Duodenal ulcer in practice
Disease of young
adults, the man and woman.
It is a symptom
of DYSPEPSIA brings to view.
Only 30-40% of ulcer
have a classic ulcer syndrome (see ULCER DUODENAL).
Smoking delays
healing and reduces the effectiveness of treatments.
The hunger pain
was suspected peptic disease but is not pathognomonic of ulcer (see
pathognomy).
The night time
pain is suggestive.
Stimulants
(alcohol, spices, vinegar, sugar) cause, as well as hot drinks, suspicious
pain.
The type of pain
can be absolutely evocative of the actual injury.
Pain relieved by
food intake is against an almost constant factor.
The usual
duodenal ulcer does not cause diarrhea.
Endoscopy will
confirm the diagnosis.
Just 6 hours of
fasting to accomplish this examination which will be without general anesthesia
and ambulatory (outpatient).
This test is
painless although a bit unpleasant. It does not require a work stoppage.
Duodenal ulcer
never cancérise, which is not true of gastric ulcer or ulcer of the antrum.
Endoscopy allows
the necessary biopsy of the lesion.
The initial
treatment should last 4-6 weeks (12 to 16 weeks in case of reflux
oesophagitis).
It is based on
the administration of inhibitors of the proton pump or anti H2 (anti H2 should
be prescribed rather the evening to cover the night hyperacidity).
The
administration of alkaline antacid powder is a good help, especially at the
beginning of treatment.
This
administration should be adapted to the persistence of pain.
Finally,
remember that before a dyspeptic syndrome for over two months, in addition to
endoscopy, ultrasound of the liver and biliary tract is necessary to search for
a possible LITHIASIS.
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