Gastric ulcer

Gastric ulcerOr (to be, the way), stomachStomach acidWith, balance of the secretion of the mucus which protects the stomach wall from stomach acid deteriorates, the hole is less crowded in the stomach wall by stomach acid, it is the sickness which feels pain, causes bleeding depending upon when. In case of the grave gastric ulcer, when the hole of the stomach wall it is connected to outside the stomach, it is.

As for condition of gastric ulcer and many of cureDuodenum ulcerIn order to be applicable, naming generically both partiesDigestion characteristic ulcerWith it calls. As a difference, as for the duodenum ulcer as for the gastric ulcer you can list to the young person the many point mainly after the middle age.

In addition,ヘリコバクター ピロリ (Helicobacter pylori) As for the possession person, emergence ratio of this disease is high in comparison with the non possession person.

Condition

The stomachache (the upper abdomen painfully) is typical as a condition of the gastric ulcer, but the back section painfully, there is no appetite, when weight decrease and hematemesis (it is the blood, it is, there is also a coffee residue way thing.) Lower blood (in case of hematorrheaBlack of mud condition flightWhen, furthermore you bled in large quantities, the blood characteristic flight), heartburn and the leaning etc. it is colorful, in Japan where medical examination advances, accidentally it is discovered and when completely there is no condition, quite it is many.

As an important complication of the gastric ulcer,Bleeding and perforatingIt is, remedy with the medical specialist whose also moment is quick is necessary. When you bled,?、Cold sweat、Blood pressure decrease、Feeling displeasure、Hematemesis、Lower bloodAnd so on condition appears. As a condition of perforation, persistenceVery strong stomachacheOppressive pain,Recoil it is painful、Muscle characteristic defenseThere is heat generation and the like.

When the stomachache increase badness it does after the food, when increase badness it does before the gastric ulcer and the food, it is assumed that when it is the duodenum ulcer is many, but really so is with it does not limit. As the disease which causes similar condition,Functional ディスペプシアFrequency to be highest, in additionDuodenum ulcer、Counterflow characteristic esophagus flame、Acutely 膵 flame、Chronic 膵 flame、Gallstone、Gall bladder flameAnd so on as for the disease which it should exclude diagnose quite it is many.

Diagnosis

When the gastric ulcer (digestion characteristic ulcer) is doubted in the condition as in description above, the gastric ulcer is proven directly, usually upper alimentary canal endoscope inspection (commonlyGastrocamera) There is many a thing which is done. Largest advantage of endoscope inspection, if you bleed, is that same remedy is possible.

Of course, when it does presence of grasp and the complication of systemic state, with purpose of diagnosis of exclusion, blood inspection and the simple X-ray film and abdomen ultrasonic inspection (echo check) etc. combining, it is.

barium contrastRoentgenAs for inspection, when there is a complication such as perforation, taboo, when condition is strong and the like, quite it is few to be done at the clinical place. With medical examination there are times when it is used.

Remedy

Digestion characteristic ulcer bleeding

Digestion characteristic ulcer bleeding is the acutely period disease which has the danger of life. Surgical remedy there is internal medicine remedy in remedy of digestion characteristic ulcer bleeding. The first remedy for ulcer bleeding was surgical excision before 1980, but when the stomach acid secretion control medicine which is called the H2 blocker is sold, control of stomach acid becomes possible, because bleeding quite decreases, later, the number of operations decreased sharply. But even presently perforation and surgical excision is done bleeding which cannot be controlled endoscope vis-a-vis.

There is endoscope remedy and medicine remedy in internal medicine remedy. When you bleed from the gastric ulcer, endoscope stopping bleeding technique is done making use of the clipping or heat probe. As for leading part of medicine remedy from H2 blocker proton pump inhibitor ( proton pump obstruction medicine) To with it moves, quite it is effective.

Digestion characteristic ulcer of climax

When it is the digestion characteristic ulcer which is not the extent which needs endoscope remedy, in order to make the occurrence risk of the bleeding characteristic digestion characteristic ulcer decrease, use of the proton pump obstruction medicine and the H2 blocker becomes necessary.

ヘリコバクターピロリ-related digestion characteristic ulcer

Around 1990, many of digestion characteristic ulcer patientヘリコバクターピロリ(The alias ピロリ germ) the fact which is possessed was recognized. Furthermore when the ピロリ germ is disinfected, 1-2 ulcer recurrence after the year was ascertained decreasing under 20%. As for the ピロリ germ the tolerance for the antibiotic medicine is strong, can see the failure of disinfecting in 10-20%. In addition, even with when it succeeds in disinfecting as for re-infection, year 0.5% it happens. When it is doubted, that it is the ヘリコバクターピロリ-related ulcer, if state of the gastric ulcer settles, disinfecting is recommended.

In Japan as a disinfectant medical therapy of the ピロリ germ, in the proton pump inhibitor 2 types antibiotic medicine have become insurance application from 2000. Remedy period being approximately 1 week, soft there is flight and a ageusia as a main side effect.

NSAIDS-RELATED digestion characteristic ulcer

NSAIDS (non steroid type antiphlogistic anesthetic medicine NON STeroidal ANti-INflammatory DRugS) With it is type of anesthetic medicine which every day is most used. シクロオキシゲナーゼ -2 the enzyme which is said is obstructed, in order to control the production of the prostaglandin which is important defense factor of the stomach mucous membrane, mucous membrane obstacle occurs. Sometimes, when you use at the time and the like of headache, excessively it does not become with problem, but the orthopedics patient andChronic joint リウマチThe digestion characteristic ulcer is generated due to the long-term continuous use in the patient et. al.. With such patient as for discontinuing NSAIDS because there is many a thing which it is not possible, it is necessary to jointly use the gastric ulcer remedy and to prevent the recurrence of the ulcer.Point professional stallAnd proton pump obstruction medicine