How Do Nsaids Cause A Peptic Ulcer
To understand how NSAIDs cause peptic ulcer disease, it is important to understand how NSAIDs work. Nonsteroidal anti-inflammatory drugs reduce pain, fever, and inflammation, or swelling.
Everyone has two enzymes that produce chemicals in your bodys cells that promote pain, inflammation, and fever. NSAIDs work by blocking or reducing the amount of these enzymes that your body makes. However, one of the enzymes also produces another type of chemical that protects the stomach lining from stomach acid and helps control bleeding. When NSAIDs block or reduce the amount of this enzyme in your body, they also increase your chance of developing a peptic ulcer.
Prevention Of H Pylori
Theres currently no vaccine to protect against H. pylori infection. Researchers arent sure exactly what causes the infection or how it spreads, so there arent standard prevention guidelines.
- Wash your hands frequently and thoroughly
- Drink water from a safe and trusted source
- Don’t eat contaminated food
Industry Influence On Research
In 2016 research into the archives of the, the for the in the US, had sponsored an influential published in 1965 in the that downplayed early findings about the role of a diet heavy in sugar in the development of CAD and emphasized the role of fat that review influenced decades of research funding and guidance on .
Research efforts are focused on new treatment modalities and various . A region on was confined to families with multiple cases of myocardial infarction. Other genome-wide studies have identified a firm risk variant on . However, these and other are found in intergenic segments and need further research in understanding how the is affected.
A more controversial link is that between infection and atherosclerosis. While this intracellular organism has been demonstrated in atherosclerotic plaques, evidence is inconclusive as to whether it can be considered a causative factor. Treatment with antibiotics in patients with proven atherosclerosis has not demonstrated a decreased risk of heart attacks or other coronary vascular diseases.
Since the 1990s the search for new treatment options for coronary artery disease patients, particularly for so called no-option coronary patients, focused on usage of and therapies. Numerous clinical trials were performed, either applying therapies, such as or , or cell therapies using different kinds of adult populations. Research is still going on â with first promising results particularly for and utilization of endothelial .
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Alternative And Complementary Therapies
There are some foods or supplements with antibacterial or antiviral properties that have been investigated for improving H. pylori infections or the ulcers that can sometimes result. These include garlic, honey, broccoli, green tea, and red wine.
H. pyloriWorld Journal of Gastroenterology
Its recommended that any alternative therapy be discussed with your doctor and should only be used along with traditional H. pylori eradication medication.
How Does H Pylori Infection Cause Damage
H. pylori multiply in the mucus layer of the stomach lining and duodenum. The bacteria secrete an enzyme called urease that converts urea to ammonia. This ammonia protects the bacteria from stomach acid. As H. pylori multiply, it eats into stomach tissue, which leads to gastritis and/or peptic ulcer.
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What Causes A Peptic Ulcer
Causes of peptic ulcers include
- long-term use of nonsteroidal anti-inflammatory drugs , such as aspirin and ibuprofen
- an infection with the bacteria Helicobacter pylori
- rare cancerous and noncancerous tumors in the stomach, duodenum, or pancreasknown as Zollinger-Ellison syndrome
Sometimes peptic ulcers are caused by both NSAIDs and H. pylori.
How Are Peptic Ulcers Treated
Acid-suppressing drugs can heal ulcers, however, if H. pylori is still present, the pain and risks associated with ulcers will come back. Therefore, the best treatment must involve getting rid of the infection as well.
An effective vaccine to prevent H. pylori infection in humans is not available. Researchers are actively working on the development of such a vaccine.
In the past, the recommended treatment involved a combination of two antibiotics and an acid-suppressing drug, called a proton-pump inhibitor , to be taken for ten days. However, over the years, H. pylori infections have become increasingly difficult to treat. As a result, new recommendations for treatment have recently been introduced which involved changes to the strength and length of time medication is to be taken. The new recommendations include the addition of a third antibiotic along with the PPI and that these are to be taken for 14 days. If you have been diagnosed with a peptic ulcer, ask your doctor about the new recommendations.
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What If I Have An Ulcer And H Pylori Infection
The medicines described earlier heal ulcers whether you have H. pylori infection or not. But, if you have H. pylori infection too, your doctor also will treat the infection. H. pylori is hard to get rid of. No single medicine can cure this infection. The best way to cure H. pylori infection is to take several medicines at the same time.
To treat an H. pylori infection, your doctor will prescribe several medicines: one or two antibiotics plus bismuth or a medicine to block stomach acid production. This means taking a large number of pills every day. Some combinations that use fewer drugs also might help. Tritec is a pill that combines bismuth and a drug to reduce acid in the stomach. It is used with an antibiotic. Helidac is another medicine that combines bismuth and two antibiotics. Your doctor will tell you which medicines you should take.
What If I Still Need To Take Nsaids
If you take NSAIDs for other conditions, such as arthritis, you should talk with your doctor about the benefits and risks of using NSAIDs. Your doctor can help you determine how to continue using an NSAID safely after your peptic ulcer symptoms go away. Your doctor may prescribe a medicine used to prevent NSAID-induced ulcers called Misoprosotol.
Tell your doctor about all the prescription and over-the-counter medicines you take. Your doctor can then decide if you may safely take NSAIDs or if you should switch to a different medicine. In either case, your doctor may prescribe a PPI or histamine receptor blocker to protect the lining of your stomach and duodenum.
If you need NSAIDs, you can reduce the chance of a peptic ulcer returning by
- taking the NSAID with a meal
- using the lowest effective dose possible
- avoiding alcohol
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How Stomach Ulcers Are Treated
With treatment, most stomach ulcers will heal within a month or two. The treatment recommended for you will depend on what caused the ulcer.
Most people will be prescribed a medication called a proton pump inhibitor to reduce the amount of acid their stomach produces and allow the ulcer to heal naturally.
If an H. pylori infection is responsible for the ulcers, antibiotics will also be used to kill the bacteria, which should prevent the ulcer coming back.
If the ulcers are caused by the use of NSAIDs, PPIs are usually prescribed and your doctor will discuss whether you should keep using NSAIDs.
Alternative medication to NSAIDs, such as paracetamol, may be recommended.
Stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed.
Read more about treating stomach ulcers.
What Are The Potential Complications Of A Stomach Ulcer
You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of gastric ulcer include:
- Internal hemorrhaging , the most common complication. Bleeding usually stops spontaneously, but about 25% of cases require surgery, according to Johns Hopkins Medicine.
- Perforated gastric ulcer, which is when there is a hole in the stomach
- Severe discomfort or pain
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What Causes A Stomach Ulcer
A stomach infection associated with Helicobacter pylori bacteria is the most common cause of stomach ulcers. The bacteria affect stomach acid and act on the stomachs lining, making it more vulnerable to acid and digestive fluids. With time, breaks occur in the lining, which can keep eroding and create a sore.
Alcohol, tobacco, and medications, such as nonsteroidal anti-inflammatory drugs , can also lead to stomach ulcers. Severe illness and radiation therapy have also been associated with stomach ulcers.
Many people around the world have H. pylori, but not everyone gets peptic ulcer disease like stomach ulcers. This means other factors are involved, including environmental and genetic factors.
Diagnosis Of Peptic Ulcers Gastritis & Helicobacter Pylori
If your child experiences symptoms of peptic ulcers, gastritis or H. pylori infection, a pediatric gastroenterologist can perform the following exams and tests to make a diagnosis:
- Physical exam. A physician will examine the abdomen for signs of bloating and can track your child’s weight loss.
- Complete medical history. Your childs physician will review your childs health records and family health history.
- Upper gastrointestinal endoscopy. Your child’s doctor can perform an upper gastrointestinal endoscopy to examine the esophagus, stomach and duodenum.
- Biopsy.A pediatric gastroenterologist may take a stomach tissue sample to study the cells for signs of damage or infection.
- Blood tests. A variety of blood tests can indicate the presence of other reasons for abdominal pain.
- Breath tests. Breath tests measure the amount of gases, such as hydrogen, in the breath which can be a sign of bacterial overgrowth in the intestines or lactose intolerance.
- Stool tests. By studying the contents of your childs stool, the physician can get information about infections that may be upsetting the digestive tract.
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How Are Ulcers Treated
Three kinds of medicines can be used to treat ulcers. All of them do a good job of healing ulcers. Your doctor can tell you which one is right for you. You should take the medicine just as your doctor tells you to.
The first kind of medicine reduces the amount of acid your stomach makes. This medicine can heal an ulcer in the duodenum in six to eight weeks. Ulcers in the stomach take a little longer to heal. You take these medicines for eight to 12 weeks if you have a stomach ulcer.
A second kind of medicine blocks the stomach’s ability to make acid. This medicine helps heal an ulcer in the duodenum in four weeks. It helps heal stomach ulcers in six to eight weeks.
A third kind of medicine coats the ulcer. It protects the sore place from stomach acid, so it can heal. This kind of medicine takes eight to 12 weeks to heal an ulcer.
Survival Of Helicobacter Pylori
The pathogenesis of H. pylori depends on its ability to survive in the harsh gastric environment characterized by acidity, peristalsis, and attack by phagocytes accompanied by release of reactive oxygen species. In particular, H. pylori elicits an oxidative stress response during host colonization. This oxidative stress response induces potentially lethal and mutagenic oxidative DNA adducts in the H. pylori genome.
Vulnerability to oxidative stress and oxidative DNA damage occurs commonly in many studied bacterial pathogens, including Neisseria gonorrhoeae, Hemophilus influenzae, Streptococcus pneumoniae, S. mutans, and H. pylori. For each of these pathogens, surviving the DNA damage induced by oxidative stress appears supported by transformation-mediated recombinational repair. Thus, transformation and recombinational repair appear to contribute to successful infection.
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Symptoms And Possible Complications Of Stomach Ulcer
The most common symptom of a stomach ulcer is stomach pain. The level and presence of pain will vary from patient to patient. This pain will predominantly appear in the upper abdomen and may wake you up at night. Sometimes this pain is mistaken as the symptom of a heart attack.
You may also experience mild nausea which is relieved by vomiting, a feeling of fullness, an inability to consume liquids at your usual rate, or a hungry feeling 1-3 hours after having consumed a meal that does not match your usual eating patterns. Other possible symptoms of a stomach ulcer include weight loss, bloody stool, and vomiting which may include blood and fatigue.
Stomach ulcers can lead to internal bleeding if they become too severe. The inflammation caused by the stomach ulcer can also lead to inflammation of the tissue lining of the abdomen, a condition known as peritonitis. Inflammation can also lead to a gastric outlet obstruction or perforation of the stomach intestines.
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H Pylori Complications: Gastritis Ulcers And Stomach Cancer
The bacterium is linked to the development of several intestinal diseases.
H. pylori is the primary cause of peptic ulcers, which are sores that form on the lining inside the stomach.
The bacterial infection known as H. pylori is harmless in some people, but it can lead to serious problems in others.
H. pylori can cause inflammation of your stomachs lining, which is known as gastritis. The infection is also considered the primary cause of peptic ulcers sores in the lining of your stomach or duodenum . Additionally, H. pylori is a risk factor for some types of stomach cancer.
Treating the infection can improve gastritis symptoms, eliminate ulcers, and may reduce your chances of developing stomach cancer, too.
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What Are Helicobacter Pylori
Helicobacter pylori are a type of bacteria. These germs are a common cause of digestive illnesses, including:
- gastritis: the irritation and inflammation of the stomach lining
- peptic ulcers : sores in the lining of the stomach, small intestine, or esophagus
- later in life, stomach cancer
How Are Hpylori Peptic Ulcers Treated
Drugs Used To Treat H. pylori Peptic Ulcers
Antibiotics: metronidazole, tetracycline, amoxicillin, clarithromycin.
H2-blockers: cimetidine, ranitidine, famotidine, nizatidine.
Proton pump inhibitors: omeprazole, lansoprazole.
Stomach-lining protector: bismuth subsalicylate.
H. pylori peptic ulcers are treated with drugs to kill the bacteria, to reduce stomach acid, and to protect the stomach lining. Antibiotics are used to kill the bacteria. Two types of acid-suppressing drugs might be used: H2-blockers and proton pump inhibitors.
H2-blockers work by blocking histamine, which stimulates acid secretion. They help reduce ulcer pain after a few weeks. Proton pump inhibitors suppress acid production by halting the mechanism that pumps the acid into the stomach. H2-blockers and proton pump inhibitors have been prescribed alone for years as treatments for ulcers. But used alone, these drugs do not eradicate H. pylori, and therefore do not cure H. pylori-related ulcers. Bismuth subsalicylate, a component of Pepto-Bismol, is used to protect the stomach lining from acid. It also kills H. pylori. Treatment usually involves a combination of antibiotics, acid suppressors, and stomach protectors.
Early results of studies in other countries suggest that 1 week of triple therapy may be as effective as the 2-week therapy, with fewer side effects.
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Is There A Peptic Ulcer Diet Plan
No particular diet is helpful for people with peptic ulcers. At one time, a bland diet and avoidance of spicy or greasy foods was recommended. Milk and dairy food have been used in the past for ulcer symptoms, but have not been proven to be effective. We now know diet has little effect on ulcers. In some people, however, certain foods seem to aggravate stomach ulcer symptoms. Keep a food diary with your intake and the resulting symptoms and avoid eating any foods that aggravate symptoms.
What Causes Stomach Ulcers
Stomach ulcers occur when the layer protecting the stomach lining from stomach acid breaks down. This allows the stomach lining to become damaged.
This is usually caused by:
- an infection with Helicobacter pylori bacteria
- taking non-steroidal anti-inflammatory drugs , such as ibuprofen or aspirin particularly if they’re taken for a long time or at high doses
There’s little evidence that stress or certain foods causes stomach ulcers.
More about the causes of stomach ulcers
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Adaptation Of H Pylori To High Acidity Of Stomach
As mentioned above, H. pylori produce large amounts of urease to produce ammonia as one of its adaptation methods to overcome stomach acidity. Helicobacter pylori arginase, a bimetallic enzyme binuclear Mn2-metalloenzyme arginase, crucial for pathogenesis of the bacterium in human stomach, a member of the ureohydrolase family, catalyzes the conversion of L-arginine to L-ornithine and urea, where ornithine is further converted into polyamines, which are essential for various critical metabolic processes.
This provides acid resistance and is thus important for colonization of the bacterium in the gastric epithelial cells. Arginase of H. pylori also plays a role in evasion of the pathogen from the host immune system mainly by various proposed mechanisms, arginase competes with host-inducible nitric oxide synthase for the common substrate L-arginine, and thus reduces the synthesis of NO, an important component of innate immunity and an effective antimicrobial agent that is able to kill the invading pathogens directly.
Alterations in the availability of L-arginine and its metabolism into polyamines contribute significantly to the dysregulation of the host immune response to H. pylori infection.
What Can I Do To Prevent H Pylori
Health experts dont know for sure how the bacteria passes from person to person. But having good health habits can help keep you safe. These habits include:
Washing your hands with soap and water. It is very important to do this after using the bathroom and before eating.
Making sure all food you eat has been cleaned and cooked safely
Making sure that your drinking water is safe and clean
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Whats The Association Between H Pylori Infection And Stomach Cancer
If you have an _H. pylori _infection, you have an increased risk for stomach cancer later in life. If you have a strong family history of stomach cancer and other cancer risk factors, even though you may not have symptoms of a stomach ulcer, your healthcare provider may recommend being tested for H. pylori antibodies. In addition to screening and treatment, your provider may suggest some lifestyle changes, such as including more fruits, vegetables and fiber in your diet. Regular checkups with your provider and following their recommendations can reduce your cancer risk.