Alternative names: Stomach ulcers Peptic ulcer disease (PUD) refers to painful sores or ulcers in the mucosal lining

of the stomach or the first part of the small intestine, the duodenum, secondary to pepsin and gastric acid secretion. The predominant causes of PUD are Helicobacter pylori infection and use of nonsteroidal antiinflammatory drugs (NSAIDs).1 Endoscopy is the widely preferred diagnostic procedure for peptic ulcer disease , as it can identify superficial lesions, ulcer scars, as well as active ulcers. Serious complications include bleeding, perforation or gastric outlet obstruction. Peptic ulcer treatment has evolved from simple dietary modifications and use of antacids to gastric acid suppression with H2-receptor antagonists and proton pump inhibitors to eradication of H. pylori infection. Surgery is indicated for patients who are resistant to medical therapy or at high-risk for complications. Pathogenesis of pepti ulcer Normally, there is a physiologic balance between peptic acid secretion and gastroduodenal mucosal defense. Mucosal injury and subsequent peptic ulcer occur when the balance between the aggressive factors and the defensive mechanisms is disrupted. The pathogenesis of peptic ulcer disease differs between duodenal and gastric ulcers. Duodenal ulcer, essentially an H. pylori-related disease, is caused mainly by an increase in the acid and pepsin load. In gastric ulcer, NSAID ingestion plays a major role in the ulcer development although H. pylori infection might also be present. Chronic, superficial and atrophic gastritis predominate in patients with gastric ulcers. Nevertheless, both ulcers are associated with an imbalance between protective and aggressive factors, with inflammation being a leading cause of the imbalance. Symptoms of Peptic Ulcer Many signs and symptoms of peptic ulcer disease are obscure. People may complain only of indigestion or other vague dyspeptic symptoms commonly found in other conditions. Classic presentations of peptic ulcer disease include Episodic abdominal pain, vomiting Weight loss Fat intolerance and Indigestion Chronic duodenal ulcer frequently presents with epigastric pain. The pain varies markedly in nature and intensity, characteristically, occurring from 90 min to 3 h after eating and frequently awakens the person at night. The pain is usually relieved in a few minutes by food or antacid. Although symptoms tend to be recurrent and episodic, duodenal ulcers

often recur in the absence of pain. Periods of remission usually last from weeks to years and are almost always longer than the episodes of pain.

Management of Peptic Ulcer The goals of management are to control any active bleeding, to heal the ulcer and prevent its recurrence. Initial management strategies are guided by the patients clinical condition and endoscopic findings. Thus, treatment may consist of 1. Medical therapy 2. Endoscopic 3. And at times, surgery.2 Medical therapy: In order to facilitate healing and to decrease the risk for recurrence of peptic ulcer disease (PUD), H. pylori should be eradicated. Patients should receive antisecretory therapy, preferably with a proton pump inhibitor (PPI) for 4 weeks. Endoscopy: Endoscopy should be performed in patients with persistent symptoms. Surgery: Surgery is recommended in the presence of complications or when the ulcer is refractory to pharmacotherapy. The most common indication for surgery is bleeding. Rarely, complications such as perforation and gastric outlet obstruction may occur. Patients negative for H. pylori infection should receive an empiric trial of acid suppression for 48 weeks and if beneficial it can be continued. Along with medications, lifestyle modifications are an important subset of management. Elimination or modification of peptic ulcer disease risk factors reduces the risk of ulcer recurrence.

Some Common Signs and Symptoms of Peptic Ulcer includes: Weight loss occur during peptic ulcer. poor appetite is a common symptom. bloating nausea burning pain in the abdomen between the breastbone and the belly button (the most common ulcer symptom) chest pain (usually dull and achy) occurs repeatedly in peptic ulcer. frequent burping or hiccuping

feeding difficulties occur in the case of peptic ulcer. blood in vomit or bowel movements, which may appear dark red or black Be worse when your stomach is empty Flare at night Often be temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication.

Some Effective Home Remedies for Peptic Ulcer includes: Drinking 1/2 juice extract of cabbage, 1/2 carrot juice is effective in treating ulcers. Banana shakes 1 or 2 glasses or 2 bananas taken with a glass of milk are effective in ulcers. Eliminating H. pylori infections with antibiotics means that your ulcer can be cured for good. Drumstick : The leaves of the kalyana murangal tree, which is a variety of drumstick, have proved helpful in the healing of ulcers. Vegetable Juices: The juices of raw vegetables, particularly carrot and cabbage, are beneficial in the treatment of peptic ulcers. Carrot juice may be taken either alone or in combination with spinach, or beet and cucumber. Almond Milk: Milk prepared from blanched almonds in a blender is very useful as a treatment for peptic ulcers. It binds the excess of acid in the stomach and supplies high quality protein. Goat's Milk: Goat's milk is also highly beneficial in the treatment of this disease. It actually helps to heal peptic ulcers. Home Remedies for Stomach Ulcers Alternative Names: Peptic Ulcers, Gastric Ulcers Some of the common home remedies for stomach ulcers (gastric ulcers) are: Castor Oil and Milk - Castor oil also has many good properties which can cure peptic ulcer. You may take 30 gm of pure odorless castor oil mixed with 250 gm's of lukewarm milk. Milk - Milk is another great curative while you are suffering from gastric ulcers (stomach ulcers). Take two or three times daily. Rest - The patient must take lot of rest while he is suffering from stomach ulcer. Cayenne and Chickweed - You may also take cayenne and chickweed in a capsule form for the treatment of bleeding ulcers.

 Honey - Honey soothes and reduces inflammation of the lining of the stomach. So you may take 2-3 teaspoon of honey daily. Bananas - Eating three bananas daily will also help you to cure stomach ulcer. Avoid Aspirin and Ibuprofen - Over-the-counter pain relievers that fall under the category of nonsteroidal anti-inflammatory drugs (NSAIDs) should be avoided by anyone who is suffering from peptic ulcers. Bamboo Leaves - Bamboo leaves are beneficial in the treatment of stomach problems. Avoid Fried Foods and Spices - You should avoid fried foods and other spices while you are suffering from stomach ulcers as it may make the condition more serious. Some other Good Herbal and Home Remedies may be: Bayberry. Bistort. Burdock. Licorice Root. Hops. Almond Milk. Hyssop. Myrrh. Pennyroyal. Pokeweed. Goldenseal. Yucca.