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Medical or self-management of peptic ulcer disease?

Medical or Self-Management of Peptic Ulcer Disease?

Regardless of what course of treatment one decides upon, a proper medical diagnosis should be the priority. Too many people embark on a path from which they leap to conclusions and then decide to treat their self-diagnosed ulcer with antacids.

Symptoms similar to peptic ulcer could be caused by unrelated factors. A competent physician will take a meticulous history, will note every symptom and the character of pain and will consider weight loss, change of bowel habits, and incidence of bloating and gas.

Also, because there are basic differences between the pain of duodenal ulcers and that of gastric ulcers, the information given to a professional can be highly significant.

Many anxious sufferers have mistaken hunger pains for ulcer pains. Others ignore subtle evidence while pursuing the misconception that all ulcers are constantly painful.

Modern medical management of ulcers no longer includes a bland diet, hourly feeding, and the use of milk for the purpose of depressing gastric secretion and providing gastric motor rest.

Because of the lack of evidence that such procedures were helpful, physicians now look upon such regimens with disfavor. Frequent feedings, for example, interfere with normal acid production and result in increased production of acid at night, when sleeping patients are unable to neutralize it.

Increased consumption of milk could result in an imbalance of calcium levels in the blood, causing milk-alkali syndrome, a condition that elevates other chemical levels and results in side effects such as dizziness, nausea, anorexia, vomiting, weakness, lethargy, headache, and behavior disorders.

Bland diets result in vitamin-mineral deficiencies, depriving the patient of much-needed nourishment and energy to deal with stresses of pain and prolonged treatment.

Medical treatment usually consists of drugs that inhibit or neutralize gastric acid secretion. The antacids vary in availability from prescription to over-the-counter drugs with unlimited access.

Not all antacids are alike. Each has its own set of advantages and disadvantages. The liquid form is more efficient than tablets. Patients should check carefully with their doctor and pharmacist to understand clearly the vagaries of a particular medication.

Another medical approach is to suppress acid formation. For this purpose, acid-suppressing drugs are prescribed. As opposed to antacids, which neutralize either by chemically reacting with or by absorbing acid, suppressors (anticholinergics) act by reducing the amount of acid secreted by the stomach.

Anticholinergics act by inhibiting the nervous impulses that directly stimulate both acid secretion and the release of the hormone gastrin. Because these drugs have a nerve-blocking effect throughout the body, functions of many other organs are negatively affected. Side effects can be severe.

Another problem with acid-suppressing drugs is that their relaxing effects on the stomach interfere with emptying functions. The elderly, who are usually people with heart problems or eye difficulties, would be wise to avoid using anticholinergics.

Another favorite treatment in ulcer disease is to sedate the patient so that anxiety, restlessness, and irritability are reduced. Sedatives, however, reduce alertness and impair mental functioning.

Whether the use of antidepressants can become habit-forming is a question that confronts the physician prescribing such drugs. Also, every tranquilizer poses hazards of side effects. Some are serious enough to limit an individual's ability to drive, operate machinery, and react to sudden changes in the environment.
COPYRIGHT 1989 Vegetus Publications
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Copyright 1989 Gale, Cengage Learning. All rights reserved.

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Publication:Nutrition Health Review
Date:Sep 22, 1989
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