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Medically speaking the entire
spectrum of the disease is called as acid peptic disease.
What causes APD?--
APD occurs when the acid starts irritating the inner cells (mucosal
layer) of the stomach.
Why doesn't acid in the stomach always
irritate the stomach mucosa?--
In the stomach there is a fine balance between the agressive factors
& the defensive factors.
Acid is required for the digestion of food. However if it comes in
contact with the surface cells it can digest them too. Hence acid is an
aggressive factor for them.
Defensive factors include--
The surface cells secrete mucous-- a slimy substance which keeps the
acid away from the surface cells by coating them. This mucous also has
bicarbonate ions which cause local neutralisation of acid. Mucous &
the bicarbonate secretion further depends upon factor called as
prostaglandins. When this delicate balance is disturbed APD results.
What can disturb this balance?--
- Drugs--Aspirin & similar
drugs, steroids--impair the secretion
of the prostaglandins, hence hamper defensive factors.
- Alcohol
- Helicobacter pylori.
- Improper dietary habits--No
breakfast, oily/spicy/pungent foods.
- Genetic tendency--known to exist.
- Cigarette smoking
- Type A personality--This is a controversial topic presently with
many conflicting reports. However the stress associated with a hard
driven "'always on the toe-always on the go" job is
responsible.
Symptoms of APD--
Most common complain is the burning pain in the upper part of the
abdomen.
Some patients may complain of nausea & vomitting. The pain may be
severe enough to wake the patient from sleep.
Treatement--
- Antacids--These provide quick relief.However they are not very
useful for long term treatement. The gas produecd due to reaction
between the acid & the antacid can cause a bloating sensation.
- H2 receptor
blockers--eg Ranitidine,famotidine etc.These are much
better than the antacids.
- Proton Pump
blockers--eg.Omeprazole.These are very effective
agents as they can completely abolish the secretion of acid.
- Eradication of
H.pylori.--Details
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