Peptic ulcer disease

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
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 Triggers
Arg-n	Best remedy for stomach ulcers. Sharp Ulcerative/ Burning pain is felt in stomach Pain radiates to other regions of the abdomen.		Sometimes gnawing in nature. Symptoms such as belching, nausea, vomiting may also appear along with these radiating pains. In abdominal distension Arg-n is one of the most effective remedies for stomach ulcers.
Nux-v	Stomach ulcer that stomach region is touch sensitive Tightness and pressure may be felt in the stomach after eating.	Eating even the smallest amount of food. Spicy food, Tobacco, Coffee Alcoholic drinks	Nausea, Vomiting, Eructation's, Flatulence, Heartburn are concomitants
Kali-bi	Gastric round ulcer cases with a feeling of heaviness in the stomach soon after eating. Stomach load.		Low appetite in stomach ulcers.
Lyc	Stomach ulcers + Burning, Constrictive pains Marked Flatulence Abdominal Fullness/ Bloating	Bloating starts soon after eating. Pain amel from taking warm water. Agg: Farinaceous food like Cabbage and Beans
Carb-v	Stomach ulcers + burning pain Stomach ulcers + Sour belching/ Heartburn. Pain may extend from stomach to back.	Eating the smallest amount of food, even light food, agg the symptoms	Epigastric area may also be sensitive and tender to touch.
Hydr	Treating stomach ulcers + Weight loss/ Emaciation. Key symptom: Constant sore feeling in the stomach.		Cutting and sharp pain in the stomach may also be present Weakness and a loathing of food in epigastrium Chronic gastritis
Graph	Gastric ulcers with vomiting immediately after eating food	Constrictive and burning pain in the stomach is experienced after eating.	Excessive belching, the taste of ingesta is also present
Phos	When a cold drink relieves pain of stomach ulcers.	Burning in the stomach after eating	ُour, bitter belching may also be experienced in such cases.

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	Nat-p C30 two doses daily
Third line	Symph 0 two doses daily

Tissue Salt Remedies

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

Related entities

• Gastritis
• GERD