Acid peptic diseases include;

• Duodenal ulcer.

• Stomach ulcer

• Erosion of stomach

• Inflammation or gastritis of stomach.

• Oesophageal ulcer or erosion.

• Gastroesophageal reflux disease

• Ulcer in the part just beyond duodenum i.e.jejunum

• Ulcer or inflammation in the Mackel’s diverticulum in presence of ectopic gastric mucosa.

The feature of pain includes;

• 

  Image by drppanda via Flickr

  Colic pain in the upper mid-abdomen,

• Mostly marked either in empty stomach in case of duodenal ulcer or after taking food in case of stomach ulcer.

• Gradually the pain looses the timing in relation to food as the disease progresses.

• The pain is more marked in the winter season, i.e. seasonal exacerbation.

• Heart burn due to reflux of acid.

The disease can be assessed through endoscopy. Very good non-surgical treatment options are available now-a-days.

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An ulcer in the first part of duodenum with accompanying edema and gastritis seen here.

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Acid peptic disease commonly affects stomach,duodenum and/or lower esophagus .An uncommon site is Mackel’s Diverticulum. There may be the presence of ectopic stomach mucosa to cause the symptoms.Here there is  the same pathology to cause ulcer or inflammation.

Mackel’s diverticulum is an out pouching of intestine in it’s lower end.It is of short length and is blind.The pain here may not have a time relation to food or periodicity.Sometimes it causes perforation.Pain is felt little to the right side of umbilicus .May confuse with an appendicitis or a stone in the  right ureter.

It is difficult to diagnose.An ultrasonogram ,CT or barium meal follow through may help in diagnosis.Now-a-days a capsule endoscopy will accuratey diagnoses it.Nuclear imaging may help in diagnosing Mackel’s diverticulitis. Many a times when a normal looking appendix is found in a surgery for appendicitis a Mackel’s diverticulum is searched for.

Treatment is only surgery and is very effective.

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