colombo agr

Peptic ulcer disease

Other Peptic ulcer, stomach ulcer, gastric

names ulcer, duodenal ulcer

Deep gastric ulcer

Specialty Gastroenterology

General surgery

Symptoms Heartburn, upper abdominal pain,

nausea, belching, vomiting, blood in
the stool, weight loss, weight gain,
[1]
bloating, loss of appetite yellowing

of the skin and whites of the eyes

difficulty swallowing
 Complicatio Bleeding, perforation, ulcer
ns perforation, blockage of the
[2]
stomach

Causes Helicobacter pylori bacteria,

non-steroidal anti-inflammatory
drugs(NSAIDs), tobacco smoking,
[1][3]
Crohn's disease

Diagnostic Based on symptoms, confirmed by

method [1]
endoscopy or barium swallow

Differential Stomach cancer, coronary heart

diagnosis disease, inflammation of the stomach
[1]
lining, gallbladder inflammation

Treatment [1]
Medications, stopping NSAIDs,

stopping smoking, stopping alcohol

consumption

Medication Proton pump inhibitor, H2 blocker,

[1][4]
antibiotics

Frequency [5]
87.4 million (2015)

Deaths [6]
267,500 (2015)

Peptic ulcer disease (PUD) is a break in the inner lining of the stomach, the first part of the small
[1][7]
intestine, or sometimes the lower esophagus. An ulcer in the stomach is called a gastric ulcer,
[1]
while one in the first part of the intestines is a duodenal ulcer. The most common symptoms of a
duodenal ulcer are waking at night with upper abdominal pain and upper abdominal pain that
[1] [8]
improves with eating. With a gastric ulcer, the pain may worsen with eating. The pain is often
[1]
described as a burning or dull ache. Other symptoms include belching, vomiting, weight loss, or
 [1] [1]
poor appetite. About a third of older people have no symptoms. Complications may include
[2]
bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of
[2]
cases.

Common causes include the bacteria Helicobacter pylori and non-steroidal anti-inflammatory drugs
[1]
(NSAIDs). Other, less common causes include tobacco smoking, stress as a result of other serious
health conditions, Behçet's disease, Zollinger–Ellison syndrome, Crohn's disease, and liver
[1][3] [1]
cirrhosis. Older people are more sensitive to the ulcer-causing effects of NSAIDs. The
diagnosis is typically suspected due to the presenting symptoms with confirmation by either
[1]
endoscopy or barium swallow. H. pylorican be diagnosed by testing the blood for antibodies, a
[1]
urea breath test, testing the stool for signs of the bacteria, or a biopsy of the stomach. Other
conditions that produce similar symptoms include stomach cancer, coronary heart disease, and
[1]
inflammation of the stomach lining or gallbladder inflammation.

[9]
Diet does not play an important role in either causing or preventing ulcers. Treatment includes
stopping smoking, stopping use of NSAIDs, stopping alcohol, and taking medications to decrease
[1]
stomach acid. The medication used to decrease acid is usually either a proton pump inhibitor (PPI)
[1]
or an H2 blocker, with four weeks of treatment initially recommended. Ulcers due to H. pylori are
[4]
treated with a combination of medications, such as amoxicillin, clarithromycin, and a PPI. Antibiotic
[4]
resistance is increasing and thus treatment may not always be effective. Bleeding ulcers may be
[2]
treated by endoscopy, with open surgery typically only used in cases in which it is not successful.

[1]
Peptic ulcers are present in around 4% of the population. New ulcers were found in around 87.4
[5]
million people worldwide during 2015. About 10% of people develop a peptic ulcer at some point in
[10] [6][11]
their life. Peptic ulcers resulted in 267,500 deaths in 2015, down from 327,000 in 1990. The
[2]
first description of a perforated peptic ulcer was in 1670, in Princess Henrietta of England. H. pylori
was first identified as causing peptic ulcers by Barry Marshall and Robin Warren in the late 20th
[4] [12]
century, a discovery for which they received the Nobel Prize in 2005.

ee that it’s essential to wash your face thoroughly with lukewarm water and a
gentle cleanser before applying any other products.
This allows you to start with a clean slate and prevents other products from
washing off.

Landriscina suggests keeping it basic and avoiding something that strips the
skin. However, figuring out what that means for you may not be an exact
science.

“It’s a trial and error thing,” he says.

Plus, what works now may not be best for you in 10 years.

“The right fit may change,” Landriscina says. “As we get older, our skin gets
drier.”

He says your best bet is to start with something designed for sensitive skin, as
that’s least likely to cause irritation.

If you know your skin type, Colombo suggests opting for something designed
for it.

For example, people with oily or acne-prone skin often do best with a foaming
cleanser, whereas people with normal or dry skin typically prefer gentle,
nonfoaming options.

Colombo suggests Cetaphil Dermacontrol Foaming Cleanser for oily skin and
Cerave Hydrating Cleanser for dry skin.

Moisturizer
Landriscina explains that the skin is designed to keep the outside out (dirt,
bacteria) and inside in (organs, bones, and joints).

However, it can lose water. That’s where moisturizer comes in.

“Using a good moisturizer repairs skin barrier function and holds in water,”
Landriscina says.

Landriscina recommends:

● La Roche-Posay Cicaplast Balm B5 for those with dry skin.

● Naturium Multi-peptide Moisturizer for people with normal skin.
● Neutrogena Hydroboost Gel Cream for those with oily skin.

Sunscreen

Though some moisturizers have SPF 15, Landriscina and Colombo say it’s
essential to apply sunscreen and reapply it every 2 hours if you’re exposed to
the sun.

They recommend a broad-spectrum sunscreen, which blocks both harmful

UVA and UVB rays. Look for one that is at least SPF 30.

“UV rays and UV radiation are the primary modifiable risk factor when it
comes to skin cancer risk,” Landriscina says. “Using sunscreen every day
consistently the correct way is one of the best things you can do to prevent
skin cancer.”

Skin cancer is the most common cancer in the United States, according to the
American Academy of Dermatology Association (AAD).
Sunscreen should always go on after cleanser and moisturizer. Allow it to dry
before applying makeup.

“It has to form an even film over the skin,” Landriscina explains. “Putting skin
care products on after it can disrupt it.”

Nice-to-have skin care products

Another study from 2015

Trusted Source

suggested that topical application of products containing Ubiquinone (coQ10)

could reduce free radicals.

A 2016 systematic review

Trusted Source

notes that early evidence shows tumeric could have a positive effect on skin
health if applied topically or taken orally.

Landriscina says antioxidants are often present in moisturizers, so you may

not need an extra product. You can also find them in serums. Colombo
recommends Vidaderma Vitamin C serum.
Hydrating serum

Though a quality moisturizer should do the trick, a hydrating serum can be

particularly useful for people with dry skin or who live in drier climates.

Landriscina recommends looking for one with hyaluronic acid and glycerin.

“They are humectants and lock in hydration,” Landriscina says.

A 2012 study

Trusted Source

suggested that hyaluronic acid could hydrate the skin, but a 2021 study

Trusted Source

indicated that these benefits depend on the molecular weight.

The AAD lists glycerin as an ingredient in creams or ointments that can help
relieve dry skin.

Retinol or retinoids

Retinols and retinoids can be great for aging skin.

Colombo explains that retinols are available over the counter, whereas
retinoids require a prescription from a dermatologist or primary care physician.

A 2016 study
Trusted Source

found that topical application of retinoids significantly reduces wrinklesafter

12 weeks.

Skin care items you can live

without
Landriscina and Colombo believe skin care is about quality, not quantity.
Some tools appear more valuable than they actually are.

They recommend steering clear of:

● Cleansing brushes. They can be harsh on the skin. “Two clean hands
are a perfect way to clean the skin,” Landriscina says.
● One-time use facial masks. “They’re like cloth masks soaked in a
hydrating serum,” Landriscina says. He adds that a hydrating serum can
be used multiple times, so it’s more budget-friendly and better for the
environment to opt for a bottle.
● Skin oils. “For most people, those don’t moistu