Real Health. Real Simple .
by Samuel Snyder, D. O.
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About The Author
Created by Christopher Green R.N. B.A.
Dr. Samuel Snyder is Associate Professor and Chair of Internal Medicine at Nova Southeastern University College of Osteopathic Medicine. He is a Fellow of the American College of Physicians, the American Society of Nephrology, and the American College of Osteopathic Internists. He is board certified in both Internal Medicine and Nephrology. He writes scientific and popular articles and lectures widely on a wide range of medical subjects.
What is Peptic Ulcer Disease?
eptic ulcers are inflamed craters in the stomach or duodenum, the tube
connecting stomach to small bowel. This painful condition often kicks
up late at night, causing sharp or burning pain right in the gut. The
ulceration can be severe enough to cause bleeding, and the first sign
of trouble might be throwing up red blood.
Years ago, having an ulcer in the stomach meant a person was sentenced to a diet of soft, bland, creamy foods. The thought then was that these would soothe the ulcer, and speed healing by neutralizing excess stomach acid, which we supposed was the culprit. But it didn’t work. In fact, some of those foods increase acid secretion by the stomach.
Gradually medications were developed that actually suppressed acid secretion. The first of these were the H-2 blockers. It turns out that stomach acid secretion is stimulated by histamine, the same chemical that causese congestion, runny noses and eyes in allergy attacks. H-2 blockers can effectively reduce the histamine stimulated release of stomach acid, and allow ulcers to heal within weeks to months. The most commonly used H-2 blockers are cimetidine (Tagamet™) and ranitidine (Zantac™).
H-2 blockers were superseded by a class of drugs known as proton pump inhibitors. These are somewhat more potent in their ability to reduce acid secretion. Healing begins within days, and symptom relief is rapid. These include omeprazole (Prilosec™), (Prevacid™), (Nexium™), and (Aciphex™).
But it took an unusual leap in medical research to get to the true cause of most ulcers. A young Australian researcher named Barry Marshall noticed some bacteria in microscopic slides of ulcer specimens. He managed to culture the bugs, called Helicobacter pylori. Then he drank a flask of the broth containing several million of them. In a very short period of time, he had the classic symptoms of peptic ulcers, and the diagnosis was confirmed by endoscopy (a fiberoptic scope in his stomach) with a biopsy.
Fortunately, he had figured out the right antibiotics to kill this bacteria.
This revolutionized our understanding of ulcers. Until then, no one expected ulcers to be caused by an infection. We know now that this infection is fairly widespread, and often asymptomatic. Helicobacter is also responsible for most cases of gastritis, a less severe form of inflammation of the stomach lining. This infection can usually be treated successfully by combinations of antibiotics, and there are a number of successful combinations available.
And for this pioneering work, Dr. Marshall won the Nobel Prize in Medicine.
Real Health. Real Simple .