Article 17: Characteristics of Gastrointestinal Ulcers and Viral Hepatitis in the Elderly

Characteristics and prevention of peptic ulcers in the elderly

Gastric and duodenal ulcers are collectively referred to as peptic ulcers.

Gastric ulcers mostly occur in the lesser curvature and antrum of the stomach; duodenal ulcers mostly occur in the duodenal bulb.

Because the formation of ulcers is related to the digestive action of gastric acid and pepsin, they are called peptic ulcers.

Characteristics of peptic ulcers in the elderly:

1. Most patients have peptic ulcers before the age of 60, therefore, the course of the disease is generally long.

2. Due to the unique psychological characteristics of the elderly, such as unstable emotions and irritability, they are prone to developing ulcers over time.

3. Symptoms are not as typical as in young people. Rhythmic pain, acid reflux, and heartburn are less common. The main symptoms are poor appetite, weight loss, malabsorption, malnutrition, and anemia.

4. Elderly people have poor gastric motility and reduced gastric tension, causing food to remain in the stomach for a longer time. This stimulates the antrum of the stomach to produce a large amount of gastrin, which can lead to gastric ulcers.

Therefore, the incidence of gastric ulcers is higher in the elderly than in duodenal ulcers.

5. Elderly people have weak immune systems and are prone to complications.

For example, atrophic gastritis and gastric cancer are more common, as are massive bleeding from gastrointestinal ulcers, gastrointestinal perforation and shock caused by bleeding, and pyloric obstruction.

6. Elderly people often have complex medical conditions, with many suffering from various diseases such as cardiovascular, lung, cirrhosis, cholecystitis, brain, and kidney diseases, all of which can cause digestive tract ulcers.

7. Elderly people, especially those who frequently take medication, may experience damage to the gastric mucosa due to drug irritation, such as aspirin and hormones used to treat arthritis, which can cause ulcers.

To prevent ulcers, it's important to maintain good gastrointestinal health, protect your teeth, eat less sweets, brush your teeth morning and night, eat a balanced diet, and consume plenty of fiber-rich foods and fruits. Cook food to be appealing in color, aroma, and taste, and retain a certain amount of moisture.

Eat meals on time, and don't eat too much at dinner.

Do not smoke, and do not drink excessively.

Develop a regular bowel movement habit and pay attention to the color of your stool.

Regular physical examinations should be conducted at least once a year.

If elderly people frequently experience upper abdominal pain, acid reflux, and black stools, they should go to the hospital immediately for examination. If necessary, a gastroscopy can be performed to clarify the diagnosis.

After being diagnosed with peptic ulcer, you should rest, eat small, frequent meals, avoid spicy foods, abstain from smoking and alcohol, and cooperate with medication treatment.

There are many treatment options for senile peptic ulcers (gastric and duodenal ulcers).

For example, for those with excessive stomach acid, medications that reduce stomach acid, such as sodium bicarbonate, aluminum hydroxide, and calcium carbonate, are used; histamine H₂ receptor blockers, such as ranitidine and famotidine, are used; proton pump inhibitors, such as omeprazole and lansoprazole, are used; gastric mucosal protectants, such as dexamethasone, are used; and there are also drugs to combat Helicobacter pylori, such as metronidazole, oral gentamicin, and carbapenem, etc. A one-week treatment regimen of antacids plus anti-Helicobacter pylori drugs is often used.

In other countries, there is a method of applying medication locally to ulcers and then removing it, which has shown very good results.

Elderly people and viral hepatitis

Viral hepatitis is classified into five types: hepatitis A, B, C, D, and E caused by viral infections.

Hepatitis B is the most common disease among the elderly. Since hepatitis D is contracted on the basis of hepatitis B, its incidence rate is also relatively high. Elderly people also have a high chance of contracting hepatitis C due to the frequent need for blood transfusions for other diseases. They are less likely to be infected with hepatitis A and hepatitis E.

Although the incidence of hepatitis in the elderly is not high, the onset is atypical, the symptoms are severe, and there are many cases of moderate to severe hepatitis and complications, resulting in a high mortality rate.

People who drink alcohol are especially susceptible to hepatitis B and hepatitis C, which can develop into chronic hepatitis, cirrhosis, and in some cases, liver cancer.

Elderly patients with hepatitis often experience severe symptoms and a rapid onset, including significant fatigue, loss of appetite, upper abdominal distension, nausea, vomiting, and hepatomegaly. They may also experience fever and chills. Acute hepatitis is characterized by significant jaundice, markedly elevated transaminase levels in liver function tests, and severe liver cell damage.

Some elderly patients develop mental symptoms in the early stages, which can easily be confused with hepatic coma.

Because elderly people have weak immune systems, the recovery time is long, generally requiring 2 to 3 months.

Therefore, elderly patients with hepatitis should be hospitalized immediately upon diagnosis.

In short, hepatitis is much more serious in the elderly than in young people.

Unfortunately, there is currently no specific cure for hepatitis. Treatment mainly involves rest, improved nutrition, and the use of liver-protecting Chinese and Western medicines that do not damage the liver under the guidance of a doctor.

Patients should abstain from alcohol and avoid opportunities that could lead to hepatitis infection. For example, controlling what you eat can prevent hepatitis A and E. Hepatitis B, C, and D are often contracted through intravenous infusions and blood transfusions, so it is essential to strictly inspect injectable supplies and blood products to avoid viral hepatitis infection.

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