Abdominal pain can originate from any partof the abdomen, and its location helps narrow down the differential diagnoses.In today’s post, we'll focus on pain arising from the epigastric region orupper-left quadrant of the abdomen, specifically related to the stomach, gallbladder or pancreas. Using your imagination, consider the complexities these organs present.

Today, our focus will be on peptic ulcer disease (PUD), a common condition involving ulcers in the stomach (gastric ulcer) or the duodenum (duodenal ulcer).

What exactly is Peptic Ulcer Disease?

PUD is a condition characterised by the formation of open sores (ulcers), on the inner lining of the stomach (gastric ulcers) and the duodenum (duodenal ulcers). Though both types share common symptoms, the clinical presentation can help differentiate between them.

How Does Peptic Ulcer Disease Arise?

PUD arises from several factors, including:

1.     Infection from Helicobacter pylori

2.     Excessive secretion of gastric acid caused by infection, specific foods, stress, tumors and lifestyle

3.     Inadequate protection of the lining of the stomach and duodenum against digestion by acid and pepsin

4.     Use of certain Drugs like Non-steroidal anti-inflammatory drugs (NSAIDs) e.g. Aspirin and Corticosteroids

What are the signs and symptoms of peptic ulcer disease?

Gastric and duodenal ulcers share several features but differ in key aspects. Both can be worsened by dietary indiscretions such as consuming spicy or oily foods, as well as poor eating habits like late meals or skipping meals. In gastric ulcers, pain typically worsens after eating, whereas in duodenal ulcers, pain tends to occur when the patient is hungry—often between meals—and may even wake them at night. The pain in both types is episodic and located in the epigastric region. Gastric ulcer pain may range from a dull ache to a burning or severe discomfort, while duodenal ulcer pain is often described as gnawing or cramp-like. Antacids can ease pain in both gastric and duodenal ulcers. Vomiting may provide temporary relief in gastric ulcers, whereas duodenal ulcer pain is usually relieved by eating. Vomiting can occur in both cases. Weight loss is more common with gastric ulcers due to fear of eating, while duodenal ulcers may lead to weight gain as patients eat more frequently to relieve discomfort.

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How is Peptic Ulcer Disease Diagnosed?

PUD diagnosis methods include:

1.     Medical History and Physical Examination

2.     Laboratory Tests (Blood tests and Stool tests to detect H. pylori infection)

3.     Upper Gastrointestinal Endoscopy (Direct visualisation of ulcers and enabling the collection of tissue samples (biopsy) for further analysis)

4.     Biopsy

5.     Imaging Tests e.g. X-rays or CT scans

6.     Urea Breath Test

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At Beaver Health, our world-class ISO-accredited lab service performs both blood and stool tests to check for H.pylori infection in patients presenting with the above complaints. These tests not only detect H. pylori but also rule out other intestinal parasites. Additionally, our referral center is available to X-rays, CT scans and Upper Gastrointestinal endoscopies, confirming the presence of ulcers in the stomach or duodenum.

How is Peptic Ulcer Disease Treated?

·       Pain Relief by reducing gastric acid secretions e.g. Medications such as Omeprazole.

·       H-Pylori bacteria eradication e.g. A combination of antibiotics and a stomach acid reducer

·       Promoting ulcer healing, such as recommending lifestyle changes like quitting smoking

·       Preventing ulcer recurrence through wholistic dietary counselling to avoid triggering factors

·       Preventing and managing complications that may arise from Ulcer e.g. Monitoring for complications like bleeding or medications to promote blood clotting.

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In rare and severe cases requiring surgical intervention, Beaver Health stands ready to collaborate with our state-of-the-art referral center, ensuring the highest level of care. For medication needs, our pharmacy service offers full support with quality branded and generic drugs. Additionally, our detailed dietary counselling and lifestyle adjustment coaching regimen, complement our medical expertise providing complete health management.

How Can I Avoid Peptic Ulcer Disease?

·       Avoid alcohol and smoking

·       Avoid foods that aggravate pain(trigger foods)

·       Avoid or manage stress

·       Maintain a healthy lifestyle

·       Take medications wisely

·       Regular check-ups

Peptic ulcer disease presents a multi-faceted challenge, due to the multitude of causative factors involved. By understanding how to manage and prevent PUD effectively we can easily minimise the impact of PUD on our lives and maintain digestive health.

In the next part of our blog series on digestive health, we will learn how to interpret abdominal pain. Stay tuned to Beaver Health as we continue our journey towards a healthier digestive system and overall well-being.