(c) For the patient who has ingested poisons, toxic chemicals, or
corrosive substances, emergency treatment for the specific substance is necessary.
For example, ingestion of a chemical that is acid in nature is treated with an alkali to
neutralize the acid. Treatment which follows is based on the damage done to the
patient's body.
b. Peptic Ulcer. This stomach problem is common among adults. It has been
suggested that peptic ulcer is more common among executives, salespeople, and
others who do competitive work in an industrial society, this gastric problem being a
reaction to the stresses and strains of life in a complex society. Actually, people in all
walks of life throughout the world in all types of society develop peptic ulcers. This
problem is more common among men, particularly those in their thirties and forties.
(1) Definition. A peptic ulcer is an acute or chronic ulceration (an open
lesion) in a part of the digestive tract that comes in contact with gastric juice, either in
the lining of the stomach or the duodenum. The term peptic ulcer refers to an ulcer in
any part of the gastrointestinal tract; therefore, peptic ulcers are further classified
according to location--gastric peptic ulcer or duodenal peptic ulcer.
(2) Etiology. The stomach must secrete acid for a peptic ulcer to develop.
Everybody's stomach secretes acid; however, some people develop ulcers while other
people do not. Ulcers develop when the elements which protect the stomach's mucosal
lining are unable to resist the corrosive effects of the acid or pepsin secreted into the
stomach. Some studies show that stress upsets the balance between the stomach's
secretions and mucosal lining resistance with the result that ulcers develop. Some
drugs such as aspirin, some nonsteroidal anti-inflammatory drugs, and some
corticosteroids cause ulcers. Discontinue the drug, and these ulcers tend to heal
without recurring unless the person takes the offending drug again. Extreme gastric
hyperacidity which produces atypical peptic ulcers is part of the disease Zollinger-
Ellison syndrome.
(3) Duodenal peptic ulcer. The duodenal ulcer is caused by the action of
gastric juice and is found on the mucosa of the duodenum. The patient may have no
symptoms but feel vaguely uncomfortable, have symptoms which are not normal for
ulcers, or have some typical symptoms. Typical symptoms include general stomach
tenderness, stomach pain 40 to 50 minutes after a meal, and/or stomach pain which
begins after the person has gone to bed. Stomach pain for this disorder has been
described as gnawing, burning, aching, or hunger pangs. The person eats, takes an
antacid, or vomits and feels better. Examination of the patient reveals stomach
tenderness and guarding. The problem may be chronic or periodic and is ten times
more frequent in men than women.
MD0581
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