PEPTIC ULCERS
The Duke of Edinburgh once said that the trouble with British industry was that there were too many one ulcer men in two ulcer jobs. He was wrong. The reverse is true. The higher the socioeconomic status the less the incidence of all sorts of disease. In health as elsewhere success breeds success.
Peptic ulcers may be either gastric or duodenal in origin. Experts seem to think that the causes of each may be different; although no consensus exists as to what those causes may be. Whatever their origins, peptic ulcers affect one in five of the population at some stage of their lives and there is a cumulative mortality of ten per cent which remains unchanged in spite of advances in treatment.
The cat was thrown amongst the peptic ulcer pigeons in 1990, when a group of Perth researchers discovered that most cases of peptic ulceration occurred in conjunction with gastric or duodenal infections of a bacterium called Helicobacter Pyloridi. Even more noteworthy was the fact that eradication of the Helicobacter contributed to the healing of peptic ulceration. In the case of duodenal ulcers, antibiotic treatment results in a 50 per cent cure rate. This outcome is better than that produced by any treatment modality ever used before.
Other factors known to influence the appearance of peptic ulceration are nicotine and Non Steroidal Anti-inflammatory Drugs used in the treatment of arthritis. Alcohol and diet are not now considered to be risk factors for the development of peptic ulcer disease.
Peptic ulcers frequently cause burning pain in the stomach. It occurs a few hours after meals and often on an empty stomach. Sometimes the pain wakes people up in the middle of the night.
Diagnosis of peptic ulceration hinges on the results of gastroscopy or a barium meal. Optimal treatment is presently undergoing a process of expert review. Surgery is largely obsolete unless severe bleeding or perforation cannot be stopped by medical means alone. The use of H2 receptor blocking drugs like Zantac and Tagamet must also be called into question. The discovery of Helicobacter Pyloridi and the success of antibiotic therapy places this billion dollar group of chemicals high up on the list of endangered species.
Home Remedies
Ulcer diets are a thing of the past. Avoid active and passive smoking. Don't take NSAIDS for arthritis. When the epidemiology of Helicobacter is elucidated it may be possible to give advice relating to the prevention of re-infection. Prescription of antibiotics for members of the family or the close contacts of people with peptic ulcer may be come necessary. One day the invention of an anti Helicobacter vaccine may make the medicinal contribution to the treatment of peptic ulcer disease as limited as the current surgical interventions.
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GENERAL HEALTH
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