1, duodenal ulcer
Gastric ulcer is caused by weakened defense factors and relatively strengthened attack factors. Duodenal ulcer is caused by the increase of gastric acid secretion, and gastric acid is an attack factor. Most duodenal ulcers collected by Medical Education Network occur in the duodenal bulb at the entrance of duodenum. This part is easy to come into contact with gastric acid flowing out of the stomach, and the mucosa is easy to be injured.
When the body and mind are under strong pressure, gastric acid secretion will increase, and the duodenal mucosa will fester and evolve into a "erosion" state. Usually, erosion will heal naturally after a period of time, but if it is eroded repeatedly, the mucosa of duodenal bulb will degenerate into "gastric metaplasia" tissue similar to gastric mucosa. Here, if infected with Helicobacter pylori, the defense function of mucosa will be reduced, thus further developing erosion and forming ulcers.
The main symptoms of ulcer are epigastric pain, hematemesis and hematochezia. There will be pain in the upper abdomen centered on the heart socket. The degree of pain varies from person to person. Some people have colic, and some people feel bloated, dull or burning.
Pain is related to diet. Gastric ulcer usually begins on an empty stomach or about 30 minutes after meals, and duodenal ulcer begins on an empty stomach, 2-3 hours after meals or at night. Duodenal ulcer is more common in empty abdominal pain or night pain.
This kind of pain will be relieved temporarily as long as you eat. This is because the gastric juice that stimulates the mucosa is neutralized by food. Under normal circumstances, after a few days of symptoms, due to the body's defensive reaction, a film called white fur is produced on the surface of the ulcer, and the pain will be alleviated.
Peptic ulcers usually have symptoms such as heartburn or burping. The symptoms of heartburn are more obvious when lying down than when standing or sitting, especially when lying on the left side. This is because when lying on the left side, gastric juice is easy to flow back to the lower part of the esophagus and stimulate the esophageal mucosa.
Hematemesis and bloody stool are also common symptoms of peptic ulcer. When the ulcer reaches the depth, the blood vessels that run through the muscle layer will be invaded, causing bleeding. Hematemesis is more common in gastric ulcer and hematochezia is more common in duodenal ulcer.
When vomiting blood, you will feel queasy at first, and then you will spit out a lot of coffee-like liquid. This is because the blood in the stomach is mixed with gastric juice, which turns the blood brown. Generally speaking, most of them are gastric juice, and the amount of bleeding is not much.
Blood means that blood flows into the intestine and is discharged with feces. At this time, there will be black stool (cypress oil stool). Serious complications can be life-threatening.
Perforation: whether it is gastric ulcer or duodenal ulcer, when the ulcer deepens, it may break through the stomach wall or intestinal wall (perforation), forming a hole, and food will flow into the abdominal cavity from the gastrointestinal tract, causing acute peritonitis. At this time, the pain will spread to the whole abdomen, and the abdominal muscles will be stimulated and become nervous. Touching the abdomen will feel as hard as a board. This typical performance is called "plate belly".
Once it becomes acute peritonitis, it is easy to cause shock symptoms. Patients will appear pale, cold sweat, blood pressure drop, and fall into a state of difficulty breathing or disturbance of consciousness. If the hole is not blocked by surgery within a few hours, it will be life-threatening.
Bleeding: If the ulcer bleeds a lot, it will sometimes cause shock. Therefore, patients should be sent to the hospital quickly, and drugs such as anhydrous alcohol should be injected around the ulcer site with gastroscope to stop bleeding.
Pyloric obstruction: Pyloris refers to the outlet part of the stomach. If there are recurrent ulcers in this area, the food passage will be narrowed (narrowed), and symptoms such as nausea, vomiting, indigestion and swelling of the upper abdomen will appear. Food will accumulate in the stomach because it can't pass smoothly, and sometimes it will cause the stomach to expand.
If the child has duodenal ulcer, it is easy to cause pyloric obstruction, so pay special attention.
Peptic Ulcer in Children In recent years, the number of children suffering from peptic ulcer is increasing day by day, and the types of diseases vary with age. Children, including newborns, to children in the lower grades of primary school, are mainly acute gastric ulcers. When children are under mental and physical stress, they will complain about pain near the heart socket, and sometimes they will have symptoms of hematemesis. Children's ulcers in primary schools and above are mainly collected and sorted by the duodenal ulcer medical education network. Children usually complain of pain near the heart socket on an empty stomach, sometimes accompanied by bloody stool and other symptoms. Duodenal ulcer in children is easily overlooked, and many cases are getting worse and worse because they are not diagnosed and treated in time. In addition, there are many cases of recurrence. When a child complains of abdominal pain, parents should pay attention to it. If you suspect a peptic ulcer, you should take your child to the hospital for examination immediately.
2, gastric ulcer
It is generally believed that gastric ulcer may be caused by the imbalance between "defense factor" to protect mucosa and "attack factor" to harm mucosa.
Mucus covers mucosa, resistance of mucosa itself, blood circulation in mucosa, etc. It is a defense factor to protect mucosa; However, digestive juices such as gastric acid and pepsin, smoking, drinking, Helicobacter pylori and so on. , is an attack factor that damages mucosa.
It is autonomic nerve that regulates the balance of power between defensive factors and offensive factors. The autonomic nerve center is located in the hypothalamus, and it will issue various instructions dominated by gastric juice secretion. Healthy people's autonomic nerves will work normally and maintain balance, so there will be no ulcers.
However, when the body and mind are under strong pressure, the autonomic nerve will be affected, leading to the disorder of gastric regulation. In this way, the role of defense factors will be weakened, and as a result, the collection and collation of medical education network will lead to the strengthening of attack factors, gastric mucosal damage and ulcer.
The mechanism of this kind of gastric ulcer is often compared to a balance with defensive factors and offensive factors as weights. Under pressure, the fulcrum position of the supporting balance will shift, which will eventually lead to the aggravation of the attack factor.
Progressive pattern of gastric ulcer
1) Some mucosa was eroded. Tissue defects are shallow, which are common in acute ulcers that heal naturally in 2 ~ 3 weeks. 2) Tissue defect passes through muscularis mucosa and spreads to submucosa. It is common in ulcers that occur in pyloric sinuses. 3) The tissue defect further extends to the muscularis propria. It is most common in gastric ulcer. When the ulcer destroys the blood vessels in the muscle layer, bloody stool or hematemesis will occur. 4) Finally, it breaks through the serosa and forms a state of gastric perforation. Patients with severe stomachache and pale face should seek medical advice as soon as possible.