The main causes of ulcer disease! Find out everything about this disease from gastroenterologist Ecaterina Ciobanu

A condition found in approximately 1 in 10 people that significantly affects quality of life is ulcers.

Ecaterina CEBANU, GASTROENTEROLOGIST: “Ulcer disease is a breakdown of the lining of the stomach or duodenum, which can progress to all layers of the stomach. Basically, up to 10% of the population suffers from gastric ulcer or duodenal ulcer.”

After evolution, the ulcer can be acute and chronic, when it presents periods of remission and exacerbation of the disease.

Ecaterina CEBANU, GASTROENTEROLOGIST: “In the foreground as a cause of ulcer disease, it would be Helicobacter infection. A fashionable, common infection, practically 50% of the world’s population is infected. It can be asymptomatic, but if the infection is retained in the stomach for a long time, it could potentially lead to various pathologies.”

It is believed that approximately 50% of the population is infected with Helicobacter pylori.

Ulcers often occur as a result of an imbalance between the factors of aggression, i.e. hydrochloric acid, and the protective factors of the stomach, such as mucus and bicarbonate.

In the ulcer there is an imbalance between the factors of aggression (hydrochloric acid) and the factors of protection (mucus and bicarbonate).

Ecaterina CEBANU, GASTROENTEROLOGIST: “The imbalance can be conditioned by the administration of gastrotoxic drugs such as anti-inflammatories. The first would be the use of aspirin, it annihilates or influences the protective mechanisms.”

In young people, duodenal ulcers caused by Helicobacter pylori are more common, while in the elderly, gastric ulcers associated with polymedication are more common.

Duodenal ulcers, caused by Helicobacter pylori, are more common in young people.

Gastric ulcers associated with polymedication are more common in the elderly.

Ecaterina CEBANU, GASTROENTEROLOGIST: “Ulcer disease can also be caused by another series of less common cases, such as diseases caused by gastrin hypersecretion, hormonal diseases that can lead to gastric hypersecretion.”

Among the basic risk factors can be listed: alcohol consumption, smoking, stress and unbalanced diet.

Ecaterina CEBANU, GASTROENTEROLOGIST: “The patient’s clinic is usually the classic phenomenon of pain in the epigastric area, which sets in 10-15 minutes after a meal in the case of a gastric ulcer, and 2 hours after a meal in the case of a duodenal ulcer. In duodenal ulcer there is also a night pain, which wakes the patient from sleep like a dagger blow. The second frequently encountered phenomenon is dyspeptic phenomena: nausea, vomiting, early satiety, transit alteration phenomena, bloating phenomena.”

In gastric ulcer, more often epigastric pain occurs 10-15 minutes after a meal.

In duodenal ulcer, pain may occur 2 hours after a meal, or at night with a stabbing-like sensation.

In the case of hemorrhage, a common complication of ulcers, the patient may present with anemia and bleeding, manifested by melanic, black stools and vomiting with coffee grounds.

Ecaterina CEBANU, GASTROENTEROLOGIST: “The investigations that confirm the presence of gastric ulcers is the upper digestive endoscopy, which allows the investigation of the upper digestive tract.”

Other investigations can be performed, but endoscopy has the advantage of being able to take the biopsy and sample for Helicobacter right away.

Ecaterina CEBANU, GASTROENTEROLOGIST: “The tests for Helicobacter, which are frequently encountered, would be the blood test. It is not the most correct method, because it does not reflect the truth, it may reflect an old immunity and not a current infection. We usually rely on testing either stool, faecal antigen, or the breath test for Helicobacter.”

Diagnosis can be made by faecal analysis, breath test and blood test for Helicobacter.

Ulcer treatment is complex and begins by addressing a dietary regimen.

Ecaterina CEBANU, GASTROENTEROLOGIST: “The patient is encouraged to eat healthy, balanced, to eat boiled, baked, to exclude foods that could irritate the mucosa, such as: coffee, mint, super-spiced foods, drinks and hot foods. Obviously, smoking and alcohol are given up.”

Ecaterina CEBANU, GASTROENTEROLOGIST: “But we intervene with medicine anyway. The first categories of drugs indicated are acid-suppressing drugs, either from the proton pump inhibitor category or from the beta-blocker category.”

In the case of Helicobacter infection, the patient also undergoes a specific treatment for this infection.

Ecaterina CEBANU, GASTROENTEROLOGIST: “If Helicobacter infection is confirmed, it must be treated. Any ulcer disease should be checked endoscopically if it has been completely treated.”

An endoscopy is performed after any type of ulcer disease to determine if it has completely healed.

Ulcer prevention involves the administration of gastric protection drugs, in the case of polymedication, and the treatment of Helicobacter infection if detected.

Ecaterina CEBANU, GASTROENTEROLOGIST: “We rely on healthy food, at the right time with a balance in everything. And then let’s exclude alcohol consumption, let’s exclude smoking, the stressful factor and have a good quality of life.”