Stomach ulcers are open, inflamed sores in the lining of the stomach. They are also known as gastric ulcers or peptic ulcers. Ulcers can also occur in the upper part of the small intestine — these are known as duodenal ulcers. Show Seek medical attention immediately if you experience:
What are the symptoms of a stomach ulcer?Most people with a stomach ulcer do not experience any symptoms. The most common symptom is burning pain in the upper abdomen. The pain can travel to the chest and neck, bellybutton, or back. Other less common symptoms include:
Sometimes, stomach ulcers can lead to more serious symptoms, such as:
If you have any of these symptoms, see a doctor immediately. What causes stomach ulcers?The most common causes of stomach ulcers are: People are more at risk of developing a stomach ulcer if they smoke or drink alcohol, or have a family history of ulcer disease. Spicy foods do not cause stomach ulcers, but they can worsen the symptoms. How are stomach ulcers diagnosed?Stomach ulcers are most commonly diagnosed by endoscopy — using a flexible tube with a tiny camera that is passed into the mouth and down to the stomach. This procedure is done under general anaesthetic. Your doctor may also order blood tests, stool tests or an x-ray. You are also likely to have tests to check for Helicobacter pylori infection. Usually this involves a breath test, or a test of the stomach lining during endoscopy. How are stomach ulcers treated?If you have a stomach ulcer, you may be given:
Some people have one of these treatments, while some have both. If you have a stomach ulcer that was caused by taking anti-inflammatory medications, do not stop these without talking to your doctor first. To help manage symptoms, you can also:
ABOUT DIAGNOSIS TREATMENT
An ulcer occurs when part of the lining of the stomach or intestines becomes deeply eroded. This typically happens in the stomach (gastric ulcer) or the in the duodenum (duodenal ulcer), which is located at the lower end of the stomach and the beginning of the small intestine. Ulcers range from quite small to an inch or more in size.
Symptoms vary depending on where the ulcer is and how old the patient is. Many patients, especially older ones, may have no symptoms. When symptoms do occur, they tend to come back again and again. Stomach (or peptic) ulcers may produce few or no symptoms, or they may cause burning, gnawing pain in the upper middle part of the abdomen that is relieved by eating or taking an antacid. Stomach ulcers often are not consistent. For example, eating sometimes will make the pain worse rather than better with certain types of ulcers, such as pyloric channel ulcers, which are often associated with bloating, nausea and vomiting, symptoms of a blockage caused by swelling (edema) and scarring. Duodenal ulcers tend to cause consistent pain. A patient may feel no pain when he or she awakens, but by midmorning it is present. The pain can be relieved by eating, but it usually returns two to three hours later. Pain that wakes a patient at night is common for duodenal ulcers. Causes and Risk Factors At one time ulcers were believed to be the result of too much stomach acid. It is now known that the main factors that lead to ulcers are the bacteria H. pylori and non-steroidal anti-inflammatory drugs (NSAIDS). These disturb the normal defense and repair processes of the mucosal linings, making them more vulnerable to attack from stomach acid. How H. pylori causes ulcers is not entirely clear. One theory is that the organism causes ammonia to be created so that it can survive in the stomach's acid. The ammonia may then erode the mucous barrier that protects the cells of the digestive tract. Other poisons and enzymes from the bacteria may also be a cause, and proteins produced by the body in response to inflammation may play a role. NSAIDs tend to cause inflammation of the GI tract lining. Weak acids themselves, NSAIDS cause a number of changes within the stomach, including reduced flow of blood to the stomach, less mucus production, and less cell repair and reproduction. All of these tend to break down the process of defense and repair that keeps the mucosa healthy.
A doctor usually bases a diagnosis of peptic ulcer on the patient's history. A physician will want to rule out the presence of stomach cancer, which can have similar symptoms. This is especially true in patients who are older, have lost weight, have severe symptoms or do not respond to treatment. The diagnosis can be confirmed through a variety of studies, such as:
In the past, ulcers were treated by trying to neutralize or decrease the amount of acid in the stomach. Current treatment focuses on eliminating H. pylori through antibiotics. Antibiotic treatment should be given to all ulcer patients who have been diagnosed with H. pylori, even if they have no symptoms or are being treated to reduce stomach acid. Antibiotic treatment is especially important for patients who have had complications in the past. Antibiotics to treat H. pylori are evolving, and a combination of antibiotics is usually prescribed. The symptoms of an ulcer can be relieved by taking antacids, which can also help prevent the symptoms from coming back and help promote healing of the ulcer. Antacids must be taken five to seven times a day and can interfere with the body's ability to absorb other drugs. The two general types of antacids are:
While there is currently no evidence that changing the diet helps an ulcer heal faster or prevents its return, a doctor may suggest that any food that causes distress be eliminated. These may include fruit juices, spicy foods and fatty foods. Alcohol tends to increase the acid in the stomach, and ulcer patients are usually advised to restrict their drinking of alcohol. Persons who smoke are at a higher risk of developing ulcers and complications. Smoking also slows the healing process and makes the return of ulcers more likely. Although surgical treatment is being prescribed less often, surgery may be necessary if complications do not respond to medical therapy, symptoms are severe or there is a suspicion that the ulcer may be cancerous. More than 60% of people have a return of their ulcers a year after traditional treatment has ended. Fewer than 10% of people have a recurrence of ulcers after anti-H. pylori therapy. The use of non-steroidal anti-inflammatory drugs might also affect recurrence of ulcers. Complications Certain complications can also result from peptic ulcers, including:
Treatment of complications varies. For example:
Persons who have H. pylori-related ulcers may be at higher risk for certain forms of cancer and lymphoma. © 2000-2022 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. |