Stomach ulcers and duodenal ulcers are generally collectively referred to as peptic ulcers, sometimes referred to simply as ulcers. Stomach acid (hydrochloric acid) and pepsin (a type of enzyme) that originally digest food digest their own stomach wall and duodenal wall, thereby damaging mucosal tissue, which is the main cause of peptic ulcers.

1. Duodenal ulcer

Gastric ulcer is caused by the weakening of defensive factors and the relative enhancement of the power of attacking factors. Duodenal ulcers are caused by increased secretion of gastric acid, which is an attack factor. Most duodenal ulcers collected and compiled by medical education websites occur in the duodenal bulb at the entrance to the duodenum. This area is easily exposed to gastric acid flowing from the stomach, and the mucosa is easily injured.

When the body and mind are under strong pressure, gastric acid secretion will increase, and the mucosa of the duodenal bulb will ulcerate, evolving into a state of "erosion". Usually, erosion will heal naturally after a period of time, but if erosion occurs repeatedly, the mucosa of the duodenal bulb will degenerate into "gastric metaplasia" tissue similar to gastric mucosa. And if you are infected with Helicobacter pylori, the defense function of the mucosa will be reduced, causing erosion to further develop and ulcers will form.

The main symptoms of ulcers are upper abdominal pain, vomiting blood, and bloody stools. There will be pain in the upper abdomen centered in the pit of the heart. The level of pain varies from person to person, with some experiencing cramping, while others experience distended, dull or burning pain.

Pain is related to diet. For gastric ulcers, the pain usually starts on an empty stomach or about 30 minutes after a meal, while for duodenal ulcers, the pain starts on an empty stomach or 2 to 3 hours after a meal. Or the medical education website collects and compiles the pain that starts at night. Duodenal ulcers are more common with fasting pain or night pain.

This kind of pain will be temporarily relieved as long as you have a meal. This is because gastric juices that irritate the mucosa are neutralized by food. Generally, after the symptoms persist for a few days, the pain will be relieved due to the body's defense response, which causes a thin film called white coating to form on the surface of the ulcer.

Peptic ulcers also often cause symptoms such as heartburn (heartburn) or burping. Heartburn symptoms are more noticeable when lying down than when standing or sitting, and are especially intense when lying on your left side. This is because gastric juice easily flows back into the lower part of the esophagus when lying on the left side, irritating the esophageal mucosa.

Vomiting blood and bloody stools are also common symptoms of peptic ulcer. When the ulcer reaches a deep level, the blood vessels penetrating the muscle layer will be violated, causing bleeding. Gastric ulcers are more common with hematemesis, while duodenal ulcers are more common with bloody stools.

When you vomit blood, you will feel nauseated at first, and then you will vomit a large amount of coffee-like liquid. This is because the blood in the stomach mixes with gastric juice and undergoes chemical changes, causing the blood to turn brown. Generally speaking, most of it is gastric juice, and the amount of bleeding is not large.

Bloody stool means that blood flows into the intestines and is excreted together with the feces. At this time, black stool (tarry stool) will appear. Severe complications can be life-threatening.

Perforation: Whether it is a gastric ulcer or duodenal ulcer, when the ulcer deepens, it may break through the stomach or intestinal wall (perforation), forming a hole, and food will flow from the gastrointestinal cavity into the abdominal cavity, causing acute peritonitis. At this time, the pain will expand to the entire abdomen, the abdominal muscles will be stimulated and become tense, and the abdomen will feel as hard as a board when touched. This typical phenomenon is called a "slab-shaped abdomen."

Once it becomes acute peritonitis, it is easy to cause shock symptoms. The patient will appear pale, break out in cold sweats, have a drop in blood pressure, and have difficulty breathing or become unconscious. If surgery is not performed to block the hole within a few hours, it can become life-threatening.

Heavy bleeding: If an ulcer bleeds a lot, it can sometimes cause shock. Therefore, the patient should be sent to the hospital quickly, and drugs such as absolute alcohol should be injected around the ulcer site using a gastroscope to stop the bleeding.

Pylorus obstruction: The pylorus refers to the exit part of the stomach. If ulcers occur repeatedly in this area, the food passage will become narrowed (stenosis), causing symptoms such as nausea, vomiting, indigestion, and a feeling of distension in the upper abdomen. Food can accumulate in the stomach because it cannot pass through it easily, sometimes causing the stomach to become dilated.

If children suffer from duodenal ulcer, it is easy to cause pyloric obstruction, so special attention should be paid.

Peptic ulcer in children In recent years, the number of children suffering from peptic ulcer has been increasing, and the type of disease varies with age. Acute gastric ulcers mainly occur in children from toddlers to lower primary school students, including newborns. When children are under mental or physical stress, they will complain of pain near the heart and sometimes vomiting blood. Ulcers that appear in children in the upper grades of primary school are mainly collected and compiled on the duodenal ulcer medical | education website. Children usually complain of pain near their heart on an empty stomach, sometimes accompanied by bloody stools and other symptoms. Duodenal ulcers in children are easily overlooked, and in many cases symptoms become increasingly severe because they are not diagnosed and treated in time. In addition, recurrences are common, so parents should pay attention when their children complain of abdominal pain. If you suspect peptic ulcer, take your child to the hospital for examination immediately.

2. Gastric ulcer

It is generally believed that the reason why gastric mucosa ulcers may be due to the imbalance between the "defense factors" that protect the mucosa and the "attack factors" that damage the mucosa. Caused by.

The mucus covering the mucosa, the resistance of the mucosa itself, and the blood circulation in the mucosa are the defensive factors that protect the mucosa; while digestive juices such as gastric acid and pepsin, smoking, drinking, and Helicobacter pylori, etc., It is an attack factor that damages mucous membranes.

It is the autonomic nervous system that regulates the balance of power between defense factors and attack factors. The autonomic nervous center is located in the hypothalamus and issues various instructions including gastric juice secretion. In healthy people, ulcers will not occur because the autonomic nervous system operates normally to maintain balance.

However, when the body and mind are under strong pressure, the autonomic nervous system will be affected, leading to disorders of the gastric regulatory function. In this way, the effect of the defense factors will be weakened, and as a result, the power of the attack factors will be enhanced, the gastric mucosa will be injured, and ulcers will appear.

This mechanism of gastric ulcer production is often compared to a balance with defense factors and attack factors as weights. When under pressure, the position of the fulcrum supporting the balance will shift, eventually causing the attack factor to increase.

How gastric ulcers progress

1) Part of the mucosa is eroded. The tissue defect is shallow and is common in acute ulcers that heal naturally in 2 to 3 weeks. 2) The tissue defect crosses the muscularis mucosa and affects the submucosa. Commonly seen in ulcers occurring in the pyloric sinus. 3) The tissue defect further extends to the muscularis propria. Most common in gastric ulcers. When an ulcer destroys blood vessels in the muscle layer, bloody stools or vomiting of blood can occur. 4) Eventually breaks through the serosa and forms a gastric perforation state. During the attack, the patient has severe stomach pain and looks pale, and should seek medical treatment as soon as possible.