Ulcer

Ulcerul is an excavation (crater) in the mucosa of the stomach or duodenum (the first portion of the intestine). Peptic ulcer disease occurs at any age, but the peak incidence is in young individuals.

Ulcer, as a disease, occurs due to an imbalance between acid aggression and anti-acid barrier (there is no ulcer without acid!). Factors involved in the development of ulcers include hydrochloric acid, reflux of duodenal contents into the stomach, alcohol, smoking, stress, and certain medications (such as aspirin, diclofenac, ketoprofen, indomethacin, prednisone).

The periodicity of ulcers consists of alternating pain-free periods with painful phases. Ulcerative periods usually have a seasonal character, being more pronounced in spring and autumn. The risk of developing peptic ulcer disease is 2.5 times higher in first-degree relatives of ulcer patients. It should be noted that not every abdominal pain suggests an ulcer.

Ulcer pain has typical characteristics: the pain is usually epigastric (in the 'pit of the stomach'); it varies in intensity, from burning to gnawing. One of the important characteristics is the rhythm of the pain or its relationship with food (known as 'meal periodicity'). The closer the ulcer is to the esophagus, the earlier the pain occurs after meals: in gastric ulcer, pain occurs 30-60 minutes after food intake, while in duodenal ulcer, it occurs 4-5 hours postprandially: in this case, the pain resembles "hunger pain" and most commonly occurs at night, waking the patient from sleep; the patient reports relief after eating.

Unlike the pain in gastritis, the pain from duodenal ulcer is the only abdominal pain that improves after eating, so the patient can diagnose it themselves! The pains do not occur in the morning upon waking. Other symptoms include vomiting (which can relieve pain, which is why they are sometimes intentionally induced by the patient), heartburn, belching, nausea, constipation. Appetite is maintained or even increased.