Peptic ulcers
Peptic ulcers are primarily caused by Helicobacter pylori, an invasive bacterial species. The bacteria colonize the duodenal and gastric membranes, thus causing inflammation. However, the bacteria are only linked to the ulceration of the membranes. Sharp burning sensations typify peptic ulcers in the upper epigastrium (Vernon, 2019, p. 655). These sensations of pain usually subside after a meal. This suggests a relationship between peptic ulcers and digestive secretions. Thus far, research has linked the burning sensations experienced by peptic ulcers patients to the imbalanced secretion of pepsin and digestive acids(hydrochloric acid) by the mucosal cells lining the duodenal canal. The H. pylori infection causes inflammation of the epigastrium hence the pain (Vernon, 2019, p. 653). The imbalanced acid-pepsin secretion leads to impaired defensive mechanism of the duodenal walls, which compounds the pain sensations witnessed in peptic ulcers.
The subsidence of pain after a meal directly link peptic ulcers to acid-pepsin secretion. In a typical non-ulcerated gastric canal, the mucosal membrane protects the walls of the alimentary canal from the self-destructive action of digestive enzymes and juices. Most of the digestive enzymes and juices secreted in epigastrium are active on proteins. The cells of the walls lining the epigastrium are made from proteinous material (Vernon, 2019, p. 657). In the absence of a protective mucosal lining or food, these enzymes and juices digest the walls lining the epigastrium. This leads to severe pain and burning sensations in the upper epigastrium and back. After a meal, these enzymes and juices(majorly pepsin and hydrochloric acid) have a boosted supply of substrates to digest. As such, acid-pepsin action shifts from the epigastric lining to the dietary substrates (Vernon, 2019, p. 656). As a result of this shift, the burning sensation subsides after a meal.
The prescribed pharmacologic therapy for peptic ulcers involves a combinational therapy consisting of antibiotics, proton pump inhibitors, and bismuth salts. Antibiotics are pharmacologic agents that exert their therapeutic effects by killing or inactivating bacteria. The primary cause of peptic ulcers is a bacterial strain, H. pylori (Vernon, 2019, p. 655). The use of antibiotic therapy helps in the elimination of H. pylori hence facilitating the management of peptic ulcers. Proton pump inhibitors reduce the production of gastric acids by up to 90%. A reduction in gastric acid production consequently reduces pain and irritation of the epigastrium caused by peptic ulcers (Vernon, 2019, p. 657). In an acidic medium, bismuth salts adhere to the mucosal linings, thus inhibiting the action of pepsin. Bismuth also stimulates the biosynthesis of prostaglandins which act as anti-inflammatory agents. Therefore, bismuth salts help reduce inflammation in peptic ulcers. A combinational therapy with antibiotics, proton pump inhibitors, and bismuth salts help kill the bacterial agent of peptic ulcers(H. pylori), inhibit gastric acid overproduction, and prevent inflammation of the ulcerated regions (Vernon, 2019, p. 658). This provides a holistic treatment for peptic ulcers