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 Peptic
Ulcer Disease (PUD) and Acid Reflux (known as Gastroesophageal Reflux
or GERD) are two of the most common known digestive disorders. Together,
they affect over one-third of the U.S. population. Fortunately,
the majority of those who suffer with these conditions can be treated
and go on to lead normal, healthy, productive lives.
Peptic
Ulcer Disease (PUD)
We
all have about a 10% chance of developing PUD at some time during
our lives. There are certain risk factors, however, that make it
more likely. Males get the disease more frequently than females
and genetics are thought to play a role. Other common risk factors
include aspirin use (and other non-steroidal anti-inflammatory
medications such as ibuprofen and naproxen, but not Tylenol), a
specific bacterial infection (the bacteria is called Helicobacter
pylori or H. pylori), cigarette smoking and alcohol abuse.
Stress, as you may have heard from your mom, can also be a contributing
cause.
There
are two major types of ulcers and their symptoms can be different.
The first is a duodenal ulcer. You may know that the duodenum is
the first portion of your gut that food enters once it leaves the
stomach. This is the most common location for an ulcer, and accounts
for about 75% of cases. The most common symptom is burning epigastric
pain, which usually comes on 90 minutes to 3 hours after a meal.
The pain often comes on at night and may be relieved by eating and
antacids.
The
second type of ulcer is a gastric ulcer. This disease will also
give you epigastric pain, but the pain is usually unrelated to food
and may actually be made worse with eating. The treatment for both
of these ulcers is similar.
First,
avoid aspirin / other non-steroidal anti-inflammatory drugs, smoking
and alcohol. Second, physicians will commonly prescribe antacids
or medications to decrease stomach-acid secretion (drugs like Pepcid,
Tagamet, Axid, Zantac and others). Often, your doctor will also
prescribe a brief course of antibiotics to eliminate a probable
H. pylori infection in your gut. These simple measures will allow
most patients to get back to an active, pain-free life!
Acid
Reflux or Gastroesophageal Reflux (GERD)
Up
to 33% of all American adults will experience at least one episode
of heartburn per month. This aggravating symptom is caused by GERD.
Although the exact etiology of GERD is unknown, it is thought to
be due to inappropriate relaxation of the muscle which acts as a
barrier between the stomach and the esophagus. This muscle normally
protects the esophagus (the tube that connect your throat to your
stomach) from the large amount of acid in your stomach. When this
muscle doesnt stay closed tightly, acid from the stomach can rise
up into the esophagus and cause heartburn.
Risk
factors for heartburn include obesity, pregnancy, smoking and a
common condition known as hiatal hernia (the stomach sits a little
higher in the body than usual). Because GERD is so common, many
who get the disease have no risk factors at all. Symptoms are commonly
aggravated by lying down and eating certain foods and relieved by
sitting up. Treatment is often done in steps.
First,
patients are asked to elevated the head of their bed and to make
certain dietary changes. Coffee, citrus juices and spicy foods are
notorious culprits and should be avoided. Avoidance of food for
at least 3 hours before going to bed has also been shown to decrease
episodes of heartburn.
Antacids
are also commonly prescribed to relieve symptoms. In addition, your
doctor may prescribe acid-reducing medications just like the ones
used for peptic ulcer disease (e.g. Pepcid, Zantac, Axid and others).
As in PUD, these simple measures are usually enough to return people
to their normal lives!
Other
Tests For PUD and GERD
Your
doctor may want you to go through additional testing with either
one of these conditions, depending on your situation. One common
test is a barium swallow, where you will be asked to drink a liquid
substance and then have an x-ray taken. Another test is called endoscopy
and involves placing a small tube into your esophagus and stomach.
A camera on the end of the tube allows the physician to see inside
your stomach. Both tests are quite common, low-risk and painless.
They can be important in monitoring your condition and making sure
there are not more serious disease processes taking place.
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