Peptic ulcer disease: Difference between revisions

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=== Signs/ Symptoms ===
=== Signs/ Symptoms ===
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=== '''Related entities''' ===
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* Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of cases
* Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of cases
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*[[Gastritis]]
*[[GERD, Gastroesophageal Reflux Disease|GERD]]
*[[Dyspepsia]]
*[[Flatulent remedies|Flatulence]]
*Nausea
*Vomiting
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!
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!Key Sign / Symptom
!Key Sign / Symptom
! colspan="2" |
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!Modalities
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| rowspan="4" |'''H. Pylori Infection With Peptic Ulcers'''
| rowspan="4" |'''<big>H. Pylori + Peptic Ulcers</big>'''
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=== [[Arg-n, Argentum Nitricum|Arg-n]] ===
=== [[Arg-n, Argentum Nitricum|Arg-n]] ===
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* Belching, nausea, vomiting may appear along with  radiating pains.
* Belching, nausea, vomiting may appear along with  radiating pains.
* Stomach ulcer + Abdominal distension
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* In abdominal distension Arg-n is one of the most effective remedies for stomach ulcers.
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=== [[Kali-bi, kalium Bichromicum|Kali-bi]] ===
=== [[Kali-bi, kalium Bichromicum|Kali-bi]] ===
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* Gastric symptoms include burning pain in abdomen, belching and nausea.  
* Burning pain in abdomen + Belching + Nausea.
* All these symptoms get better with eating.
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* Amel with eating
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=== [[Graph, Graphites|Graph]] ===
=== [[Graph, Graphites|Graph]] ===
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=== [[Uran-n, Uranium Nitricum|Uran-n]] ===
=== [[Uran-n, Uranium Nitricum|Uran-n]] ===
|'''Uranium Nitricum''' is useful when burning pain, nausea, vomiting, bloating and burping are present.
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* Burning pain+ Nausea/ Vomiting + Bloating/ Burping
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|'''Stomach Burning'''
| rowspan="2" |'''<big>Stomach Burning</big>'''
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=== [[Ars, Arsenicum Album|Ars]] ===
=== [[Ars, Arsenicum Album|Ars]] ===
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* Burning sensation is very severe
* Severe Burning sensation
* Night agg
* Weakness and weight loss may also attend.
* Warm drinks amel
* Nausea / Vomiting may appear after eating or drinking something.
* Sight or smell of food may trigger nausea and vomiting in such cases.
* Weakness and weight loss may also attend. The use of this medicine is also indicated for
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* Stitching/ Stinging pain in abdomen.  
* Stitching/ Stinging pain in abdomen.  
* '''Gastritis''' as well as '''peptic ulcers.'''
* '''[[Gastritis]]'''  
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* Night agg
* Warm drinks amel
* Nausea / Vomiting after eating or drinking (Even Slight or smell of food)
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|'''Stomach Burning And Vomiting'''
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=== [[Nux-v , Nux Vomica|Nux-v]] ===
=== [[Nux-v , Nux Vomica|Nux-v]] ===
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* V'''omiting after eating any solid or liquid food,'''  
* '''Stomach Burning And Vomiting'''
* Even the smallest quantity of water is not tolerable and vomited soon.  
* V'''omiting after eating any solid or liquid food'''  
* Rumbling and gurgling in the abdomen
* Even the smallest quantity of water is not tolerable and vomited soon.
* Abdomen feels distended with gas.  
* Abdomen Rumbling and gurgling
* '''Pain is felt in the abdomen'''  and passing stool brings momentary relief from pain.
* Abdomen feels distended with gas.
 
* '''Pain is felt in the abdomen''' 
*Stomach region is touch sensitive
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* Nausea, Vomiting, Eructation's, Flatulence, Heartburn
* Tightness/ Pressure in stomach after eating / Stomach region is touch sensitive
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* Eating even the smallest amount of food.
* Passing stool brings momentary relief from pain.
* Spicy food,
* Eating even a little
* Spicy food
* [[Cigarette smoke poisoning|Tobacco]], Coffee
* [[Cigarette smoke poisoning|Tobacco]], Coffee
* Alcoholic drinks
* Alcoholic drinks
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* Nausea, Vomiting, Eructation's, Flatulence, Heartburn are concomitants
* Tightness and pressure may be felt in the stomach after eating.
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|'''Gastric round ulcer'''
|'''<big>Gastric round ulcer</big>'''
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=== [[Kali-bi, kalium Bichromicum|Kali-bi]] ===
=== [[Kali-bi, kalium Bichromicum|Kali-bi]] ===
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* '''Gastric round ulcer''' cases with a feeling of heaviness in the stomach soon after eating.
* '''Gastric round ulcer''' +Heaviness in stomach soon after eating.
* Stomach load.
* Stomach load.
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|Low appetite in stomach ulcers.
* Low appetite in stomach ulcers.
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|'''H. Pylori Infection + Bloated In Lower Abdomen'''
|'''<big>H. Pylori + Bloated In Lower Abdomen</big>'''
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=== Lyc ===
=== Lyc ===
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* Stomach ulcers + Burning, Constrictive pains
* Stomach ulcers + Burning
* Constrictive pains
* Marked  Abdominal Fullness/ [[Flatulent remedies|Flatulence]] esp '''in the lower part.'''  
* Marked  Abdominal Fullness/ [[Flatulent remedies|Flatulence]] esp '''in the lower part.'''  
* Dyspepsia, gas and burping.
| colspan="2" |
* Little eating leads to a distended abdomen
* Little eating leads to a distended abdomen
* Dyspepsia, gas and burping.
* Pain amel from taking warm water.
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* Bloating starts soon after eating.
* Bloating starts soon after eating.
* Pain amel from taking warm water.
* Agg: Farinaceous food like Cabbage and Beans
* Agg: Farinaceous food like Cabbage and Beans
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|'''Bloated Abdomen And Burping'''
|'''<big>Bloated Abdomen And Burping</big>'''
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=== [[Carb-v, Carbo vegetabilis|Carb-v]] ===
=== [[Carb-v, Carbo vegetabilis|Carb-v]] ===
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* Epigastric area may also be sensitive and tender to touch.
* Epigastric area may also be sensitive and tender to touch.
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|'''Constant sore feeling in the stomach'''
|'''<big>Constant sore feeling in stomach</big>'''
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=== [[Hydr, Hydrastis Canadensis|Hydr]] ===
=== [[Hydr, Hydrastis Canadensis|Hydr]] ===
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* Treating stomach ulcers +  Weight loss/ [[Emaciation]]
* Stomach ulcers +  Weight loss/ [[Emaciation]]
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| colspan="2" |
* Weakness and a loathing of food in epigastrium
* Weakness and a loathing of food in epigastrium
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* Cutting / Sharp pain in stomach
* Cutting / Sharp pain in stomach  
* Chronic [[gastritis]] / [[Cancer]]
*
* Chronic gastritis
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|'''Vomiting immediately after eating'''  
|'''<big>Vomiting immediately after eating</big>'''
|[[Graph, Graphites|Graph]]
|[[Graph, Graphites|Graph]]
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* Gastric ulcers with vomiting immediately after eating food
* Constrictive / Burning pain in stomach after eating.
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* Constrictive and burning pain in the stomach after eating.
* Excessive belching, the taste of ingesta is also present
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* Excessive belching, the taste of ingesta is also present
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|'''Burning Sensation amel By Cold Drinks'''
|'''<big>Burning Sensation amel By Cold Drinks</big>'''
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=== [[Phos, Phosphorus|Phos]] ===
=== [[Phos, Phosphorus|Phos]] ===
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* When a cold drink relieves pain of stomach ulcers.
* Nausea/ Vomiting,  
* Nausea/ Vomiting, bitter or sour burping  
* Bitter or sour burping
* Soreness is felt in the pit of the stomach.
* Soreness in the pit of stomach.
* '''Gastritis''' and '''peptic ulcers'''. ([[Ars, Arsenicum Album|Ars]])   
* '''Gastritis''' + '''Peptic ulcers'''. ([[Ars, Arsenicum Album|Ars]])   
|Burning in the stomach after eating
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* Bitter belching
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* ُBitter belching may also be experienced in such cases.
* ُBurning in the stomach after eating
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|'''H.Pylori Infection With Marked Abdomen Pain'''
|'''<big>H.Pylori +  Marked Abdomen Pain</big>'''
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=== [[Coloc, Colocynthis|Coloc]] ===
=== [[Coloc, Colocynthis|Coloc]] ===
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* '''H.Pylori''' is characterized by agonizing, cutting pain in the abdomen.  
* '''Agonizing''', cutting pain in abdomen.  
* Pain of colicky, gripping nature i
* Pain of colicky, gripping nature i
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* Pressure and bending double ( bending forward and downward at the waist)relieves pain.
* [[Gastritis]]
|It is well indicated to manage gastritis.
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* Pressure amel
* Bending double and downward amel
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|'''Burps Having Sour Taste'''
|'''<big>Sour / Acrid Taste Burps</big>'''  
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=== [[Nat-p, Natrium Phosphoricum|Nat-p]] ===
=== [[Nat-p, Natrium Phosphoricum|Nat-p]] ===
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* B'''elching of sour, acrid nature'''.
* Water-brash +  Belching.
* Water brash may appear along with belching.  
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* Intense acidity and flatulence is also marked.
* Intense acidity and flatulence
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|'''Belching'''
|'''<big>Belching</big>'''
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=== [[Ant-c, Antimonium Crudum|Ant-c]] ===
=== [[Ant-c, Antimonium Crudum|Ant-c]] ===
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* It is recommended when '''belching is constant'''.
* '''Constant belching'''  
* Belching in such cases tastes mainly of eaten food.  
* Belching tastes of eaten food.
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* [[Dyspepsia]] and vomiting may also be present.
* [[Dyspepsia]] and vomiting
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=== [[Ip, Ipecacuanha|Ip]] ===
=== [[Ip, Ipecacuanha|Ip]] ===
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* Nausea is present all the time.
* Constant Nausea
* Vomiting of white glairy mucus or food appears
* Vomiting of white glairy mucus or food  
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* Nausea is not relieved even after vomiting
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* Nausea is not relieved even after vomiting
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{| class="wikitable"
{| class="wikitable"
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== Banerji protocols ==
== Banerji protocols ==
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|First line
|'''First line'''
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* Ars C3 one dose every 3 hour or 15 min before food
* [[Ars, Arsenicum Album|Ars]] C3 one dose every 3 hour or 15 min before food
* Lyc C200 one dose every 2 days
* [[Lyc , Lycopodium clavatum|Lyc]] C200 one dose every 2 days
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|Second line
|'''Second line'''
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* Nat-p C30 two doses daily
* [[Nat-p, Natrium Phosphoricum|Nat-p]] C30 BD
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|Third line
|'''Third line'''
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* Symph 0 two doses daily
* [[Symph, Symphytum Officinale|Symph]] 0 two doses daily
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* '''[[NP, Tissue Salt Remedy|NP]]''': His stomach is sour and acidic. Sour vomiting, Eructation and sour reflux, sour diarrhea
* '''[[NP, Tissue Salt Remedy|NP]]''': His stomach is sour and acidic. Sour vomiting, Eructation and sour reflux, sour diarrhea


===Related entities===
*
*[[Gastritis]]
*[[GERD, Gastroesophageal Reflux Disease|GERD]]

Latest revision as of 11:22, 9 January 2024

Clinic

  • PUD is a break in the inner lining of the stomach, the first part of the small intestine, or sometimes the lower esophagus
    • Gastric/ Stomach ulcer: Pain may worsen with eating.
    • Duodenal ulcer: Ulcer of the first part of the intestines : Waking at night with upper abdominal pain + Upper abdominal pain that improves with eating.
    • Gastrin is a peptide hormone that stimulates secretion of gastric acid y Parietal cells of the stomach and aids in gastric motility.

Signs/ Symptoms

Related entities

  • Abdominal pain, classically epigastric, strongly correlated with mealtimes.
  • In case of duodenal ulcers, the pain appears about three hours after taking a meal and wakes the person from sleep;
  • Bloating and abdominal fullness;
  • Waterbrash
  • Nausea and copious vomiting;
  • Loss of appetite and weight loss, in gastric ulcer
  • Weight gain, in duodenal ulcer, as the pain is relieved by eating
  • Hematemesis
  • Melena
  • Rarely, an ulcer can lead to a gastric or duodenal perforation, which leads to acute peritonitis and extreme, stabbing pain, and requires immediate surgery.
  • Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of cases

Causes

Dynamic Static Viral
Common
  • Helicobacter pylori
  • NSAIDs
 DHF
Uncommon
  • Behçet's disease,
  • Crohn's disease
  • Liver cirrhosis
  • Vasculitis
  • Tobacco smoking
  • Stress as a result of other serious health conditions
  • Zollinger–Ellison syndrome
  • Gastrin-secreting tumors
  • Gastric ischaemia
  • Metabolic disturbances
  • Upper abdominal radiotherapy
  • CMV
  • EBV
  • HSV-1
  • HSV- 2

Remedies

Key Sign / Symptom Modalities
H. Pylori + Peptic Ulcers

Arg-n
  • Best remedy for stomach ulcers.
  • Sharp Ulcerative/ Burning pain in stomach
  • Pain radiates to other regions of abdomen.
  • Sometimes gnawing in nature.
  • Belching, nausea, vomiting may appear along with radiating pains.
  • Stomach ulcer + Abdominal distension

Kali-bi
  • Burning pain in abdomen + Belching + Nausea.
  • Amel with eating

Graph

Uran-n
  • Burning pain+ Nausea/ Vomiting + Bloating/ Burping
Stomach Burning

Ars
  • Severe Burning sensation
  • Weakness and weight loss may also attend.
  • Stitching/ Stinging pain in abdomen.
  • Gastritis
  • Night agg
  • Warm drinks amel
  • Nausea / Vomiting after eating or drinking (Even Slight or smell of food)

Nux-v
  • Stomach Burning And Vomiting
  • Vomiting after eating any solid or liquid food
  • Even the smallest quantity of water is not tolerable and vomited soon.
  • Abdomen Rumbling and gurgling
  • Abdomen feels distended with gas.
  • Pain is felt in the abdomen 
  • Nausea, Vomiting, Eructation's, Flatulence, Heartburn
  • Tightness/ Pressure in stomach after eating / Stomach region is touch sensitive
  • Passing stool brings momentary relief from pain.
  • Eating even a little
  • Spicy food
  • Tobacco, Coffee
  • Alcoholic drinks
Gastric round ulcer

Kali-bi
  • Gastric round ulcer +Heaviness in stomach soon after eating.
  • Stomach load.
  • Low appetite in stomach ulcers.
H. Pylori + Bloated In Lower Abdomen

Lyc
  • Stomach ulcers + Burning
  • Constrictive pains
  • Marked Abdominal Fullness/ Flatulence esp in the lower part.
  • Dyspepsia, gas and burping.
  • Little eating leads to a distended abdomen
  • Pain amel from taking warm water.
  • Bloating starts soon after eating.
  • Agg: Farinaceous food like Cabbage and Beans
Bloated Abdomen And Burping

Carb-v
  • Stomach ulcers + Burning pain / soreness
  • Stomach ulcers + Sour belching/ Heartburn.
  • Stomach Pain extend to back.
  • Bloating of abdomen is a major concern.
  • Eating the smallest amount of food, even light food, agg the symptoms
  • Sour burps are prominent
  • Distension of abdomen with flatus.
  • Epigastric area may also be sensitive and tender to touch.
Constant sore feeling in stomach

Hydr
  • Weakness and a loathing of food in epigastrium
  • Cutting / Sharp pain in stomach
  • Chronic gastritis / Cancer
Vomiting immediately after eating Graph
  • Constrictive / Burning pain in stomach after eating.
  • Excessive belching, the taste of ingesta is also present
Burning Sensation amel By Cold Drinks

Phos
  • Nausea/ Vomiting,
  • Bitter or sour burping
  • Soreness in the pit of stomach.
  • Gastritis + Peptic ulcers. (Ars)
  • Bitter belching
  • ُBurning in the stomach after eating
H.Pylori + Marked Abdomen Pain

Coloc
  • Agonizing, cutting pain in abdomen.
  • Pain of colicky, gripping nature i
  • Pressure amel
  • Bending double and downward amel
Sour / Acrid Taste Burps

Nat-p
  • Water-brash + Belching.
  • Intense acidity and flatulence
Belching

Ant-c
  • Constant belching
  • Belching tastes of eaten food.
H. pylori + Intense Nausea/Vomiting

Ip
  • Constant Nausea
  • Vomiting of white glairy mucus or food
  • Nausea is not relieved even after vomiting

Banerji protocols

First line
  • Ars C3 one dose every 3 hour or 15 min before food
  • Lyc C200 one dose every 2 days
Second line
Third line

Tissue Salt Remedies

  • NP: His stomach is sour and acidic. Sour vomiting, Eructation and sour reflux, sour diarrhea
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