Prevention and treatment of anti-stomach ulcers

The originality and complexity of the etiological factors contributing to the development of ulcers, creates great difficulties in the preparation of specific programmes of measures, warning of the emergence of this disease. Prevention of peptic ulcer disease should be carried out in two main directions: the organization of recreational activities in the field of employment, welfare, nutrition, mental health, physical education and sports and organization of a system of medical preventive maintenance patients (A. A. Krivitsky, 1968). The most efficiently perform clinical examination of patients is possible only in the presence of a wide network of specialized gastroenterology clinics in urban polyclinics and hospitals. The first such offices already established in Leningrad, Ukraine (Chernivtsi, Donetsk), in Estonia.
Peptic ulcer disease is a chronic relapsing condition, and actual problem of dealing with it serves as relapse prevention, which come in 50-80% of cases. In some cases remission may be long, but usually even in cases of complete healing of ulcers and clinical recovery relapses occur at intervals from 3 months to 1-2 years (at least).
Among the causes of relapse it is necessary to mention physical fatigue (sometimes a hard working single or lifting weights), emotional overload, night work, lack of sleep, impaired diet, allergic diseases and intercurrent infections, reception of ulcerogenic drugs, alcohol, persistent Smoking. Particular importance is the time of year. Usually there are several provoke tensions factors.
What you can suggest measures to prevent a recurrence?
1. A thorough treatment of the first manifestations of peptic ulcer disease and compulsory medical examination, followed by active monitoring of a patient.
Obviously, of great importance is systematic (1 every 3-4 months) preventive courses of one of the cholinergic antagonists in combination with vikalin or other antacids, on the background of strict diet for 2-3 weeks. These courses should be conducted even in the absence of pain and dyspeptic disorders. When an acute hospitalization is required. In patients with a clearly pronounced seasonal prevalence of relapses over a month before the expected flash should undergo a course of preventive therapy. These courses prolong the period of remission, reduce the number of days of incapacity, reduce the severity of relapses.
Periodic hospitalization, undoubtedly, extend the period subsequent remission.
2. Create a quiet environment around the patient, elimination of negative emotions, traumatic psychological factors.
3. You should obtain the transfer of patients to lighter work, observance of the normal working day, with exemption from additional loads, as well as providing 8-hour sleep and one of the daily hours of rest.
4. The adherence to diet with periodic food "zigzags", but strict prohibition products, irritating the mucous membrane of the gastro-duodenal zone (see the section on the diet).
5. Smoking and alcohol should be banned. Coffee and strong tea can be consumed in limited amounts.
6. Limitation of ulcerogenic drugs (phenylbutazone, aspirin, reserpine, anticoagulants).
7. It is necessary to actively fight with allergic and intercurrent illnesses.
8. Need for understanding on the part of the patient in relation to nature, the course and character of "their" disease and values necessary medical and preventive measures.
Performance indicators preventive courses of treatment are: the total number of days of incapacity per year peptic ulcer disease, the number of exacerbations, their duration and the average number of days of incapacity of one person.
L. F. Kimlach and R. I. Pazineza (1968) found that in the absence of preventive courses of the disease occurred in 38%, and after their wide implementation in outpatient practice - only 22,4% of patients. According to their data, morbidity with temporary disability among workers per 100 people in 1962 (up preventive courses of treatment) was 2.5 monitoring and 41 day of disability, and in 1967 - 1.5 25.3 day. In 1961, the percentage of disability in connection with peptic ulcer disease was equal to 2.8, and in 1967 - 0,9.
E. I. Samson (1970) considered necessary to provide preventive treatment of patients with peptic ulcer within 5 years, with the first 2 years of treatment should be prolonged, continuous sometimes, as in the next 3 years in the absence of expressed relapse prevention courses are held 2 times a year for 1.5-2 months, usually in spring and autumn. In severe exacerbations of the disease is shown repeated hospitalization.
Materials clearly indicate the great benefits of preventive therapy courses both in medical and social aspects.
Wide active preventive measures may actually contribute to the reduction of morbidity and prevention of early disablement large populations.