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1. What are the causes of acid peptic diseases? (etiology)?
Ans It is better to use the terms commonly known and associated factors with the occurrence of this pain & discomfort in the abdomen because there are no definite & conclusive causes established.
The known causes of Hyperacidity are
- Faulty food habits like spicy, oily, sour food items in excess, fast food, junk food, roadside food in excess and irregular timings in eating
- Smoking, drinking alcohol, tea, coffee in excess
- Irregular and inadequate sleep, stressful and long duty hours
- Habitual consumption of pain killers for chronic pain (NSAIDs) or other medications for any concurrent medical conditions
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H. pylori infection reported to be through air and food
2. Do psychological factors also cause acid peptic disease?
Ans Yes, psychological factors are the common causes for acid peptic diseases.
These include:
- Executive stress/Type A personality There was a time when peptic ulcer was known as an “Executive illness” due to the stress of their jobs. Now even common people including housewives are known to develop gastritis and ulcers
- Family tensions
- Personal problems
- Exam tensions
- Disturbed sleep
- A worrying nature of the patient
The old term of hurry-worry-curry applies.
3. How to diagnose acid peptic diseases?
Ans Any acute surgical conditions (collectively labeled as “Acute Abdomen” like acute Appendicitis) should be ruled out in the beginning.
- A careful history of the illness, previous treatment taken (esp. pain killers), self medications, should be asked
- A possibility of stress (Psychological) as a causative factor should be considered
- Complete physical examination especially epigastric discomfort or pain. History of dark colored stools should be asked
- Gastric Analysis (now outdated)
- Barium Meal (may be necessary)
- Endoscopy (may be necessary)
4. What are the symptoms??
Ans It depends on the stage when the patient approaches you. They include
- Burning sensation in epigastric region
- Heaviness of stomach, dyspepsia, belching, flatulence, nausea and vomiting
- Feeling hungry at odd times and getting relief after eating (or aggravation after eating)
- In later stages there may be severe tenderness in the epigastric region
On prolonged duration patient will present symptoms of anxiety & depression such as:
- Tension
- Apprehension
- Dizziness
- Depressed mood
- Irritability
- Agitation
- Lack of energy
- Appetite disturbances
- Insomnia
5. What is the treatment of acid peptic diseases?
Ans The pharmacotherapy aims at immediate intervention in the pain process.
- This includes the use of the Antacids. They could be simple molecules to neutralize the excess acid.
- To inhibit the excessive secretion of gastric acid – H2 Receptor antagonists can be used
- Use of Proton pump inhibitors
- The surgical resections of affected parts (now not commonly done)
- Explaining the patients the need of a relaxed way of life and healthy food items.
6. What is the treatment of associated anxiety & depression??
Ans When indicated as per the symptoms anti-anxiety and antidepressant medications need to be used. There are various anti-anxiety and antidepressants available. The selection of proper drug can’t be decided without proper knowledge of the background of the patient.
The commonly prescribed antidepressants & their dosage are given in the table below
Usual adult dosage range in mgs of available antidepressants
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