Gastric and Duodenal Ulcers
An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body. When the ulcer is in the stomach, it is called a gastric (peptic) ulcer. When the ulcer is in the duodenum, it is called a duodenal ulcer.
In the past lifestyle factors, such as stress and diet, were believed to cause ulcers. Later, researchers determined that stomach acids contributed to ulcer formation. Today, research shows that most ulcers (80 percent of gastric ulcers and 90 percent of duodenal ulcers) develop as a result of infection with a bacterium called Helicobacter pylori (H. pylori).
Although all three of these factors — lifestyle, stomach acid and H. pylori — are believed to play a role in ulcer development, H. pylori is considered to be the primary cause.
Factors suspected of playing a role in the development of stomach or duodenal ulcers are Helicobacter pylori, the bacteria producing substances that weaken the stomach's protective mucosa and make it more susceptible to the damaging effects of acid and pepsin.
Smoking. Smoking increases the chances of getting an ulcer, slows the healing process of existing ulcers, and contributes to ulcer recurrence.
Caffeine. Caffeine seems to stimulate acid secretion in the stomach, which can aggravate the pain of an existing ulcer
Alcohol. Ulcers are often linked to heavy alcohol consumption.
Stress. Although emotional stress is no longer thought to be a cause of ulcers, people with ulcers often report that emotional stress increases ulcer pain.
Acid and pepsin. The stomach's inability to defend itself against gastric acids - hydrochloric acid and pepsin - is believed to contribute to ulcer formation.
Non-steroidal anti-inflammatory drugs. These drugs (such as aspirin, ibuprofen and others) make the stomach vulnerable to the harmful effects of acid and pepsin.
The most common ulcer symptom is a gnawing or burning pain in the abdomen between the breastbone and the navel. The pain often occurs between meals and early in the morning. It may last from a few minutes to a few hours. Less common ulcer symptoms include belching, nausea, vomiting, bloody or dark tarry stools, poor appetite, loss of weight, malaise, and fatigue.
People with ulcers may experience serious complications. The most common problems include bleeding, perforation, narrowing and obstruction of intestinal opening, peritonitis.
Recommended treatment may include:
Lifestyle changes. People with ulcers should avoid spicy, fatty, or acidic foods. Smoking has been shown to delay ulcer healing and has been linked to ulcer recurrence; therefore, people with ulcers should not smoke.
Medications. Gastric and duodenal ulcers are treated with several types of medications to reduce the amount of acid in the stomach. When treating H. pylori, these medications are often used in combination with antibiotics.
Surgery. In most cases, anti-ulcer medicines heal ulcers quickly and effectively, and eradication of H. pylori prevents most ulcers from recurring. However, people who do not respond to medication or who develop complications may require surgery.
Exercise 6. Complete the sentences and answer them:
What ulcers are called ... ?
What lifestyle factors were believed ...?
What is the ... cause of ulcers?
How does H. pylori affect the stomach and cause ...?
Why does smoking play a role in ...?
... increases ulcer pain?
What complications ...?
... should people with ulcers avoid?
What types of medications ...?
When may a surgical operation ...?
Exercise 7. Look through the text and find out expressions synonymic to the given ones:
The major cause, to make pain worse, bad effects, acid production, to decrease the amount of acid, alcohol intake, need the operation, hemorrhage, medicines for ulcer.
Exercise 8. What ulcer symptoms are described below?
the feeling of being about to vomit;
expelling wind from the stomach noisily through the mouth;
a general feeling of being unwell;
the reflex action of ejecting the content of the stomach through the mouth;
mental or physical tiredness;
the creation of a hole in the intestines
Exercise 9. Fill in the table “Gastric and duodenal ulcers”:
|
|
|
|
Causes |
|
|
Symptoms |
|
|
Complications |
|
|
Treatment |
|
Definition
Exercise 10. Translate into your native language:
a) Make up the questions to the underlined parts of the sentences:
Case Presentation
Harold, a fifty-eight year old grocery store manager, had recently been waking up in the middle of the night with abdominal pain. This was happening several nights a week. He was also experiencing occasional discomfort in the middle of the afternoon. Harold decided to schedule an appointment with his physician.
The doctor listened as Harold described his symptoms and then asked Harold some questions. He noted that Harold's appetite had suffered as a result of the pain he was experiencing and as a result of the fear that what he was eating may be responsible for the pain. Otherwise, Harold seemed fine.
b). Open the brackets:
The doctor (to refer) Harold to a physician that specialized in internal medicine and had Harold make an appointment for a procedure called an endoscopy. The endoscopy (to perform) at a hospital later that week. During the procedure, a long, thin tube (to insert) into Harold's mouth and directed into his digestive tract. The end of the tube was equipped with a light source and a small camera which (to allow) the doctor to observe the interior of Harold's stomach. The endoscope was also equipped with a small claw-like structure that the doctor (can) use in order to obtain a small tissue sample from the lining of Harold's stomach, if required.
The endoscopy (to reveal) that Harold (to have) a peptic ulcer. Analysis of a tissue sample taken from the site showed that Harold also (to have) an infection that was caused by Helicobacter pylori bacteria. The doctor who performed the endoscopy gave Harold prescriptions for two different antibiotics and a medication that (to decrease) the secretion of stomach acid. The doctor also (to instruct) Harold to schedule an appointment for another endoscopy procedure in 6 months.
Exercise 11. Translate into English:
Спіралевидна паличковидна грамнегативна бактерія; виразка шлунку; дуоденальна виразка; сприяти утворенню виразки; захисна слизова шлунку; вразливий до інфекції; дія пепсину та кислоти; рецидив виразки; процес загоювання; секреція кислоти; погіршувати біль; надмірне споживання алкоголю; нездптність захищатися; соляна кислота та пепсин; нестероїдні та противозапальні препарати; уразливий до шкідливої дії кислоти; тривати декілька годин; відчувати болісний ниючий та пекучий біль; затримувати процес загоювання; втрата ваги та апетиту; піддаватися лікуванню; ускладнення після перітоніту
Exercise 12. Finish the sentence using Complex Subject:
Gastric and duodenal ulcers are known …
спричиняються різними факторами;
характеризуються ниючим або гострим болем у верхній частині живота;
призводять до внутрішнькровотечі;
часто розвиваються у курців;
часто пов'язані з надмірним вживанням алкоголю;
лікуються швидко та ефективно;
викликаютьнудоту, відрижку, блювання
Exercise 13. Change the sentences using Complex Subject:
It is known that spring and autumn are those seasons when the patients with ulcer suffer from the recurrence of the disease.
It is considered that constant fatigue, the lesion of the nervous system and past diseases contribute to the onset of gastritis.
It has been found that gastric and duodenal ulcers develop more frequently in men than in women.
It is considered that too hot or too cold food contributes to the development of gastric disorders.
It is known that excessive amount of gastric acids causes irritation of the stomach mucosa.
It was supposed that complications were caused by profuse haemorrhage.
It is likely that the patient has obstruction of intestinal opening.
It is observed that in severe forms of gastritis acid secretion is completely reduced.
Exercise 14.* Compose a case history of the patient with ulcer. Use the given expressions:
Patient B. was admitted ....
He/she complained of ...
On physical examination ...
Analyses of gastric juice ...
Stool tests ...
The endoscopic examination ...
The patient was administered ...
The course of the disease was ...
The patient was recommended ...
The patient was discharged ...