Ulcers symptomatic

Ulcers symptomatic. Symptomatic stomach ulcers are acute or chronic focal lesions of the gastric mucosa, etiology and pathogenesis are different from peptic ulcer and are only one of the local gastric manifestations of the pathological state of the organism caused by various factors.

Etiology, pathogenesis. Symptomatic stomach ulcers include: a) ulcers "medicinal" (with prolonged uncontrolled intake of acetylsalicylic acid and its derivatives, derivatives of pyrazolone, indole, histamine, glucocorticosteroids, etc.); B) "hypoxic ulcers", concomitant atherosclerosis, hypertension, cardiac congestive failure, chronic pneumonia, emphysema: c) "hormonogenic ulcers" in hyperparathyroidism, ulcerogenic pancreatic tumors (Zollinger-Ellison syndrome), etc.; D) acute stress ulcers with myocardial infarction, burn disease, stroke, etc.;) ulcers with hepatitis and cirrhosis of the liver. The emergence of symptomatic gastric ulcers is often promoted by a combination of predisposing factors. Thus, in healthy individuals, long-term administration of derivatives of salicylic acid and glucocorticoids rarely causes ulceration of the gastric mucosa, while the use of the same drugs by patients with active rheumatism and rheumatic heart defects in the presence of circulatory insufficiency dramatically increases the incidence of symptomatic stomach ulcers (less often of the duodenum) .

Symptoms and course of symptomatic stomach ulcers are polymorphic. They can be asymptomatic for some time, masking the clinical manifestations of the main suffering (myocardial infarction, chronic pneumonia, hypertension, atherosclerosis, etc.), there may be an undetermined character of abdominal pain and dyspepsia, sometimes the disease proceeds with the typical symptomatology of peptic ulcer. When X-ray examination, gastroscopy reveals a peptic niche in the stomach, as with peptic ulcer. For diagnosis, anamnesis (for example, taking "ulcerogenic" medications) and examination (revealing diseases in which symptomatic gastric ulcers are often found, and establishing the relationship between these diseases and ulceration of the gastric mucosa) is of significant importance.

Tuberculosis gastric ulcers usually occur in the terminal stage of pulmonary tuberculosis. To exclude the cancer ulcer of the stomach (primary-ulcer form of cancer), a gastroscopy with targeted biopsy is necessary.

Symptomatic stomach ulcers can be acute ("stressful", etc.) and chronic (medicamentous, with cirrhosis, chronic pneumonia, atherosclerosis, etc.). Complications: perforation of the ulcer and ulcerous bleeding, often occurring on a relatively "quiet background", with no complaints from the digestive system.

Treatment - as with peptic ulcer. The main disease is treated. With "medicinal" ulcers, the drug that caused ulceration is canceled.

Prevention of symptomatic gastric ulcers is the timely treatment of diseases that are often complicated by symptomatic gastric ulcers during long-term treatment of patients with drugs that have a side effect "ulcerogenic" -systematic clinical and radiological monitoring of the stomach, examination of feces for latent blood every 3-4 days, preventive appointment Sparing diet, antacids and astringents.

The prognosis for timely detection and treatment is relatively favorable.