The term peptic ulcer usually refers to an ulcer in the lower esophagus, stomach, or duodenum.
Peptic Ulcers – CAUSE
1. Heredity – Patients with peptic ulcer often have a family history of the disease, this is particularly so with duodenal ulcers which develop below the age of 20 years. The relatives of chronic ulcer patients have three times the expected number of ulcers.
2. Helicobacter pylori – This is the most important etiological factor in peptic ulcer disease, accounting for 90% of duodenal ulcers and 70% of gastric ulcers. By causing gastritis it reduces the resistance of the gastric mucosa to attack be acid and pepsin and a gastric ulcer may result.
3. Non Steroidal Anti Inflammatory Drugs (NSAIDS) – These damage the gastric mucosal barrier and are an important etiological factor in up to 30% of gastric ulcers.
4. Smoking – confers an increased risk of gastric ulcer and to a lesser extent duodenal ulcer.
Peptic Ulcers SYMPTOMS
- Abdominal pain – Pain is referred to the epigastrium and is often so sharply localized that the patient can indicate its site with tow or three fingers – the ‘pointing sign’
- Hunger pain – Pain occurs intermittently during the day, often when the stomach is empty, so that the patient identifies it as ‘hunger pain’ and obtains relief be eating.
- Night pain – Pain wakes the patient from sleep and may be relieved by food, a drink of milk or antacids. This symptoms if found, is virtually pathognomonic of peptic ulcer disease..
- Episodic pain/ Periodicity – Characteristically pain occurs in ‘on again/off again’ episodes, lasting one to three times a week at a time, three to four times in a year. In temperate climates seasonal variation may be noted with an increased frequency of symptoms during winter and spring.
- Other symptoms –
- Loss of appetite
Peptic Ulcers – HOW DIAGNOSIS IS DONE?
- Endoscopy is the preferred method.
- Double contrast barium meal examination may be done.
Peptic Ulcers – COMPLICATIONS
The ulcer may occasionally perforate leading to peritonitis and other complications.
Peptic Ulcers – WHAT TO DIFFERENTIATE FROM?
- Occasional dyspepsia (indigestion)
- Malignant ulcer/ carcinoma
HOMEOPATHIC TREATMENT & Medicines for Peptic Ulcers
Homeopathy offers some very good medicines for peptic ulcer disease. But for a homeopath, the symptoms of the disease are much more important than the ulcer itself. This is because to select the right medicine a homeopaths needs to differentiate between the finer presentations of a disease which, vary from person to person. A homeopath not only tries to heal the ulcer but also tries to remove the general predisposition to acquire it. The homeopath not only tries to find ‘What is wrong?’, but also ‘Why it went wrong?’; ‘Where it started going wrong?’; ‘How it evolved to the current stage?’ etc. To find the answers to all these questions, a homeopath tries to gather as much information as possible regarding the pat and present medical history of the patient, his/her family history, his/her general physical and psychological characteristics etc. This hard work on the part of homeopath not only helps in removing the acute symptoms and the ulcer but also is usually able to remove the tendency for relapse. The ‘on-again/off-again’ nature of the disease is often removed and the general health of the person also improves as a result.
Some of the commonly used medicines for gastritis and duodenal ulcers are argentum-nit, arsenic-alb, atropine, geranium, hydrastis, kali-bichrom, merc-cor, ornithogalum, phosphorus, uranium-nit, terebintha, lycopodium, pulsatilla, graphites, natrum-phos, medorrhinum etc.
Peptic Ulcers – CONVENTIONAL TREATMENT
- Drugs which decrease the secretion of acids in stomach are the mainstay of treatment. These include drugs like cimetidine, ranitidine, famotidine, nizatidine, omeprazole (proton-pump inhibitor) etc
- Bismuth salts, antibiotics, and metronidazole are given to eradicate Helicobacter pylori
- Antacids are prescribed for symptomatic relief.
- Surgery is rarely indicated for ulcers resistant to therapy or where there are frequent relapses.
WHAT ELSE CAN I DO? – ACCESSORY MANAGEMENT
- Avoid cigarette
- Aspirin and Bon-steroidal Anti-Inflammatory drugs should be avoided
- Spicy and rich food may aggravate. If so, it should be avoided.
- Drink lots of water.
- Take frequent small meals instead of two or three big meals.
WHERE CAN I FIND MORE INFO? – INTERNET RESOURCES
Harrison’s Principles of Internal Medicine, 14th ed, McGraw-Hill
Davidson’s Principles and Practise of Medicine, 17th ed, 1996, Churchill Livingstone
New Manual of Homeopathic Materia Medica & Repertory, William Boericke, 2nd revised ed., 2001, B. Jain
A Concise Repertory of Homeopathic Medicines, S.R.Phatak, 3rd ed, B. Jain
The Prescriber, Clarke, reprint ed, 1998, B. Jain
Practical Homeopathic Therapeutics, Dewey, reprint ed, 1993, B.Jain