Stress Can Cause ULCER
Written by Dr. Uzoechina Ephraim Monday, 15 August 2011 17:45
Dr. Ephraim Uzoechina, is the Medical Director and Consultant Physician and Gastroenterologist of Christ The King Hospital, Enugu. He spoke to NATH OMAME, Jr, on the causes and risk factors of ulcer; its symptoms; and the relationship between social lifestyle and ulcer as well as the relationship between stress and ulcer.
What, indeed, is stress?
I will definitely handle it in line with my specialty. I know you are referring to peptic ulcer. Peptic ulcer is a heterogeneous group of disorder in which you have a bridge, or a little hole in the mucosal lining of the esophagus/stomach or the duodenum in an individual.
What are the causes or risk factors of ulcer?
For instance, the peptic ulcer that I have already mentioned refers to a little bridge which may be mild or severe in the mucosal lining of either the esophagus or duodenum in an individual. However, it could be caused by many factors, such as cigarette smoking, excessive alcohol intake, and uncontrolled use of drugs such as anti-inflammatory agents as well as excessive physical stress among others.
One thing that is very important is that ulcer is a problem that arises as a result of an imbalance between aggressive gastric factors like acid and pepsin enzyme production and defensive factors production which are things that protect the gastric mucosal barrier like the mucus and bicarbonel. Ulcer develops when this imbalance is affected in the stomach/esophagus/duodenum. This may not account for all the cases we come across. Environmental factors are also important: use of drugs. People who have arthritis consume a lot of aspirin, an anti-inflammatory agent, among several others.
You must have noticed that people now consume more alcohol in our society. So, ulcer as a disease will increase when people consume more of the things that bridge the stomach. The most salient factor that induces ulcer, currently being considered in some countries, is the H. Pylori Bacterium which has been found to be quite prevalent in our society.
How?
H. Pylori Bacterium is found in the stomach and duodenum and has been ascertained to interrupt or disturb the mucosal blood flow and the production of mucus. H. pylori Bacterium obstructs the production of defensive factors in the stomach that usually protect it from aggressive tendencies from what we eat, including the enormous amount of acids that are produced in the stomach. Ulcer begins to develop when there is an obstruction to the blood-flow in the stomach.
What symptoms do you consider in a patient before you conclude that he or she has ulcer?
Commonly, such patients will tell you they feel some annoying or burning pain in their upper abdomen. The same patient can also tell you that he or she feels the same pain also occurs towards the left side of the upper abdomen and sometimes radiates to the back.
The patient may also tell you that the pain manifest anytime he eats late in the morning or that the pain usually wakes him up early in the early hours of the morning. Generally, patients complain that the pain re-occurs after about one to five hours after eating. In some cases, some patients complain of early fullness of the stomach. Such patients are not being able to eat much.
During clinical examination, the patient will most often cringe or scream when you press the upper abdomen: that is pain will manifest when you apply little pressure to the abdomen with your hands.
It is said that too much PEPSIN can damage the stomach lining and cause ulcer. What is PEPSIN?
Pepsin in medicine represents an enzyme that helps in the digestion of protein. When food goes into the body, then, signal is given to the stomach to produce the necessary pepsin and acid to aid digestion. Once there is an obstruction, leading to an excess accumulation of pepsin and acids in the stomach preventing them from aiding digestion, then, there is trouble.
How can ulcer be avoided?
It is important that one avoids being worked up emotionally. It is important that one eats well at regular intervals. Avoid fasting. Learn to avoid food items that lead to excessive secretion of acids in the body. Even the tea that we drink on regular basis, especially those of us who are doctors, that leads to the secretion of hydrogen iron and hydrochloric acid, including caffeine producing drinks which precipitate the producing of acid should be avoided.
We understand that an ulcer left untreated can lead to a bleeding ulcer?
Yes, that is correct and can lead to complications in a peptic ulcer disease. The ulcer can involve a tiny blood vessel or a bigger blood vessel at its base, and when such occurs, it could lead to a massive outpouring of blood. The patient may begin to bleed and this can even lead to the patient vomiting blood.
There are other complications that can occur as a result of an ulcer formation in the stomach or duodenum. If that occurs, then, there is a problem. The patient may experience a lot of fluid retained in the stomach. In that case, any food eaten by the patient would not go down, making the patient to vomit more often. There is also the possibility of cancer formation when dealing with ulcer involving the stomach.
Are you saying the excessive presence of H. Pylori Bacterium in the stomach can lead to cancer?
Oh Yes!
Is there a relationship between a bleeding ulcer and a perforated ulcer?
Yes, from bleeding one can get to perforation. When it perforates it means an extreme emergency because it means the gastric content will get into the abdominal cavity.
Well, is there any connection between ulcer and self-medication?
Of course, yes! It is proven that self-medication can indeed lead to ulcer formation. In medicine, a lot of people above 50 years who are hypertensive are placed on low-dose aspirin. And it has shown clearly that these low-dose aspirin that is been widely taken is responsible for many cases of bleeding in patients.
So, what is commonly done now when patients with bleeds come to the hospital is to ask such patients whether they are on low-dose aspirin.
Can such bleeding metamorphose into stomach ulcer?
Yes!
Lifestyle factors such as smoking, alcohol and caffeine has been established as risk factors for ulcer. In an increasingly stressful environment, more people are drinking, smoking and taking caffeine, can there be a relationship between stress and ulcer?
A lot of people in our society drink alcohol and most of those who drink take a lot of aspirin for headache. And some of these will eventually metamorphose into minor ulcer within the esophagus or stomach which could lead to minor or even major bleedings. When other ulcerous conditions are present in the body, then, the presence of alcohol can worsen the situation.
Therefore, a stressful person who takes excessive alcohol and relies on aspirin for repeated headaches can with time become an ulcer patient, especially if bleeding had begun to manifest.
Can alcohol or smoking slow the healing of ulcer?
Oh Yes, it does! Once we find a patient who is supposed to be improving while on medication suddenly relapsing, we ask about the intake of alcohol, most often, you succeed in getting the persons history.
How?
They grudgingly admit that they had gone back to taking alcohol. Otherwise, ask about default in medication.
Does diet play any role in the treatment of ulcer?
Yes and no. We encourage people to eat normal diet as much as possible and only avoid those things they have personally found out cause them discomfort. We advise patients to avoid drinks that will lead to excessive production of acid in the stomach.
Is milk helpful in relieving ulcerous pains?
Excessive drinking of milk should be avoided because of the rebound effect of excessive acid production. An ulcer patient should take the normal quantity of milk he uses for his tea. An ulcer patient should not take milk in large quantity as a medication. No!
Does ulcer reoccur after treatment?
The possibility of a reoccurrence is there. One, it may be because of the inappropriate use of the drug; not keeping to the prescription given. Two, taking those things the individual is not supposed to take, such as defaulting by taking alcohol as well as inadequate treatment from the hospital. What, indeed, is stress?
I will definitely handle it in line with my specialty. I know you are referring to peptic ulcer. Peptic ulcer is a heterogeneous group of disorder in which you have a bridge, or a little hole in the mucosal lining of the esophagus/stomach or the duodenum in an individual.
What are the causes or risk factors of ulcer?
For instance, the peptic ulcer that I have already mentioned refers to a little bridge which may be mild or severe in the mucosal lining of either the esophagus or duodenum in an individual. However, it could be caused by many factors, such as cigarette smoking, excessive alcohol intake, and uncontrolled use of drugs such as anti-inflammatory agents as well as excessive physical stress among others.
One thing that is very important is that ulcer is a problem that arises as a result of an imbalance between aggressive gastric factors like acid and pepsin enzyme production and defensive factors production which are things that protect the gastric mucosal barrier like the mucus and bicarbonel. Ulcer develops when this imbalance is affected in the stomach/esophagus/duodenum. This may not account for all the cases we come across. Environmental factors are also important: use of drugs. People who have arthritis consume a lot of aspirin, an anti-inflammatory agent, among several others.
You must have noticed that people now consume more alcohol in our society. So, ulcer as a disease will increase when people consume more of the things that bridge the stomach. The most salient factor that induces ulcer, currently being considered in some countries, is the H. Pylori Bacterium which has been found to be quite prevalent in our society.
How?
H. Pylori Bacterium is found in the stomach and duodenum and has been ascertained to interrupt or disturb the mucosal blood flow and the production of mucus. H. pylori Bacterium obstructs the production of defensive factors in the stomach that usually protect it from aggressive tendencies from what we eat, including the enormous amount of acids that are produced in the stomach. Ulcer begins to develop when there is an obstruction to the blood-flow in the stomach.
What symptoms do you consider in a patient before you conclude that he or she has ulcer?
Commonly, such patients will tell you they feel some annoying or burning pain in their upper abdomen. The same patient can also tell you that he or she feels the same pain also occurs towards the left side of the upper abdomen and sometimes radiates to the back.
The patient may also tell you that the pain manifest anytime he eats late in the morning or that the pain usually wakes him up early in the early hours of the morning. Generally, patients complain that the pain re-occurs after about one to five hours after eating. In some cases, some patients complain of early fullness of the stomach. Such patients are not being able to eat much.
During clinical examination, the patient will most often cringe or scream when you press the upper abdomen: that is pain will manifest when you apply little pressure to the abdomen with your hands.
It is said that too much PEPSIN can damage the stomach lining and cause ulcer. What is PEPSIN?
Pepsin in medicine represents an enzyme that helps in the digestion of protein. When food goes into the body, then, signal is given to the stomach to produce the necessary pepsin and acid to aid digestion. Once there is an obstruction, leading to an excess accumulation of pepsin and acids in the stomach preventing them from aiding digestion, then, there is trouble.
How can ulcer be avoided?
It is important that one avoids being worked up emotionally. It is important that one eats well at regular intervals. Avoid fasting. Learn to avoid food items that lead to excessive secretion of acids in the body. Even the tea that we drink on regular basis, especially those of us who are doctors, that leads to the secretion of hydrogen iron and hydrochloric acid, including caffeine producing drinks which precipitate the producing of acid should be avoided.
We understand that an ulcer left untreated can lead to a bleeding ulcer?
Yes, that is correct and can lead to complications in a peptic ulcer disease. The ulcer can involve a tiny blood vessel or a bigger blood vessel at its base, and when such occurs, it could lead to a massive outpouring of blood. The patient may begin to bleed and this can even lead to the patient vomiting blood.
There are other complications that can occur as a result of an ulcer formation in the stomach or duodenum. If that occurs, then, there is a problem. The patient may experience a lot of fluid retained in the stomach. In that case, any food eaten by the patient would not go down, making the patient to vomit more often. There is also the possibility of cancer formation when dealing with ulcer involving the stomach.
Are you saying the excessive presence of H. Pylori Bacterium in the stomach can lead to cancer?
Oh Yes!
Is there a relationship between a bleeding ulcer and a perforated ulcer?
Yes, from bleeding one can get to perforation. When it perforates it means an extreme emergency because it means the gastric content will get into the abdominal cavity.
Well, is there any connection between ulcer and self-medication?
Of course, yes! It is proven that self-medication can indeed lead to ulcer formation. In medicine, a lot of people above 50 years who are hypertensive are placed on low-dose aspirin. And it has shown clearly that these low-dose aspirin that is been widely taken is responsible for many cases of bleeding in patients.
So, what is commonly done now when patients with bleeds come to the hospital is to ask such patients whether they are on low-dose aspirin.
Can such bleeding metamorphose into stomach ulcer?
Yes!
Lifestyle factors such as smoking, alcohol and caffeine has been established as risk factors for ulcer. In an increasingly stressful environment, more people are drinking, smoking and taking caffeine, can there be a relationship between stress and ulcer?
A lot of people in our society drink alcohol and most of those who drink take a lot of aspirin for headache. And some of these will eventually metamorphose into minor ulcer within the esophagus or stomach which could lead to minor or even major bleedings. When other ulcerous conditions are present in the body, then, the presence of alcohol can worsen the situation.
Therefore, a stressful person who takes excessive alcohol and relies on aspirin for repeated headaches can with time become an ulcer patient, especially if bleeding had begun to manifest.
Can alcohol or smoking slow the healing of ulcer?
Oh Yes, it does! Once we find a patient who is supposed to be improving while on medication suddenly relapsing, we ask about the intake of alcohol, most often, you succeed in getting the persons history.
How?
They grudgingly admit that they had gone back to taking alcohol. Otherwise, ask about default in medication.
Does diet play any role in the treatment of ulcer?
Yes and no. We encourage people to eat normal diet as much as possible and only avoid those things they have personally found out cause them discomfort. We advise patients to avoid drinks that will lead to excessive production of acid in the stomach.
Is milk helpful in relieving ulcerous pains?
Excessive drinking of milk should be avoided because of the rebound effect of excessive acid production. An ulcer patient should take the normal quantity of milk he uses for his tea. An ulcer patient should not take milk in large quantity as a medication. No!
Does ulcer reoccur after treatment?
The possibility of a reoccurrence is there. One, it may be because of the inappropriate use of the drug; not keeping to the prescription given. Two, taking those things the individual is not supposed to take, such as defaulting by taking alcohol as well as inadequate treatment from the hospital.
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