Acid Peptic Disease (APD) — Causes and Symptoms

Acid Peptic Disease is not a single disease but encompasses three main conditions:

1. Gastroesophageal Reflux Disease (GERD): Acid backing up into the esophagus (food pipe), causing heartburn.
2. Gastric Ulcer: Open sores on the inner lining of the stomach.
3. Duodenal Ulcer: Open sores on the lining of the upper part of the small intestine (duodenum).

Collectively, gastric and duodenal ulcers are known as Peptic Ulcer Disease (PUD).

The stomach is normally protected from its own strong acid (HCl) by a thick mucous layer. APD occurs when this protective layer breaks down. The two primary causes are:

1. Helicobacter pylori (H. pylori) infection: A common bacteria that lives in the mucous lining of the stomach and causes inflammation, leading to ulcers.
2. Prolonged use of NSAIDs: Non-Steroidal Anti-Inflammatory Drugs like Aspirin, Ibuprofen, and Naproxen block the chemicals that protect the stomach lining.

Aggravating factors (these don't cause ulcers, but make them worse):

• Smoking
• Heavy alcohol consumption
• Severe physical stress
• Spicy foods and poor dietary habits

• Burning stomach pain (the most common symptom), usually between the breastbone and belly button.
• Heartburn (a burning sensation in the chest).
• Bloating or feeling uncomfortably full after meals.
• Nausea and vomiting.
• Frequent burping or acid regurgitation in the throat.

Severe symptoms requiring immediate medical attention: Vomiting blood (which may look like coffee grounds) or passing dark, tarry black stools (indicating internal bleeding).

• Antacids: To instantly neutralize stomach acid (Eno, Gelusil).
• PPIs (Proton Pump Inhibitors): Drugs like Pantoprazole or Omeprazole that block the stomach's acid-producing pumps, allowing the ulcer to heal.
• Antibiotics: If an H. pylori test is positive, a course of antibiotics is required to kill the bacteria and prevent the ulcer from returning.