Peptic ulcer is a fairly common pathology, the frequency of which is decreasing thanks to treatments that are mostly effective. Without treatment, there is a risk of complications.

WHAT IS A GASTRODUODENAL ULCER?

This name covers two major conditions: gastric ulcer, which forms in the stomach, and duodenal ulcer, more common, which forms in the duodenum (the first part of the small intestine). This is a lesion of the internal wall of the stomach or duodenum, which causes tissue loss and the appearance of inflammation. Ulcer pain is the consequence of contact between the acid secreted by the stomach and the wound.
There are 2 possible locations: gastric ulcer, at the level of the stomach, and duodenal ulcer. In both cases, it is a lesion of the internal wall.

WHAT ARE THE USUAL SYMPTOMS OF AN ULCER?

This disease is accompanied by frequent burning sensations in the upper abdomen. In the case of a stomach ulcer, your pain will be aggravated by eating or drinking. In the case of a duodenal ulcer, your pain will, on the contrary, be relieved during meals, but it will increase a few hours later when your stomach is empty. You may also have the feeling of being satisfied quickly and suffer from bloating and belching. If your disease is at a more advanced stage, you may also experience weight loss, vomiting (sometimes with blood), nausea and black stools (color given by the presence of blood).
These are the classic forms but some ulcers can cause less classic symptoms.

DO I NEED TO UNDERGO ANY TESTS TO CONFIRM THE DIAGNOSIS?

The diagnosis is made by your doctor after performing a fibroscopy. This is an examination that allows your gastroenterologist to observe the inside of the digestive system by inserting a flexible device (fibroscope/endoscope) equipped with an optical system through your mouth (or more rarely through your nose. During this examination, your doctor can observe your vocal cords, then your esophagus, your stomach, your duodenum and the mucous membrane that lines them. This examination is most often performed under general anesthesia.
Sometimes, fine forceps are inserted into the endoscope to take a small piece of the mucous membrane (biopsy) and look for the presence of a bacterium involved in stomach lesions, called Helicobacter Pylori. This technique is painless.

IS IT A PAINFUL EXAMINATION?

If the examination is performed without anesthesia, the introduction of the endoscopy device is not pleasant, but it is painless in the majority of cases.
The IV placement, in the case of general anesthesia, is similar to a blood test.
The risks associated with general anesthesia are discussed during a pre-anesthetic consultation. An informed consent document will be given to you. It provides you with a lot of information to help you make your decision. You will read it and sign it.
Medical supervision is provided until the effect of the anesthesia wears off.
It is recommended that someone then accompany you home, that you do not drive and even that you do not be alone at home on the evening of the examination.

WHY DO I HAVE TO HAVE A GASTRIC FIBROSCOPY AGAIN AFTER MY TREATMENT?

This check is systematically done and new biopsies are taken to verify the effectiveness of the treatment against the Helicobacter pylori bacteria, if you have been treated for this purpose, and not to overlook a cancer presenting as an ulcer.

WHAT CAN BE THE CAUSES OF MY ULCER?

Various causes have been suggested:

• The presence of the bacteria, Helicobacter Pylori, which survives the acidity of the stomach, disrupts the mechanisms that normally protect the stomach against this acidity. It is thought to be responsible for the majority of cases of ulcers.
• Excessive production of acid by the stomach linked to excessive eating, stress, etc.
• Taking certain medications that damage the stomach wall (anti-inflammatories such as aspirin).
• Certain diseases.

Your doctor will look for the cause of your ulcer in order to put in place the most appropriate treatment.

ARE THERE PEOPLE AT RISK?

Yes. Depending on the type of ulcer, a profile of people at risk can be established. Duodenal ulcers affect men twice as often, between the ages of 45 and 64. Stomach ulcers become more common with age. They affect both men and women. People most at risk are between the ages of 55 and 65. It is often said that tobacco and alcohol consumption, stress, consumption of coffee, tea, cola-based drinks, fatty foods, chocolate, meat concentrates (liquid or cubed extracts), spices (pepper, mustard, chili, nutmeg, chili, etc.) are known to be poorly tolerated by some people.
If certain risk factors exist, it would be necessary to avoid it and have an appropriate lifestyle.

HOW CAN MY ULCER DEVELOP?

The lesion of the gastric or duodenal mucosa can be superficial or, in the absence of treatment, can become deep. The disease develops in flare-ups; this is called an ulcer flare-up, which results in pain.

ARE THERE ANY COMPLICATIONS?

If left untreated, the ulcer can cause significant digestive hemorrhages. In this case, your stools are black, which indicates the presence of digested blood. You may also vomit blood. Digestive bleeding often goes unnoticed, and it is the onset of anemia that can alert your doctor. It is by taking a blood test that we observe anemia, a significant drop in red blood cells, elements of the blood responsible for oxygenating the tissues. The ulcer can also completely perforate the digestive tract and cause peritonitis. The main sign is a sudden pain, like a stab. It can spread throughout the abdomen. Its strong intensity gradually increases. It becomes difficult to breathe. Anxiety, paleness, nausea and vomiting are common. This situation requires very rapid hospitalization.
In most cases, gastroduodenal ulcers heal provided that the doctor's prescription is strictly followed. In addition, certain precautions must be taken: avoid smoking, taking NSAIDs (anti-inflammatories) or aspirin, and drinking coffee.