Peptic Ulcers Disease - Free Paper Sample

Introduction

Peptic ulcer disease (PUD) affects approximately 28% of the global population, which translates to 70,000 Australians annually (Wauters et al., 2017). The condition tends to affect individuals depending on localities, with some having severe infections leading to death and others overcoming the disease through medication. Peptic ulcers are diagnosed into two sections, as a breakdown in the protective stomach lining called the gastric ulcers and a breakdown on the part of the intestine called the duodenum, called duodenal ulcers (Yuet al., 2019). According to Wauters et al., (2017), more than 90 per cent of peptic ulcer cases are caused by a bacterial infection called H Pylori, and the cases tend to rise on an age basis. Peptic ulcers are a dimensional infection with adverse effects on public health. The case tends to focus on numerous perspectives on the epidemic.

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Background Significance

The prevalence of the bacteria H pylori, which is the leading cause of Peptic Ulcers disease (PUD) in Australia, is relatively low, ranging from 15.45 to 31% figures mostly recorded in developed countries (Flaskerud, 2020). In Australia, the rate of H pylori infection varies across geographical regions. The above scales down to higher cases in poor regions with major public health complications. Aboriginal Australians who occupy the west have a high prevalence of the H Pylori bacteria, thus higher cases of Peptic Ulcers disease (PUD) at 76% (Joo et al., 2020). The bacteria have also been found of high amounts to migrants. However, the studies were conducted on small samples. Thus, there is no longitudinal conclusion on the infection rates of Peptic Ulcers disease (PUD).

In 1983 an Australian pathologist, Dr Robin Warren, noticed a bacterium infection in samples from biopsies from peptic ulcers. The pathologist thought it was more than a coincidence as the then conventional wisdom annotated that bacteria could not survive the acidic environment of the stomach (Wise et al., 2019). The pathologist and Dr Barry Marshall continued with their study to ascertain the cause of the infection and the cure. Later on, Marshall considered himself a lab and swallowed a solution containing the bacteria. He developed vomiting due to stomach inflammation, and the condition improved after frequent administration of antibiotics. Eventually, antibiotics became the mainstay of treatment of H pillory in Australia, and the discovery won the pair the 2005 Nobel prize for medicine (Drini, 2017). Most Australians from the western sides also have an inadequate immune response towards the bacteria, which also determines the high emergence rate of peptic ulcer disease (Joo et al., 2020). These individuals have high rates of human IL1B gene that encodes for Interleukin 1 beta. Other genes encode for tumour necrosis factor (TNF) and lymph toxins that lead to high gastric inflammation rates in the stomach lining.

Causes of Peptic Ulcers Disease in Australia

Peptic Ulcers Disease (PUD) tends to emerge when acids in the digestive tract eat the way the inner surfaces of the stomach and the ileum. The acids create very painful open sores that often bleed. The acids are mostly from a bacterium, the Helicobacter pylori (H Pylori) that live in the mucus layer, which covers the stomach and intestinal lining. Mirzaei & Zahedi (2015) argues that regular intake of certain pain relievers such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) tends to produce elements that irritate and cause inflammation to the stomach lining. The disease is also associated with age as the old tend to overconsume the above drugs more often. Other risk factors include a past family history of the ulcers, heart diseases, and frequent administration of patients to corticosteroids and antiplatelet (Yu et al., 2019).

In addition to the risk factors, most Australians change their lifestyle and eating behaviours, thus exposing themselves to the ulcer. Smoking and alcohol intake tends to irritate the inner lining of the stomach, thus increasing the intensity of the ulcers (Valery et al.,2020). The other issue is too much intake of fatty foods and spices as the two contain acidic contents. Stress also causes the ulcers as it creates an imbalance between the gastric acid-pepsin secretion and the body defence mechanism, thus realizing bicarbonate secretions in the stomach lining that erode the mucus (Byrneet et al., 2018). According to Hendrix et al., (2019), there are other minor causes of peptic ulcer disease and include gastric ischemia, metabolic disorders, cytomegalovirus (CMV), and upper abdominal radiotherapy. Crohn's conditions and vasculitis also expose the stomach lining to the H pylori bacteria. Complications Associated with Peptic Ulcers disease (PUD) (Hendrix et al., 2019)

The ulcer is preventable and manageable, but if left untreated, it can result in internal bleeding (Drini, 2017). The internal bleeding can lead to bloody vomits that can cause anaemia and death in severe cases. Peptic ulcers also tend to create a perforation in stomach walls endangering the patients to conducting peritonitis, also called abdominal cavity (Kuna et al., 2019). Peptic ulcer disease (PUD) tends to create a block in the oesophagus and the digestive tract leading to low appetites and bloating. In severe cases, Peptic ulcer disease (PUD) can increase the risk of gastric cancer and death. The ulcers may also cause obstruction and narrowing of the duodenum, thus causing abdominal pain to patients.

Treatment of Peptic Ulcers Disease

There are several procedures that patients are taken to diagnose the ulcer. The patients undergo blood tests, stool tests, and Urea Breath Tests. In unidentifiable cases, patients undergo endoscopy to ascertain H pylori presence. Patients are stopped from taking aspirin and NSAID drugs as the two produce acidic contents to treat the ulcers. As stated by Smith et al., 2019), the treatment aims at eradicating the H pylori bacteria and the damage caused by the acid. In treatment, most patients are put under the triple play therapy where two antibiotics are administered, followed by proton pump inhibitors (PPI). The proton pump inhibitors act as a base that reduces the intensity of the acid that leads to inflammation and exposure of the stomach lining. The dosage is always administered in seven days.

The best nonsteroidal anti-inflammatory drugs (NSAIDs) to use are the ones with more excellent selectivity for COX-2 and less COX-1 toxicity. According to Marshall (2016), a recent meta-analysis on randomized trials shows that putting patients under low aspirin dosage immensely reduces the acidic content, thus inhibiting cases of Peptic Ulcers Disease (PUD). The other treatment mechanism is putting patients under a double dose of H2-receptor antagonist as it contains 300mg of ranitidine (Wauters et al., 2017). Administering anti-gastric dosages as misoprostol is effective in controlling duodenal ulcers as it has been proved after 54% of patients in West Australia recovered after they were put under the medication (Smith et al., 2019). However, case by case analysis should be conducted in patients to reduce blanket assumptions as Peptic Ulcers disease (PUD) may have symptoms as those of other ulcers.

Conclusion

In summary, there is a need to create mechanisms that will see actual control and eradication of Peptic Ulcers Disease (PUD). Research needs to focus on diet, lifestyle, and stress reduction to ascertain the best strategy for controlling Peptic Ulcers Disease (PUD). However, in Australia, there is evidence of a step by step modules to treat and control Peptic Ulcers Disease (PUD). Water hygiene is also a mechanism that will control and manage the disease.

References

Byrne, B. E., et al. (2018). Short-Term Outcomes After Emergency Surgery for Complicated Peptic Ulcer Disease from The UK National Emergency Laparotomy Audit: A Cohort Study. BMJ Open, 8(8), e023721. https://bmjopen.bmj.com/content/8/8/e023721

Drini, M. (2017). Peptic Ulcer Disease and Nonsteroidal Anti-Inflammatory Drugs. Australian prescriber, 40(3), 91. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478398/

Flaskerud, J. H. (2020). Gastric Ulcers, from Psychosomatic Disease to Infection. Issues in Mental Health Nursing, 1-4. https://www.tandfonline.com/doi/full/10.1080/01612840.2020.1749332

Hendrix, I., et al., (2019). Patterns of High-Dose and Long-Term Proton Pump Inhibitor Use: A Cross-Sectional Study in Six South Australian Residential Aged Care Services. Drugs-Real World Outcomes, 6(3), 105-113. https://link.springer.com/article/10.1007/s40801-019-0157-1

Joo, J. Y., et al. (2020). Eosinophilic Gastroenteritis as A Cause of Non-Helicobacter Pylori, Non-Gastrotoxic Drug Ulcers in Children. BMC gastroenterology, 20(1), 1-8.
https://link.springer.com/article/10.1186/s12876-020-01416-7

Kuna, L. et al. (2019). Peptic Ulcer Disease: A Brief Review of Conventional Therapy and Herbal Treatment Options. Journal of Clinical Medicine, 8(2), 179.
https://www.mdpi.com/2077-0383/8/2/179/pdf

Marshall, B. (2016). Warren and Marshall—Changemakers. http://www.abc.net.au/health/library/stories/2007/01/25/1832175.htm

Mirzaei, S. M. S., & Zahedi, M. J. (2015). Prevalence of Helicobacter Pylori-Negative, Nonsteroidal Anti-Inflammatory Drug-Related Peptic Ulcer Disease in Patients Referred to Afzalipour Hospital. Middle East Journal of Digestive Diseases, 7(4), 241. https://www.researchgate.net/publication/24018317_Systematic_Review_The_Global_Incidence_and_Prevalence_of_Peptic_Ulcer_Disease/citation/download.