over 50 years of age who have new symptoms of dyspepsia;

Patients of any age who have symptoms of “anxiety” (unexplained weight loss, gastrointestinal bleeding, vomiting, difficulty swallowing, anemia);

X-ray examination using contrast. This method has been standard in the diagnosis of peptic ulcers prior to endoscopy and tests for the detection of Helicobacter Pylori. The patient drinks a solution containing barium. X-rays are then used to treat areas that may show inflammation, active ulcers or deformities, or scarring from previous ulcers. Endoscopy is more precise method diagnostics than x-rays.

Treatment of stomach and duodenal ulcers

Deciding which treatment is most effective for patients with symptoms of nonulcer dyspepsia or peptic ulcer disease depends on a number of factors.

Treatment of gastric and duodenal ulcers in patients who do not take non-steroidal anti-inflammatory drugs (NSAIDs)

If endoscopy is performed soon after the symptomatic patient's first visits to the doctor, treatment is based on the endoscopy findings:

If an ulcer is visible and the patient is infected with Helicobacter Pylori, treatment for the infection is initiated followed by the addition of 4-8 weeks of proton pump inhibitor (PPI) treatment. Most patients improve with this treatment;

If the ulcer is present and H. Pylori is not, patients are usually treated with a PPI for 8 weeks;

If the bowel does not prolapse and the patient is not infected with H. Pylori, the first attempts at treatment are usually with a PPI. These patients do not require antibiotics to treat Helicobacter pylori. But other possible causes of their symptoms should also be considered.

Most patients who do not have risk factors for complications are treated without prior endoscopy. The type of treatment is determined based on the patient's symptoms, H. Pylori blood results, or breath tests.

Patients who are not infected with H. Pylori are tested for functional (non-ulcer) dyspepsia. These patients are most often given acid-reducing medications for 4-8 weeks. If this dose is not effective, it is doubled, which sometimes relieves symptoms. If there is still no relief of symptoms, patients may undergo endoscopy. In this group of patients, symptoms may not improve. However, it is unlikely that an ulcer is present.

Patients with positive reaction for Helicobacter pylori infection will receive antibiotics to treat Helicobacter Pylori. Those with ulcers are more likely to respond to antibiotic treatment. When endoscopy is not done before treatment, patients without ulcers are treated with antibiotics. Even if patients positive result test for H. Pylori, it is unlikely that those who do not have an actual ulcer will have a complete response to antibiotics.

Antibiotics and combined treatment regimens for gastric and duodenal ulcers to eliminate H. Pylori.

The standard treatment regimen uses a combination of two antibiotics and drugs that reduce the acidity of gastric juice.

Drugs that reduce the acidity of the gastrointestinal tract, as well as increase the ability of antibiotics to destroy H. Pylori:

Metronidazole can be used instead of Amoxicillin in patients who are allergic to penicillin.

Bismuth may be recommended along with antibiotics. If subsequent testing determines that the bacteria have not been eliminated, this should be done no sooner than 4 weeks after completion of therapy. Test results before this time may not be accurate.

In most cases, drug treatment relieves ulcer symptoms. However, symptom relief is not always a sign successful treatment as persistent dyspepsia does not necessarily mean that treatment has failed. Heartburn and others GERD symptoms may worsen and require acid-suppressing medications.

Treatment fails in approximately 10-20% of patients, usually when they do not follow their doctor's orders.

Compliance with antibiotic standards may be poor. About 30% of patients experience side effects from antibiotics. Gastrointestinal problems are very common and severe diarrhea can occur.

Treatment may also fail if patients have strains of H. Pylori that are resistant to antibiotics. When this happens, various drugs are tried.

Recurrent infections after successful treatment. Studies in developed countries show that once the bacteria are eliminated, recurrence rates are below 1% per year. Re-infection bacteria is possible, however in areas where the incidence of H. Pylori is very high, and sanitary conditions poor. In such regions, the rates of re-infection are %.

Treatment of NSAID-induced ulcers

If patients are diagnosed with ulcers or bleeding caused by NSAIDs, they should:

Get tested for Helicobacter Pylori and, if infected, take antibiotics;

Use drugs that reduce acidity. Research shows that these drugs reduce the risk of NSAID-induced ulcers, although they do not completely prevent them.

Medicines used for stomach and duodenal ulcers caused by NSAIDs or Helicobacter Pylori.

A number of drugs are used to treat ulcers caused by NSAIDs:

Proton pump inhibitors (PPIs). Medicines intended for the treatment of acid-related gastrointestinal diseases by reducing the production of hydrochloric acid. These are drugs for the treatment of patients with peptic ulcers, regardless of the cause. They suppress the production of stomach acid by blocking the gastric acid pump, a molecule in the gland that is responsible for the secretion of acid in the stomach.

PPIs can be used either as part of a drug regimen for H. Pylori or only for the prevention and healing of NSAID-induced ulcers. They are also useful for treating ulcers caused by Zollinger-Ellison syndrome. They are believed to be more effective than H2 blockers. Some people carry a gene that makes PPIs less effective. This gene is present in 18-20% of people who are of Asian descent.

Drugs approved for the prevention and treatment of ulcers:

In theory, long-term use of PPIs in people with Helicobacter pylori may reduce acid secretion enough to cause atrophic gastritis (chronic inflammation of the stomach), which is a risk factor for stomach cancer. Long-term use of PPIs may also mask symptoms of stomach cancer and confuse the diagnosis. However, there have been no reports of an increase in the incidence of stomach cancer with long-term use of these drugs.

H2 blockers. H2 blockers block the production of histamine, a substance produced by the body that encourages acid secretion in the stomach. H2 blockers were standard method treatment of peptic ulcers until PPIs and antibiotics against Helicobacter Pylori were developed. H2 blockers cannot cure ulcers, but they are helpful in some cases. They are effective only for the duodenum. Four H2 blockers are currently the most commonly prescribed.

All four drugs are good means with few side effects:

Famotidine is the most powerful H2 blocker. Its most common side effect is headache, which occurs in 4.7% of people taking it. Famotidine is virtually free of drug interactions, but may have significant Negative consequences in patients with kidney disease.

Cimetidine (Tagamet). Has few side effects. However, about 1% of people taking it experience mild, temporary diarrhea, dizziness, rash, or headache. Interacts with a number of commonly used drugs. Long-term use of excessive doses (more than 3 g per day) may lead to erectile dysfunction or breast enlargement in men.

Ranitidine (Zantac) - interacts with very few medications. May cause more pain and heal ulcers faster than cimetidine among people under 60 years of age, but may not be so in older patients. A common side effect of Ranitidine is headache, which occurs in about 3% of people taking it.

Nizatidine has virtually no side effects or drug interactions.

Misoprostol - increases the level of prostaglandins in the gastric mucosa, which protects against the main gastrointestinal side effects of NSAIDs. Misoprostol can reduce the risk of NSAID-induced ulcers in the upper small intestine by two-thirds and in the stomach by three-quarters. It does not neutralize or reduce acid, so while the drug is useful for preventing NSAID-induced ulcers, it is not useful for treating existing ulcers. Misoprostol may cause miscarriage or birth defects, so pregnant women should not take it.

Sucralfate works by attaching itself to the ulcer and protecting the stomach from further acid damage. It also promotes protective processes in the stomach. Sucralfate has the same ulcer healing rate as H2 blockers. Apart from constipation, which occurs in 2.2% of patients, the drug has few side effects. Sucralfate interacts with a wide range of drugs, including Warfarin, Phenytoin and Tetracycline.

Antacids. Antacids are the first medications recommended to relieve heartburn and mild dyspepsia. They are not effective in preventing or healing ulcers, but may help in the following ways:

Neutralize stomach acid with various combinations of three main compounds - magnesium, calcium and aluminum;

May protect the stomach by increasing sodium bicarbonate and mucus secretion.

Research suggests that liquid antacids work faster and more effectively than tablets, although some studies suggest that both forms work equally well.

There are three main salts used in antacids:

Magnesium compounds are available as magnesium carbonate, magnesium trisilicate and, most commonly, magnesium hydroxide (Magnesia). The main side effect of these magnesium compounds is diarrhea;

Calcium carbonate (Titralac and Alka-2) are powerful and fast-acting antacids, but can cause constipation. There have been rare cases of hypercalcemia ( higher level calcium in the blood) in people taking calcium carbonate for a long period. Hypercalcemia can lead to renal failure;

Aluminum. The most common side effect of antacids containing aluminum compounds (Amphogel, Alternagel) is constipation. Maalox and Mylanta are combinations of aluminum and magnesium that balance side effects, diarrhea and constipation. People who take large amounts of antacids containing aluminum may be at risk of calcium loss and osteoporosis. Long-term use also increases the risk of kidney stones. People who have recently experienced gastrointestinal bleeding should not use aluminum compounds.

Antibiotics. H. Pylori can be treated with the following antibiotics:

Amoxicillin is a form of penicillin. Very effective remedy against Helicobacter Pylori and is inexpensive. But some people are allergic to it;

Clarithromycin (Biaxin) is part of the macrolide class of antibiotics. It is the most expensive antibiotic used against H. Pylori. A very effective remedy. However, there is growing bacterial resistance (the body's resistance to the action of factors) to this drug. Resistance tends to be higher in women and increases with age. Researchers fear that resistance will increase more and more as long as people use the drug;

Tetracycline - effective medicine, but it has unique side effects, including discoloration of children's teeth. Pregnant women should not take tetracycline;

Ciprofloxacin (Cipro) or Levofloxacin (Levaquin), fluoroquinolones—also sometimes used in H. Pylori regimens;

Metronidazole (Flagyl) was the basis of the initial combinations for Helicobacter pylori. However, bacterial resistance to this drug is also still increasing;

Bismuth. Compounds that contain Bismuth destroy the cells of H. Pylori bacteria. High doses of Bismuth can cause vomiting and depression, damage to the central nervous system, but for patients with ulcers they rarely cause side effects;

Surgical treatment of gastric and duodenal ulcers

When a patient comes to the hospital with bleeding ulcers, an endoscopy is usually performed. This procedure is critical for diagnosing, determining treatment options, and treating bleeding ulcers.

For high-risk patients or those with signs of bleeding, options include: watchful waiting with medical treatment or surgical intervention. The first important steps for massive bleeding are to stabilize the patient and support vital signs with gastric fluid replacement and possibly a blood transfusion.

Bleeding stops spontaneously in 70-80% of patients, but surgery will be required in approximately 30% of patients who come to the hospital with bleeding ulcers.

Endoscopy is a surgical procedure that is more commonly used, usually in combination with medications such as epinephrine and intravenous PPIs to treat ulcers and bleeding in patients at high risk of rebleeding. 10-20% of patients require major abdominal surgery for bleeding.

In cases high risk, the doctor may inject Epinephrine directly into the ulcer to enhance the effect of the heating process. Adrenaline activates the process leading to blood clotting, narrows the arteries and increases blood clotting. Intravenous administration of Omeprazole or Pantoprazole significantly prevents rebleeding. Endoscopy is effective for most people for bleeding. If rebleeding occurs, repeat endoscopy is effective in approximately 75% of patients. The rest will require major abdominal surgery. The most serious complication of endoscopy is perforation of the stomach and intestines.

Some medications may be needed after an endoscopy. Patients who have Helicobacter Pylori bacteria need triple therapy, which includes antibiotics and PPIs, to eliminate them immediately after endoscopy. Somatostatin is a hormone that is used to prevent bleeding in cirrhosis of the liver. Researchers are also studying other treatments such as Fibrin (blood clotting factor), etc.

Extensive abdominal surgery. Extensive surgical intervention in bleeding ulcers is now necessarily preceded by endoscopy. Some emergencies may require surgery—for example, when an ulcer punctures the walls of the stomach or intestines, causing sudden severe pain and life-threatening infections.

Standard open surgeries use a wide incision abdominal wall standard surgical instruments. Laparoscopic techniques make small incisions in the abdominal cavity through which miniature cameras and instruments are inserted. Laparoscopic techniques are increasingly being used for perforated ulcers and are considered to be comparable in safety to open surgery. Laparoscopic surgery also results in less pain after the procedure.

There are several surgical procedures designed to provide long-term relief from ulcer complications. This:

Resection of the stomach (gastrectomy). This procedure is indicated for peptic ulcer disease in very rare cases. The affected area of the stomach is removed. The small intestine is attached to the rest of the stomach, and gastrointestinal function is preserved;

Vagotomy - nervus vagus cut to interrupt messages from the brain that stimulate acid secretion in the stomach. This surgery may cause problems with gastric emptying. A recent change in which only parts of the nerve are cut may reduce this difficulty;

An antrectomy, in which the lower part of the abdomen is removed. This part of the stomach produces a hormone responsible for stimulating digestive juices;

Pyloroplasty. During this operation, the doctor enlarges the opening leading to the duodenum and small intestine, allowing the contents of the stomach to pass more freely. Antretomy and pyloroplasty are often performed with vagotomy.

How to replace aspirin for stomach ulcers

For chronic pain patients, a number of other anti-inflammatory medications may be tried to minimize the risk associated with ulcers:

COX-2 inhibitors (coxibs) - they block inflammation as a result of the action of the COX-2 enzyme. With this drug, NSAIDs cause less gastrointestinal distress.

However, after numerous reports of cardiovascular events with COX-2 inhibitors, only celecoxib (Celebrex) is still available, but it must be used with great caution (regular NSAID use also increases the risk of cardiovascular disease);

Arthrotec is a combination of Misoprostol and the NSAID Diclofenac. May reduce the risk of gastrointestinal bleeding. However, there is a side effect: the drug can cause miscarriage at any stage of pregnancy, and therefore it should not be used during pregnancy;

Acetaminophen (Tylenol, Anasin-3) is the most common NSAID alternative. Inexpensive and generally safe. With Acetaminophen there is much less risk of gastrointestinal NSAIDs. However, patients who take it in high doses for long periods are at risk of liver damage, especially if they drink alcohol excessively. Paracetamol may also pose a small risk serious complications in the kidneys of people who already have kidney disease. Until recently, the recommended maximum daily dose of Paracetamol was 4 grams (4000 mg), but a reduction in this dose is now recommended;

Tramadol is a pain reliever that was previously used as an alternative to opioids. It has opioid-like properties but is not addictive. The combination of Tramadol and Acetaminophen (Ultraset) provides faster pain relief than Tramadol alone and provides more long-term relief than Acetaminophen alone. Side effects of Tramadol include nausea and itching, but the drug does not cause the same severe gastrointestinal problems as NSAIDs.

Nutrition for stomach ulcers

Research since then has shown that a bland diet is not effective in reducing the prevalence or recurrence of ulcers, and that eating numerous small meals throughout the day is no more effective than eating three times a day. However, large amounts of food should still be avoided, as distension of the stomach can lead to painful symptoms ulcers.

Fruits and vegetables. A diet that is rich in fiber can cut your risk of developing ulcers in half and speed up the healing of existing ulcers. Fiber is found in vegetables and fruits. Useful Vitamin And it is found in many of these products.

Milk. Milk encourages acid production in the stomach, although moderate amounts (2-3 cups per day) do not seem to cause any harm. Some probiotics, which are "good" bacteria, are added to yogurt and other fermented milk drinks. Their consumption may protect the gastrointestinal tract.

Coffee and carbonated drinks. Coffee (both decaffeinated and decaffeinated), soft drinks, fruit juices with citric acid- increase acid production in the stomach. Although no studies have proven that any of these drinks contribute to ulcers, people who consume more than 3 cups of coffee per day may increase their susceptibility to Helicobacter Pylori infection.

Spices and pepper. Studies conducted on spices, including pepper, have yielded conflicting results. The general rule is to use these substances in moderation, and avoid them if they irritate the stomach.

Garlic. Some studies suggest that large amounts of garlic may exhibit some protective properties against stomach cancer, although one study found that garlic offered no benefits against H. Pylori, and in large quantities can cause significant GI distress.

Olive oil. Research conducted in Spain has shown that phenolic compounds found in olive oil may be effective against eight strains of H. Pylori, three of which are antibiotic resistant.

Vitamins. Although vitamins have not been shown to protect against ulcers, H. pylori may impair the absorption of vitamin C, which may confer a higher risk of stomach cancer.

Modern research has shown that acetylsalicylic acid, when taken orally, can cause a disease such as aspirin-induced gastric ulcer. As a result, the popular, inexpensive, over-the-counter drug should not be used without the supervision and prescription of a physician. This is especially true for patients who already have a history of diseases of the gastrointestinal tract, the elderly and children.

ASA as a factor in the occurrence of peptic ulcer

Composition and action

The main ingredient in Aspirin tablets is active substance ASA supplemented with starch filler. The medicine is often used in the treatment of ARVI as an antipyretic and analgesic. The second area of application is the therapy and prevention of vascular pathologies and thrombosis by thinning the blood. The drug is available in every home medicine cabinet as a first-line remedy for fever during viral and bacterial infections.

ASA was synthesized in 1853 from willow bark and has been a Bayer trademark since 1899.

Indications and contraindications

The drug requires consultation with a doctor.

Doctors and patients had long suspected the ability of acetylsalicylic acid to cause peptic ulcers and erosive gastritis, but only in last years it was confirmed clinical studies, although it was not fully explained. The toxic, chemical, allergic and corrosive effect of Aspirin on the mucous membranes of the stomach and intestines, causing fragmented necrosis, has been noted. Indications for use against this background are problematic, but in exceptional cases allowed in small doses. Factors that aggravate the danger are the sale of the drug without a prescription and the lack of awareness of the population about the possible harmful effects. After all, ASA is used for pain of various etiologies, when there is a headache, for example, without prior consultation with a doctor.

Can I take it if I have stomach problems?

Aspirin ulcer symptoms do not differ from other types of this disease. If pain in the gastrointestinal tract intensifies when using ASA, you should stop taking it immediately and consult a doctor for advice. Continued use will worsen the condition and can sometimes cause internal bleeding, symptoms of which include bloody vomiting, black feces, and anemia. A dosage form with an insoluble coating is available to protect the organ mucosa. Tablets taken on an empty stomach, which should not be done, provoke pathology and sometimes lead to perforation of the ulcer.

Defects in the lining of the stomach do not occur in all patients while taking aspirin. At risk:

patients already diagnosed with gastrointestinal diseases;
aged people;
patients weakened after illness with reduced immunity and in the rehabilitation stage after surgery;
persons predisposed to allergies;
children under 3 years of age;
pregnant and lactating women.

Mechanism of ulcer occurrence

A stomach ulcer caused by taking Aspirin is no different in symptoms from a disease provoked by other factors. It is characterized by:

pain in the epigastric region, especially at night;
abnormal stool, often with signs of hemorrhage;
hiccups, nausea and vomiting after eating.

If these pathological signs appear while taking Aspirin, treatment should be stopped immediately and consult a gastroenterologist for advice.

After introducing ASA or other salicylates into the patient’s body (orally and intravenously), during FGDS, transformations in the gastric mucosa can be seen. Around the particles of acetylsalicylic acid on the gastric mucosa, swelling, redness, tissue necrosis and hemorrhages into the underlying layers are observed, which indicates the allergic nature of the pathological changes.

Through clinical trials, the ability of aspirin particles to cause inflammatory changes around them has been established. The gastric mucous layer coagulates, partially losing its protective ability.

Even short-term or one-time use of a large dose of ASA causes an aspirin ulcer of the gastrointestinal tract or. Often this is a consequence of medical illiteracy of the population, when a person believes that by taking a large amount of medicine, he can independently stop a cold without contacting a therapist.

In this case, uncrushed tablets remain in the stomach cavity for a long time without dissolving. The acid corrodes the delicate mucous membrane, damaging the walls of nearby vessels. As a result, hidden bleeding may occur. The situation is complicated by the fact that this process can exist for a long period without symptoms. The patient does not feel pain, heartburn or nausea.

Then obvious symptoms of internal bleeding suddenly appear:

vomiting streaked with blood or “coffee grounds”;
weakness;
black tarry stools;
signs of anemia.

Patients with such symptoms require hospitalization in a hospital. Sometimes there is a need for surgical treatment.

The harmful effects of aspirin on the gastric lining increase with the simultaneous use of other drugs, especially Prednisolone and Butadione. Inflammation and ulceration of the mucous membrane of the digestive organ disappear after discontinuation of treatment with salicylates and antiulcer pharmacological therapy.

What can replace aspirin?

Aspirin treatment, and especially long-term treatment, can lead to dangerous complications, such as an ulcer with perforation and bleeding.

Aspirin is also an inexpensive and popular antipyretic and analgesic that is used for all colds accompanied by hyperthermia and headache. However, instead of this dangerous drug, it is wiser to use analgesics of different pharmacological groups that do not have a pronounced ulcerogenic effect, for example:

Metamizole,
Piroxicam,
Sumatriptan,
Indomethacin,
Ketorolac,
Ibuprofen,
Celecoxib,
Diclofenac.

All over the world, for acute respiratory viral infections or other colds, paracetamol (aka children's Panadol) is used instead of ASA. In pediatric practice, it is a drug that is used primarily.

The most popular antiplatelet drugs are:

Cardiomagnyl,
Lospirin,
Aspecard,
Aspirin-cardio.

Therapy for aspirin ulcers

Salicylic and aspirin ulcers of the mucous membrane of the digestive organ have scanty symptoms, but their complications are always sudden and sometimes very severe. Most often, defects are localized in the antrum of the stomach, closer to the pylorus. Manifestations of damage by salicylates can be very different, from erosive gastritis to true ulcers.

To reduce the irritating effects of ASA, doctors recommend drinking it with plenty of milk. It is contraindicated to take the medicine on an empty stomach or with alcohol.

A peptic ulcer is an open wound or moist area that tends to develop in one of two places:

In the lining of the stomach (stomach ulcer);
- in the upper part of the small intestine - the duodenum (duodenal ulcer).

Duodenal ulcers are three times more common than gastric ulcers.

Ulcers develop when digestive juices appear in the stomach, intestines, and digestive glands and the lining of the stomach or duodenum is damaged.

Ulcers can average from 0.62 cm to 1.25 cm in diameter. Helicobacter Pylori bacteria are the main cause of peptic ulcers. Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) is the second most common cause.

Mechanism of ulcer formation

Two important components of digestive juices are hydrochloric acid and the enzyme pepsin. Both substances are critical in breaking down and digesting starches, fats and proteins in food. They play different roles in ulcers.

- Hydrochloric acid. It is a common misconception that excess hydrochloric acid, which is secreted in the stomach, is solely responsible for the production of ulcers. Patients with duodenal ulcers tend to have higher than normal levels of hydrochloric acid, but most patients with peptic ulcers have normal or lower than normal acid levels. Having stomach acid is actually important for protecting against H. Pylori, the bacterium that causes peptic ulcers in most cases. The exception is ulcers that occur from Zollinger-Ellison syndrome, a rare genetic condition in which a tumor in the pancreas or duodenum secretes very high levels of gastrin, a hormone that stimulates the secretion of hydrochloric acid.

- Pepsin. This enzyme breaks down proteins in food. It is also an important factor in the formation of ulcers. Since the stomach and duodenum are composed of proteins, they are sensitive to the action of pepsin. However, the body has a defense system to protect the stomach and intestines against these two potent substances:

A layer of mucus that covers the stomach and duodenum (the first line of defense);
- bicarbonate, which secretes a layer of mucus that neutralizes digestive acids;
- hormone-like substances prostaglandins that help dilate the blood vessels in the stomach to ensure good blood flow and protect against injury. Prostaglandins can also stimulate the action of bicarbonate and mucus.

The destruction of these protective mechanisms makes the mucous membrane of the stomach and intestines susceptible to the effects of acid and pepsin, increasing the risk of ulcers.

> Reasons ulcers of the stomach and duodenum

H. pylori survives in highly acidic environments. H. Pylori stimulates the increase and release of gastrin. Higher gastrin levels promote increased acid secretion. The increase in acid damages the intestinal lining, leading to ulcers in certain individuals. H. Pylori also modifies certain immune factors that allow these bacteria to evade detection by the immune system and lead to frequent inflammation, even without invading the mucosa. Even if ulcers do not develop as is believed, the bacteria Helicobacter pylori is the main cause of active chronic inflammation in the stomach - gastritis, and in the upper part of the small intestine - duodenitis. H. Pylori is also strongly associated with stomach cancer and possibly other extraintestinal problems. H. Pylori bacteria are most likely transmitted directly from person to person. However, little is known about exactly how these bacteria are transmitted.

It is not yet entirely clear how these bacteria are transmitted. Possible transmission methods include:

Intimate contact, including contact with liquid by mouth;
- diseases of the gastrointestinal tract (especially with vomiting);
- contact with feces (feces);
- contaminated wastewater.

Although Helicobacter pylori are quite common, ulcers in children are very rare - only 5-10% of H. Pylori-infected adults. Several factors may explain why some infected patients get ulcers:

Smoking;
- drinking alcohol;
- presence of relatives with peptic ulcer disease;
- male gender;
- infection with a bacterial strain that contains a cytotoxin-related gene.

When the bacteria Helicobacter Pylori was first identified as the main cause of peptic ulcers, it was found in 90% of people with duodenal ulcers and about 80% of people with stomach ulcers. As more people are now tested and treated for the bacteria, the rate of H. Pylori-induced ulcers has decreased. Currently, H. Pylori is found in about 50% of people with peptic ulcers;

Factors that cause ulcers in H. Pylori carriers

Certain factors may increase the risk for ulcers in NSAIDs:

Age 65 or older;
- history of peptic ulcer or gastrointestinal bleeding;
- other serious illnesses such as congestive heart failure;
- use of medications such as: anticoagulant Warfarin (Coumadin), corticosteroids, osteoporosis drug Alendronate (Fosamax), etc.;
- alcohol abuse;
- Helicobacter Pylori infection;
- other risk factors for ulcers from H. Pylori or NSAIDs;
- stress and psychological factors;
- bacterial or viral infections;
- bodily injury;
- radiation therapy;
- smoking. Smoking increases acid secretion, decreases prostaglandins and bicarbonate, and decreases blood flow. However, research results on the actual effect of smoking on ulcers vary.

- genetic factors. Some people have strains of H. Pylori with genes that make the bacteria more dangerous and increase the risk of ulcers;

- immune disorders. Some people have a disorder of the intestinal immune response that allows bacteria to injure the intestinal lining;

- lifestyle factors. Although lifestyle factors such as chronic stress, coffee and smoking have long been considered the main causes of ulcers, they are now thought to only increase susceptibility to ulcers in some H. Pylori carriers - and nothing more;

- stress. Although stress is no longer thought to be a cause of ulcers, some research suggests that stress may predispose a person to ulcers or prevent existing ulcers from healing;

- shift work and interrupted sleep. People who work night shifts have a significantly higher incidence of ulcers than day workers. Researchers suspect that frequent sleep interruptions may weaken the immune system's ability to defend against harmful bacteria.

- non-steroidal anti-inflammatory drugs (NSAIDs). Long-term use of NSAIDs such as aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) is the second most common cause of ulcers. NSAIDs also increase the risk of gastrointestinal bleeding. The risk of bleeding continues as long as the patient takes these drugs, and it may continue for about 1 year after the break. Short courses of NSAIDs for temporary pain relief should not cause serious problems because the stomach has time to recover and repair any damage that has occurred.

15-25% of patients taking NSAIDs regularly will have evidence of one or more ulcers, but in most cases these ulcers are very small. Long-term use of NSAIDs can possibly damage the small intestine. Even low doses of aspirin (81 mg) may pose some risk, although the risk is lower than with higher doses. The risk is greatest in people who use very high doses of NSAIDs for long periods of time, especially those with rheumatoid arthritis.

- Medications. Some medications other than NSAIDs can also make ulcers worse. These include: Warfarin (Coumadin) - an anticoagulant that increases the risk of bleeding, oral corticosteroids, some chemotherapy drugs - Spironolactone and Niacin. Bevacizumab, a drug used to treat colorectal cancer, may increase the risk of gastrointestinal perforation (perforation or ulcer perforation is when an ulcer breaks beyond the stomach or duodenum and releases its contents). Although the benefits of Bevacizumab outweigh the risks, gastrointestinal perforations are very serious. If they occur, patients should stop taking the drug.

Zollinger-Ellison syndrome (ZES).. Another cause of peptic ulcers, although much less common than H. Pylori or NSAIDs, is Zollinger-Ellison syndrome. A large number of acid is produced in response to overproduction of the hormone gastrin, which in turn causes tumors of the pancreas or duodenum. These tumors are usually cancerous and must be removed. Acid production must also be suppressed to prevent new ulcers.

ZES should be suspected in patients with ulcers who are not infected with H. Pylori and who have no history of NSAID use. Diarrhea may occur before ulcer symptoms. Ulcers occurring in the second, third or fourth parts of the duodenum or in the jejunum (the middle part of the small intestine) are signs of ZES. Gastroesophageal reflux disease (GERD) is more common and often more severe in patients with ZES. Complications of GERD include ulcers and narrowings (strictures) of the esophagus.
Ulcers associated with ZES are usually persistent and difficult to treat. Treatment involves removing the tumor and suppressing the acid with special medications. In the past, gastric removal was the only treatment option.
Experts don't know what factors actually increase the risk of developing ulcers.

Symptoms stomach and duodenal ulcersAnd

- Dyspepsia. The most common symptoms of peptic ulcer disease are collectively known as dyspepsia. However, peptic ulcers can occur without dyspepsia or any other GI symptoms, especially if they are caused by NSAIDs.

Main symptoms of dyspepsia:

Complications stomach ulcers

Most people with severe ulcers experience significant pain and insomnia, which can have a dramatic and negative impact on their quality of life. In addition, treating ulcers is extremely expensive.

- Bleeding and hemorrhage. Ulcers caused by H. Pylori or NSAIDs can be very serious if they cause bleeding or perforation of the stomach or duodenum. Up to 15% of people with ulcers have some bleeding, which can be life-threatening. There are ulcers in which small intestine attaches to the abdomen and, as a result of narrowing or closing of the intestinal opening, can swell and produce scars. In such cases, the patient vomits the entire contents of the stomach, and urgent emergency treatment is prescribed.

Because ulcers often do not open from the gastrointestinal symptoms of NSAIDs until bleeding begins, doctors cannot predict which patients taking these drugs will develop bleeding. The risk of an adverse outcome is highest in people who have had long-term bleeding from NSAIDs, bleeding disorders, low systolic blood pressure, mental instability, or other serious and adverse health conditions. By group increased risk Among the entire population are older people and those who have other serious illnesses, such as heart problems.

- Stomach cancer. Stomach cancer is the second leading cause of cancer death worldwide. In developing countries, where levels of Helicobacter Pylori are very high, the risk of developing stomach cancer is now six times higher than in developed countries. H. Pylori can be carcinogenic (producing cancer in the stomach), like cigarette smoke in the lungs. Infection with Helicobacter pylori promotes a precancerous condition called atrophic gastritis. This process most likely begins in childhood.

When Helicobacter pylori infection begins in adulthood, it poses a lower risk of cancer because atrophic gastritis may develop. Other factors, such as specific strains of Helicobacter Pylori and diet, may also influence the risk of developing stomach cancer. For example, a diet high in salt and low content fresh fruits and vegetables - is associated with great risk. Some evidence suggests that a strain of H. pylori that carries the cytotoxin gene may be a specific risk factor for the development of precancerous lesions.

Although there is conflicting evidence, some studies suggest that early elimination of H. Pylori may reduce the risk of developing stomach cancer in the general population. It is important to monitor patients over a long period of time after treatment. People with duodenal ulcers caused by Helicobacter pylori appear to have a lower risk of developing stomach cancer, although scientists don't know why. It is possible that the duodenum and stomach are affected by different strains of H. Pylori. And perhaps the high levels of acid found in the duodenum may help prevent bacteria from spreading to important areas of the stomach.

- Other diseases. H. pylori is also weakly associated with other extraintestinal disorders, including migraine, Raynaud's disease, and skin conditions such as chronic urticaria. Men with stomach ulcers may face a higher risk of developing pancreatic cancer, although duodenal cancer does not appear to pose the same risk.

Endoscopy from Fujifilm on the website fujitora.com

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Mechanism of ulcer occurrence

What can replace aspirin?

Therapy for aspirin ulcers

Aspirin and peptic ulcers

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Aspirin and peptic ulcers

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Stomach and duodenal ulcers: causes, symptoms, diagnosis, treatment

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Symptoms of stomach and duodenal ulcers

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Antibiotics and combined treatment regimens for gastric and duodenal ulcers to eliminate H. Pylori.

Treatment of NSAID-induced ulcers

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How to replace aspirin for stomach ulcers

Nutrition for stomach ulcers

ASA as a factor in the occurrence of peptic ulcer

Composition and action

Indications and contraindications

Can I take it if I have stomach problems?

Mechanism of ulcer occurrence

What can replace aspirin?

Therapy for aspirin ulcers

Mechanism of ulcer formation

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Factors that cause ulcers in H. Pylori carriers

Symptoms stomach and duodenal ulcersAnd

Complications stomach ulcers

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