Tokushukai Medical Group

Treatment of disorder

Treatment of disorder

Gastroenterological Medicine: Gastric and Duodenal Ulcer

Leading to bleeding or perforation by mucosal deficiency.

The disease occurred by gastric and duodenal mucosal deficiency. Duodenal ulcer is mostly occurring among younger generation (from 20 years old to 40 years old). Especially wall of duodenal is thin so that it is easy to progress deeper position, so that it bleeds or being perforated (make a hole) with cutting blood vessel. Ulcer has a clear separation of the boarder from surrounded tissues, and progress to deeper over the surface. Symptoms are mostly abdominal pain upper, and when bleeding from ulcer part, vomiting of blood or black stool can be seen. On duodenal ulcer, abdominal pains occur when fasting time at night, but pain is eased when having a meal.

Developed by mucosal disorder by gastric acid.

In addition to the Helicobacter Pylori infection at the stage of youth, high chloride food, smoking, analgesic (aspirin) or steroid dosage are the main causes. Because of these causes, balance of protective function of mucosal and the attack of gastric acid are collapsed, then with getting mucosal disorder by gastric acid stronger, disease is advanced. They say, helicobacter pylori gastritis infection rate is more than 90% in gastric and duodenal ulcer. Furthermore, it is said that gastric and duodenal ulcer is developed in relation with stress or genetic contributor.

Check the status of ulcer part by mainly endoscope.

Fig.1: Miniaturized stage of ulcer
Gastric and duodenal ulcer is diagnosed mainly by endoscope test. In active stage, bleeding or swelling can be found at ulcer part, and in curing stage, ulcer becomes shallow, miniaturized or disappeared are observed. (Fig. 1)

If bleeding hemostasis is applied, or no bleeding medicine treatment.

In case bleeding at Blood Vessel (Fig.2) or activated bleeding (Fig.3) are recognized, endoscope hemostasis is applied, and when no bleeding, drug medication is applied.

Fig.2: Possible to bleed blood vessel

Fig.3: Active bleeding from blood vessel in ulcer.

Fig.4: After Endoscopic Hemostasis
Former case, hemostasis the bleed caused vessel using cautery knife with verifying with endoscope. (Fig.4) Latter case where no bleeding is found, drug medication inhibiting gastric acid secretion is applied. Treatment in 8 weeks for gastric ulcer, and 6 weeks for duodenal ulcer can cure more than 80%. But in case endoscopic hemostasis cannot be done or in case ulcer is too deep so that perforation is already made, surgical operation may be necessary.

Recommend Pylori sterile filtration for prevention of recurrence

It is regarded as that pathogeny of ulcer is mainly related with Helicobacter Pylori Gastritis infection. When Gastric and Duodenal Ulcer is diagnosed, and helicobacter pylori inspection is positive, sterile filtration for pylori is recommended for recurrence preventive purpose. Sterile Filtration Treatment is an internal medication, taking both inhibiting gastric acid secretion drug and 2 kinds of antibacterial agent. Smoking is considered as individual factor so that it may possibly recur even after the sterile filtration, if in case continue smoking. In case when analgesic or steroid dosage is necessary, it is recommended to take acid reducer together.