Peptic ulcer resembles a “seven kinds of disease”

January 9, 2010 · Posted in Symptoms of gastric ulcer 

1, functional dyspepsia (non-ulcer dyspepsia NUD)

Functional dyspepsia refers to dyspepsia symptoms without ulcer or other organic diseases such as chronic gastritis, duodenitis, or biliary tract illness. This disease is quite common, more common in young women. Sometimes the symptoms resemble duodenal ulcer, but X-ray and gastroscopy Quewu ulcer was found. May have decreased stomach muscle tone, manifested as postprandial abdominal fullness discomfort, belching, acid reflux, nausea and loss of appetite, taking antacids can not be relieved, but after taking metoclopramide or domperidone for improvement. Often the performance of patients with neurosis, such as anxiety, insomnia, nervous tension, depression, depression, etc. can also be associated with irritable bowel syndrome, spastic colon manifested as painless abdominal pain or diarrhea, psychological treatment or tranquilizers and sedatives sometimes effective.

2, chronic gastric and duodenal inflammation

Often with chronic non-regularity of upper abdominal pain, endoscopy showed chronic antral gastritis and duodenal inflammation, but no ulcer, is the main means of diagnosis and identification.

III gastrinoma

Also known as Zolinger-Ellison syndrome, non-β cells in pancreatic tumors secrete large amounts of gastrin caused by is characterized by hypergastrinemia and high gastric acid secretion, and multiple, intractable peptic ulcer. Tumors tend to be small (<1cm) slow growth, half of the vicious. Er Shi wall due to overstimulation of gastrin cell hyperplasia, a large number of gastric acid secretion, so that the upper jejunum of upper digestive tract, including regular bathing in high-acid environment, leading to multiple ulcers to in the atypical position (the ball descending duodenum after the segment and Cross-section or even the distal jejunum) as its features. Such ulcers are very refractory, conventional gastric recurrence after surgery more common, and complicated by bleeding, perforation and obstruction. About 1/4-1/3 of cases with diarrhea. Diagnostic point is that: ① the basis of excessive gastric acid secretion, and often> 15mmol / h, BAO/MAO60%; ② X-ray examination showed atypical location of the ulcer often. In particular, multiple ulcers. Accompanied by a large number of gastric juice and thickened gastric folds of the gastric mucosa; ③ refractory ulcers, conventional gastric surgery does not work, easy to recur after operation; ④ associated with diarrhea; ⑤ serum gastrin> 500ng / L (normal <100ng / L) . Recently reported that effective with the H2-receptor antagonists, but the effects are not consolidated, often have to remove the tumor or for total gastrectomy.

4, gastric cancer

Gastric ulcer and gastric ulcer distinction of great importance, but sometimes more difficult. A number of gastric ulcers at an early stage, its morphology and clinical presentation may resemble a benign ulcers, and even after treatment may be temporarily healed (false more), so there are advocates for all patients with gastric ulcer should be carried out endoscopy, long on the edge of the ulcer biopsy clear the nature of the ulcers.

5, hookworm disease

Hookworms can cause duodenal inflammation, bleeding, or even melena, peptic ulcer symptoms may resemble. Endoscopy can be seen in the duodenum parasitic hookworm and bleeding points. All coming from rural areas while indigestion symptoms, shall find hook routine stool examination for eggs, deworming treatment is effective and can identify duodenal ulcer.

6, gastric mucosal prolapse syndrome

The disease may have upper abdominal pain, symptoms can be intermittent due to prolapse was intermittent. Abdominal pain, ulcers in general there is no rhythm or night pain, antacids can not be alleviated, but can be due to posture (supine or the left foot of the bed elevated) pressure is easing. Rely mainly on diagnostic X-ray barium meal examination showed duodenal bulb with “mushroom-like” or “umbrella” shadow defects.

7, cholecystitis and cholelithiasis

See more middle-aged women the disease can also cause chronic, recurrent upper abdominal pain, and sometimes misdiagnosed as peptic ulcer. Pain and a general lack of rhythm ulcers, often caused by the consumption and the attack and, if typical of Biliary Colic, Murphy sign was positive acute attack often have fever and jaundice, gallbladder imaging, B ultrasound and ERCP (endoscopic retrograde cholangiopancreatography) to check can be diagnosed.

Next Article: Ulcer perforation in three-stage progression

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