Round ulcer

Description:

Round ulcers develop on mucous membranes of the lower part of a gullet, a stomach and the gatekeeper, a duodenum and a jejunum.

• About 80% of all round ulcers — duodenum ulcers, they most often occur at men aged between 20 and 50 years.

• Ulcers on mucous a stomach meet at men of middle age and elderly, especially more often at those who constantly accept anti-inflammatory drugs or abuse alcohol.

• Duodenum ulcers usually have a chronic current, with remissions and aggravations, but at 5 — 10% of patients the complications demanding surgical intervention develop.

Reasons of a round ulcer:

Though the exact reason of development of ulcers is unknown, it is considered that their emergence is promoted by weakening of a mucous membrane, its insufficient blood supply or defects. Data of the last researches showed that the stress can strengthen gastric secretion for a long time owing to what on mucous a stomach, a duodenum and a gullet erosion develop.

Symptoms of a round ulcer:

Usually a signal of an aggravation of a round ulcer is heartburn and a gastric disturbance. Reception for once of a large number of food leads to stomach stretching, pain, feeling of overflow and raspiraniye develops. Weight loss and the repeating episodes of bleedings from a digestive tract can also be a characteristic symptom.

In the presence of erosion in a duodenum heartburn and pain on average department of a stomach which pass after meal are characteristic. The person gets fat (he eats much to remove discomfort), the specific feeling of bubbles of hot water at a back wall of a throat is characteristic. The pain attack usually begins in 2 h after food when a stomach empty. Pain can also develop after reception of aspirin or the use of orange juice, coffee or alcohol. Aggravations happen several times in a year. Vomiting and other digestive disturbances are noted seldom.

Treatment of a round ulcer:

The drug treatment which was based on use of the antacids neutralizing acid, and diets now consists in the basic in appointment of antagonists histamine H2 receptors, or, more simply, H2 blockers. The substance which is present at all fabrics – a histamine – possesses multiple action and, in particular, strengthens secretion of a gastric juice. H2 blockers, such as Cimetidinum or ranitidine, interact with histamine receptors, temporarily (reversibly) inactivating them and reducing thereby secretion of hydrochloric acid. Apply antimicrobic means, including antibiotics to destruction of H. pylori that sharply reduces probability of a recurrence of an ulcer. It is necessary to exclude administration of drugs, the round ulcers promoting education, in particular aspirin. With an initiation of treatment the majority of ulcer symptoms quickly disappears, but real recovery demands much bigger time.


Surgical treatment which is carried out now more and more seldom is directed to decrease in secretion of hydrochloric acid or by an antrektomiya, i.e. removal of that site of a stomach where hormone the gastrin strengthening release of pepsin and hydrochloric acid or by means of vagisection, i.e. section of all or some gastric branches of a vagus nerve which are also stimulating secretory processes in a stomach cosecretes. The emergency surgeries are made at a perforation of the ulcer and sometimes at acute or repeated bleeding. Use of H2 blockers along with the general decrease in frequency of heavy ulcers of a duodenum reduced also the frequency of surgical interventions.