Symptoms of stomach ulcers and duodenal ulcer are often reminiscent of manifestations of other diseases or absent altogether. That is why timely diagnostics is important, which avoids such complications as internal bleeding and malignant degeneration of cells.
Ulcer of the stomach and duodenum: the features of the disease
The ulcer of the stomach and duodenum in the elderly and the elderly is 10% of all cases of ulcer disease in Ukraine.
In these age groups, it has a number of features that patients and their relatives do not always pay attention to, which sometimes complicates diagnosis, reduces the effectiveness of the treatment and directly affects the outcome of the disease.
There are two variants of the development of ulcers of the stomach and duodenum of the elderly and the elderly, which occur at the same frequency:
- Prolonged peptic ulcer disease that arose at a young age and since then periodically aggravated;
- Stomach ulcer, originated in the elderly, which is often a secondary nature, as a concomitant lesion in other diseases.
A peptic ulcer, which arose at a young age, preserves seasonal exacerbations (mainly in the spring and autumn). In this case, the exacerbation takes longer and more difficult than in younger years. There is also a frequent combination of ulcerous lesions of the stomach and bulb of the duodenum.
A peptic ulcer that has arisen in old age, it is also called "late ulcer disease" or "senile ulcers" associated with the presence of age-related changes in the patient's body and, in the first place, with the development of atherosclerosis, which affects the blood supply of many organs, including Gastric mucosa
In this case, the processes of natural regeneration and protective properties of the epithelium of the stomach are violated. And the presence of concomitant diseases, which are characteristic of the elderly, further worsens the condition of the patient, as they are also based on the violation of microcirculation in almost all organs and tissues.
Such diseases include:
- coronary heart disease,
- Hypertonic disease
- Atherosclerosis of the aorta and its branches,
- Varicose lesion of the vessels of the extremities,
- Chronic pyelonephritis,
- Diabetes mellitus and others.
In this case, unlike other types of peptic ulcer, which are mainly caused by bacteria, in elderly patients 25-30% of helicobacter is not detected.
In some cases, "late ulcers" occur asymptomatic or with insignificant discomfort, which patients often do not pay attention to, and the ulcerous disease is detected by accident, in the examination of other complaints and other diseases.
This clinical picture is more typical for ulcers located in the middle and upper parts of the stomach, often with a marked decrease in acidity, which is uncharacteristic for young and middle-aged people.
In fibro-gastroduodenoscopy and X-ray examination in elderly patients, in spite of all the poverty of subjective symptoms, there is a presence of larger (2-3 cm in diameter and more) stomach ulcer in younger patients.
In 30% of elderly patients, iron deficiency anemia, which is associated with increased bleeding ulcers due to the fragility of the vascular wall and the violation of metabolic processes in it.
In addition, in elderly patients bleeding from ulcerative education is observed in 2 times more often than in young ones, and is accompanied by a change in the color and structure of the chair (it becomes liquid and black).
Such a condition in medicine is called "melena", but it can be observed not only in peptic ulcer and duodenal ulcer, but also in other diseases accompanied by bleeding of different intensity in the organs of digestion.
Gastric ulcer and duodenal ulcer: diagnosis
Diagnosis of ulcers of the stomach and duodenum is a very complicated and responsible process, on which depends not only the deprivation of the patient from the suffering associated with the disease, but also the prognosis of the disease itself and the quality of life of the patient, since this age group is much more prone to oncological diseases.
It has now been established that the probability of a malignant tumor of an existing ulcer of the stomach does not exceed the probability of a primary malignant tumor of the stomach, and malignant degeneration of duodenal ulcer is a rare phenomenon.
Unfortunately, it is not always possible without a biopsy to establish a diagnosis of a malignant tumor of the stomach, as in many cases the infiltration-ulcerative form of cancer in conducting instrumental studies (X-rays and fibro-gastroduodenoscopy) gives a picture of the usual great benign ulceration.
There is a number of clinical indications that allow us to assume the presence of primordial-ulcerative cancer.
- Rapid (less than a year) development of the disease;
- Asthenization of a patient's condition with growing weakness, weight loss, significant weakening of appetite;
- Accelerated ESR in the patient's blood;
- The development of iron deficiency anemia;
- With X-rays, a number of signs typical of a malignant tumor are associated with the presence of a large, asymmetric ulcerative defect, decreased elasticity of the walls of the stomach due to infiltrative tumor growth and a number of other symptoms;
- When sensing the stomach, there is a "zero" acidity (achillia) and a periodic presence of blood impurities in the gastric contents;
- During fibrogastroduodenoscopy there is a bleeding flat ulcer, the bottom of which is covered with clots, around the ulcer there is inflammatory edema, uneven thickening of the mucosa, often associated with submucosal tumor growth. During this study, a biopsy is required from different parts of the ulcer and other parts of the stomach mucosa, which allows you to put a more accurate diagnosis.
Therefore, patients in the sloping and senile age as well as their relatives should not refuse the doctor's appointment as it will help to timely diagnose and prescribe appropriate treatment that will help restore health and prevent serious complications.