Gastric Ulcer
This is characterized by ulceration of the stomach's mucous membrane. Sympathetic stimuli
inhibit the Brunner's glands which secrete a mucosa-protecting mucus. The stomach's lining thus
becomes more vulnerable to acids.
Gastric ulcer causes epigastric pain which comes in bouts lasting for a few weeks at intervals of
months. The pain occurs from 30 minutes to 2 hours after eating and it is not relieved by eating.
There may also be nausea, regurgitation and distension.
If the ulcer perforates, this is a serious emergency and the patient should be hospitalized as soon
as possible. It is characterized by a severe epigastric pain which soon spreads to the whole
abdomen and is aggravated on coughing and deep breathing. The pain often radiates to the
shoulder. The patient looks very distressed and under shock and, in contrast to the restlessness of
a gall-bladder and renal colic, he or she is reluctant to move. The abdomen is rigid and does not
move with breathing. The pain may deceptively subside about 6 hours after its onset. This may
give the dangerous impression that improvement is taking place. This is followed, however, by a
rise in the pulse rate and the patient's condition becomes more and more grave.
Carcinoma of the Stomach
This occurs only in middle age, usually after 40. The epigastric pain increases gradually over the
years. There is also difficulty in swallowing, lack of appetite and vomiting. In advanced cases,
the patient may vomit blood which looks like coffee-grounds. The patient looks increasingly
cachectic and his or her complexion is sallow. There will be anaemia or melaena if there is
chronic perforation. The liver may be enlarged with nodules.
Duodenum
Duodenal Ulcer
This is characterized by ulceration of the duodenum associated with increased secretion of acid.
The pain starts in the centre of the epigastrium and comes in bouts. It usually starts 2 to 3 hours
after eating and it is relieved by eating little and frequently. Other symptoms are similar to those
of gastric ulcer.
Pancreas
Pancreatitis