Chronic Peptic Ulcers: Diagnosis and Management Insights

Follow-up on examination report?

Hello, doctor.
In 2015, I underwent further evaluation due to abnormal fecal occult blood results during a health checkup, which led to a colonoscopy and gastroscopy.
During these procedures, a polyp in the rectum was found and removed.
However, this year I visited the clinic three times for stomach pain without a clear diagnosis, and I was subsequently admitted for further examination and treatment.
During my hospitalization, two additional polyps in the rectum were discovered and removed, but I still experienced discomfort in my stomach post-surgery.
On the day of my discharge, the doctor diagnosed me with esophageal ulcer and gastric ulcer.
In 2015, the doctor diagnosed me with chronic peptic ulcer disease.
How can I determine which specific digestive organ or area is referred to by the term "chronic peptic ulcer disease"? After the polyp removal in 2015, I did not experience any abdominal or stomach pain until this year.
Is there a possibility of recovery?

Ting, 20~29 year old female. Ask Date: 2018/07/19

Dr. Chen Shidian reply Gastroenterology and Hepatology

Hello, the term chronic peptic ulcer does not have a specific meaning; it generally refers to gastric or duodenal ulcers.
There should be no correlation between colon polyp removal and stomach pain, and further observation is recommended.
Changhua Hospital cares about your health.
Chen Shidian

Reply Date: 2018/07/19

More Info

Chronic peptic ulcers are a common gastrointestinal condition characterized by the formation of sores in the lining of the stomach or the first part of the small intestine (duodenum). They can also occur in the esophagus, particularly in individuals with gastroesophageal reflux disease (GERD). The diagnosis and management of chronic peptic ulcers involve a comprehensive understanding of their etiology, symptoms, diagnostic procedures, and treatment options.

Diagnosis of Chronic Peptic Ulcers
The diagnosis of chronic peptic ulcers typically begins with a thorough medical history and physical examination. Patients often report symptoms such as abdominal pain, bloating, nausea, and changes in appetite. In your case, the presence of gastrointestinal bleeding indicated by abnormal fecal occult blood tests led to further investigations, including endoscopy. Endoscopy allows direct visualization of the gastrointestinal tract and the opportunity to obtain biopsy samples for histological examination.

In your situation, the discovery of rectal polyps and subsequent diagnoses of esophageal and gastric ulcers highlight the importance of regular surveillance and follow-up in patients with a history of gastrointestinal issues. Chronic peptic ulcers can be classified based on their location: gastric ulcers (in the stomach), duodenal ulcers (in the duodenum), and esophageal ulcers (in the esophagus). Each type may have different underlying causes and treatment approaches.

Management of Chronic Peptic Ulcers
The management of chronic peptic ulcers primarily focuses on alleviating symptoms, promoting healing, and preventing complications. Treatment options include:
1. Medications: Proton pump inhibitors (PPIs) are commonly prescribed to reduce gastric acid secretion, promoting ulcer healing and alleviating pain. Antacids and H2-receptor antagonists may also be used. If Helicobacter pylori infection is present, antibiotics are necessary to eradicate the bacteria.

2. Lifestyle Modifications: Patients are advised to avoid irritants such as nonsteroidal anti-inflammatory drugs (NSAIDs), alcohol, and smoking, which can exacerbate ulcer symptoms. Dietary changes may also be beneficial, although specific dietary restrictions can vary among individuals.

3. Regular Monitoring: Given your history of polyps and ulcers, regular endoscopic surveillance is crucial. This allows for the assessment of ulcer healing and the detection of any potential malignancy, especially in the context of chronic inflammation.

4. Surgical Intervention: In cases where ulcers do not respond to medical therapy or if complications arise (such as perforation or significant bleeding), surgical options may be considered.

Prognosis and Healing Potential
Regarding your question about the potential for healing, chronic peptic ulcers can heal with appropriate treatment. However, the healing process may vary based on several factors, including the ulcer's location, underlying causes, and adherence to treatment recommendations. It is essential to follow up with your healthcare provider to monitor your condition and adjust treatment as necessary.

In summary, chronic peptic ulcers are a significant health concern that requires careful diagnosis and management. Regular follow-up, adherence to treatment, and lifestyle modifications are key components in promoting healing and preventing recurrence. If you have ongoing symptoms or concerns, it is crucial to communicate with your healthcare provider for tailored advice and management strategies.

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