THE STOMACH

I have stomach trouble a lot of paint and nause. I thing i have gastritis, but i amtold

there are several kinds. Is it so?

Basicialy, gastritis is an inflammation of the mucous lining of the stomach. Symptoms

include pain, nausea, vomiting. Vomiting blood, and blood in the faeces. Because the

problem ia usully classified as either chronic or acute, you could indeed say there are

different types.

Acute gastritis is more intense. It doesn’t last lonng as chronic gastritis,

however, and if you have acute gastritis, the mucous lining of your stomach will, in

most cases, return to normal. Alcohol and aspirin are prime suspects; tobacco and

coffee can be, too, as can any drug or irritant that attacks the mucous lining that

protects the stomach. Stress and trauma can also cause disruption. Other episodes

may be triggered by radiation or surgery because intense paint sometimes

accompanies acute gastritis, teh conditions is often mistaken for a stomach ulcer.

The cause of chronic gastritis hasn’t factors that provoke acute gastritis may be

significant, and added to the list of possible cause are endocrine secretions from the

duodenum. It recurs more frequently as you grow older. No one knows for sure if

chronic gastritis leads to stomach ulcers or if stomach ulcers produce gastritis. What

does seem fairly certain is that it is associated whith the development of pernicious

anemia (see p.461).

How are acute and chronic gastritis diagnosed treated?

Tissue examination, gastric endoscopy (see p.126), or a barium swallow (see p.123)

may be used to help diagnose gastritis. Prevention (avoiding the irritants that cause

the problem) is the best treatment cases of acute gastritis, antacids are usually

prescribed. In some cases, they may be supplemented by stronger medications to

subdue to excess acid build-up. Help for patients who are haemorrhaging involves

blood replacement; pH monitoring, in which stomach contents are tested for acidity

and neutralised with antacids or other medicines; and stomach washing for the

removal of blood. In extreme cases, surgery may be recommended.

Chonic gastritis is so poorly undersood that no consistent therapy has been

developed to treat it. Vitamin B12 injections can help cerrect pernicious anaemia

(p.461); surgery may be performed.

My sister says she has gastric eration. Is this samw as gastritis?

Gastric eration is a kind of gastritis, but is potentially more dangerous and usually

affects a specific area of the stomach lining. If your sister is taking aspirin or other anti-

inflammatory drug, she must be careful that they do not aggrevate her condition.

Specific symptoms of gastric erosion involve the appearance of bright red blood in

vomit, or blood (drak red or black) in stools, together with abdominal plain.

New drugs are being developed that create less irritation than aspirin. For the

present, Alka-seltzer provides adequate short-term relief, because it includes an

antacid as well as aspirin. If your sister’s symptoms last longer than two or three days,

enteric-coated aspirin might be helpful. It is designite to bypass the stomach and

dissolve in the intertines and so lessens the chance of erusion.

Be sure to remind yaour sister to take potentially irritating medications (unlesa

contraindicated) immadiately after meals-never on an empty stomach. And whatewer

she swallows should be washed dwon with plenty of water. If she is feeling weak, she

should she her doctor. Loss of blood could be causing anaemia and a feeling of

weakness.

I would like to know the facts about stomach ulcers my doctor thinks i may have one

Ulcers are small pits or craters that penetrale the lining of the stomach (or the

duodenum). This specific and painful penetration is what distinguishes them from the

superficial erosions that cause trouble for gastritis sufferens.

Stomach ulcers and doudenal ulceres (see p.215) are also referred to as peptic

ulceres. There is a good reason for this. If you have stomach ulcers, the probable

cause is an imbalance between the hydrochloric acid and pepsin enzymes that digest

food and the protein secretions and mucus that protect the lining of the stomach. There

doesn’t necessarily haveto be an excess of acid and pepsin to cause problems. In fact,

if you have stomach ulcer, you are likely to have either normal or below normal levels

of acid secretion. Imbalance is the key factor here.

In addidtion, a blackflow of bile and pancriatic enzymes from the duodenum can

make things worse; this may happen if the spincter located between the stomach and

duodenum isn’t funcationig properly.

After increasing during the first part of this century, the incidence of ulcers in

Western countries began to drop off in the 1950. There are now fewer people suffering

from gastric ulcers than from duodenal ulceres, but it is gastric not duodenal ulcer

patieants who may develop cancer as a result of their disease.

Some doctors suggest that ‘hunger panges’ that come and go signal stomach

ulcers; others rague that these symptoms are typical of duodenal disease. Universally

recognised symptom for both gastric and duedenal ulcer problems, however include
cramping, aching, nausea and vomiting. Gastric endoscopy (see p,126) is often

preferred to X-rays for diagnostik purposes because it detects ulcers more accurately

and allows for tissue biopsy. Either technique, however, can be followed to rule out or

confrim the presence of cancer.

Who gets stomach ulcers?

For a long time doctors believed that having a certain type of personality or lifestyle

was likely to make someone develop ulceres. Recent studies, however, have cast

doubt on this belief. For in stance, stress has long been considered a critical factor,

but it has now been shown that air traffic controllers, who work under extreme

pressure, have no more ulcers than people selected at random.

Usually gastric ulcer patients are men and woman over 40. Many of them have

been taking some form of steroid drug (see p.476), aspirin or nonsteroidal

antiinflammatory drugs. People with blood type O are slightly more susceptible to

either gatric or duodenal ulcers. There is a higher incidence of ulcers among smokers.

Women past menopause are more likely to develop gastric ulcers a fact that leads

some to suggest that the famale hormone oestrogen plays a part in prevention. People

who have already had ulcers are more likely to get them again near the site of an old

one.

will my doctor recommend antacids or prescription drugs to treat my ulcer?

There are many and various treatments for a gastric ulcer. Your doctor will try

what is most suitable for you. Let’s take a look at what various drugs can do. Antacids

(see p.104) neutralise stomach acids. By doing so, they prevent pepsin from becoming

active. Preseption drugs, on the other hand, such as cimetidine and ranitidine (see

p.202), don’t neutralise acids; they prevent cells from secreting their usual amount.
 Sucralfate (carafate) is another drug that does not reduce acidity. Instead, it

produces a kind of gel that shields the ulcer while the cells regenerate. Sucralfate,

unlike cimetidine and ranitidine, is not easily absorbed, so that relatively few side

effects are experienced. Colloidal bismuth (De-Nol) coats the ulcer and protects its

surface, thus allowing the ulcer to heal. It is claimed that the healing is longer-lasting

than with the use of other drugs, but it cannot be taken an a long-term basis because

of the theoretical risk of bismuth toxicity. Various anticolinergic drugs inhibit gastric

acid and pepsin secretion, and are often used to supplement other preparation.

My stools are black and tarry. Could my stomach ulcer have turned into something

more serious?

Regrettably, yes, your symptoms are frequently a sign of internal blecding,

which occurs in 10 to 15 per cent of gastric ulcer sufferers. A bleeding ulcer (either

gastric or duodenal) is a serious condition.

You might develop anaemia. And if an ulcer cuts into one of the blood vassels,

you my faint, or vomit blood (an indication of haemorrhaging). Bleending is critical in

patients over 60 or those with other serious problems.

Another serious ulcer complication is what is known as perforation. This occurs

in about 10 per cent of ulcer patients and 10 per cent of the time it is made worse by

bleending. The chief symptom is the sudden onset of sharp pain. Perforation occurs

when the ulcer eats throught the acid, food particles and bacteria to spill can cause

peritonitis (see p.226) an infection of the abdominal cavity. Both bleending ulcers and

perforations demand immediate medical attention.

Obstruction is another ulcer complication; it occurs most commonly in the

pyloric channel (between the stomach and the duodenum). In the elderly, particularly,
it results from the build up of scar tissue. Symptoms are nausea, stomach pain,

bloating and vomiting of undigested food.

I had ulcer surgery and now i get sweaty and weak when i drink fizzy lemonade. Why?

You my be experiencing what is known as postoperative dumping sydrome. Your

stomach is smaller and the lemonade you drink now passes rapidly into the small

intestine, which hurries to digest it. Ease up on sweet liquids and desserts until your

system has hed a chance to readjust a change which could take three to ten months.

Eat smaller meals, aswell as high protein, low carbohydrate ones. And if you do

happen to have a large meal, lie down for about 15 minutes after eating.

Another complication of ulcer and other stomach surgary is weight loss. The

stomach capacity is reduced, so it is possible that the intake of kilojoules will be

reduced accordingly.

Besides taking medication, waht can i do to help my stomach ulcer?

Drinking milk is still recommended by some dooctors, but studies have shown that

taking too much can produce a rebround effect. This means that, as a result of drinking

of drinking large quantities of milk, even more stomach acid may be produced.

If you too much alcohol, on the other hand, you can demage the lining of your

stomach, so cutting down on or your eliminating liquor from the diet is always advised

by all doctors. Coffe is also on the forbidden list, because it enhances acid secretions,

especially if drunk on an empty stomach.

Doctors have softened their approach towards diet therapy for ulcers. What

many now suggest is that you note which foods and drinks are bothering you and then

cut out of your diet.

 If you are of smoker,quit, cigarettes may or may not have been responcible for

your ulcer, but they almost centainy aggrevate it now that you have it. Eat several

small meals and day instead of three large ones; the presence of food in the stomach

combats acidity problems. In addition, it is always helpful to avoid stressful situation.

Finally, a piece of advice that is easily overlooked and often sneered at sleep.

Does eating high fibre foods help in preventing ulcers?

Some researchers believe that it can help. They maintain that when eating hig

fibre food (seenp.199), you must chew more thoroughly. This activity makes the

salivary glands produce more salivia, which acts as an acid buffer in the stomach.