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
H. Pylori Infection With Peptic Ulcers	Arg-n	Best remedy for stomach ulcers. Sharp Ulcerative/ Burning pain is felt in stomach Pain radiates to other regions of the abdomen. Argentum Nitricum is most prominently suited for treating gastric ulcers in this condition. The main symptom is pain in the stomach radiating to other parts of abdomen. The pain is mainly of stitching, gnawing and burning in nature.		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.
	Kali-bi	Kali Bichrome and Graphites are two other wonderful homeopathic medicines for H. pylori with peptic ulcers. They are prescribed when gastric symptoms include burning pain in abdomen, belching and nausea. All these symptoms get better with eating.
	Graph
	Uranium Nitricum	Uranium Nitricum is useful when burning pain, nausea, vomiting, bloating and burping are present.
Stomach Burning	Ars	Arsenic Album is a highly recommended medicine to manage burning in stomach. The burning sensation is very severe which gets worse at night. Taking warm drinks offers relief. Nausea and vomiting may appear after eating or drinking something. The 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 stitching or stinging pain in abdomen. This medicine is best for treating gastritis as well as peptic ulcers.
Stomach Burning And Vomiting	Nux-v	Nux Vomica is very helpful in managing burning sensation in stomach and vomiting. There is vomiting after consuming any solid or liquid food, even the smallest quantity of water is not tolerable and vomited soon. There is rumbling and gurgling in the abdomen and the abdomen feels distended with gas. Pain is felt in the abdomen  and passing stool brings momentary relief from pain. 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.
H. Pylori Infection With Bloated In Lower Abdomen	Lyc	Stomach ulcers + Burning, Constrictive pains Marked Flatulence Abdominal Fullness/ Bloating Homeopathic medicines Lycopodium is recommended for H. pylori infection with a bloated abdomen in the lower part. Lycopodium is helpful when abdomen gets bloated soon after eating. Little eating leads to a distended abdomen in such cases. This is often attended with dyspepsia, gas and burping.	Bloating starts soon after eating. Pain amel from taking warm water. Agg: Farinaceous food like Cabbage and Beans
Bloated Abdomen And Burping	Carb-v	Stomach ulcers + burning pain Stomach ulcers + Sour belching/ Heartburn. Pain may extend from stomach to back. Carbo Veg is the most helpful where bloating of abdomen is a major concern. There is distension of abdomen with flatus. Sour burps are prominent in such cases. Burning sensation and soreness is felt in stomach.	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
Burning Sensation Relieved By Cold Drinks	Phos	When a cold drink relieves pain of stomach ulcers. Homeopathic medicine Phosphorus is helpful when there is marked burning pain in the stomach which gets relieved by cold drinks. Nausea and vomiting,bitter or sour burping may attend. Soreness is felt in the pit of the stomach. Like Arsenic Album, Phosphorus is also an important medicine to treat gastritis and peptic ulcers.	Burning in the stomach after eating	ُour, bitter belching may also be experienced in such cases.
	Coloc	H.Pylori Infection With Marked Abdomen Pain Colocynth is an effective medicine for H.pylori infection with abdomen pain. It is best indicated when the infection is characterized by agonizing, cutting pain in the abdomen. Pain of colicky, gripping nature is also treated well with Colocynth. Pressure and bending double ( bending forward and downward at the waist)relieves pain. It is well indicated to manage gastritis.
Burps Having Sour Taste	Nat-p	Natrum Phos is one of the best homeopathic medicines for H. pylori with belching of sour, acrid nature. Water brash may appear along with belching. Intense acidity and flatulence is also marked.
H. Pylori Infection With Belching	Ant-c	Homeopathic Medicines For The most effective homeopathic medicines for H. pylori infection along with belching is Antimonium Crudum. It is recommended when belching is constant. Belching in such cases tastes mainly of eaten food. Dyspepsia and vomiting may also be present.
Infection With Intense Nausea And Vomiting	Ip	Ipecac is prescribed when nausea and vomiting are experienced. Nausea is present all the time. Vomiting of white glairy mucus or food appears, but the nausea is not relieved even after vomiting. Ipecac is one of the best homeopathic medicines for H. pylori infection with symptoms of this kind.

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