How We Care For Peptic Ulcers
The Division of Gastroenterology, Hepatology and Nutrition at Boston Children’s Hospital cares for infants, children, and young adults with gastrointestinal conditions like peptic ulcers. We provide the most comprehensive and leading-edge endoscopic services in the country for the care and treatment of peptic ulcers.
What Is The Treatment For Peptic Ulcers
The choice of treatment depends on whether or not the ulcer is caused by infection with H pylori. Correct diagnosis is key to whether a treatment works or not. If the bacteria are the cause, treatment focuses on killing the infection. Regardless of whether the bacteria are the cause, reducing acid in the stomach is another important focus of treatment.
The following treatments are recommended for ulcers:
- Lifestyle changes: Quit smoking, avoid alcohol, aspirin, and NSAIDs
- Acid-blocking medications
- Medications that protect the lining of the stomach and duodenum
- “Triple-therapy” or “dual-therapy” regimens for ulcers caused by H pylori
No single medication works to get rid of H pylori infection. Two combinations have been found that work well in most people.
These treatments are generally given for two weeks.
Once H pylori bacteria are eradicated from a person’s digestive tract, usually it will not come back. The ulcers usually heal completely and do not return.
Treatment for bleeding ulcers depends on the severity of blood loss and includes:
It is important to remember that treatment may not work if the diagnosis is not correct. If the doctor diagnoses an ulcer, it is important to determine whether the ulcer is caused by infection with H pylori.
How Common Are Stomach Ulcers
Stomach ulcers are very common in Western countries. In the United States, there are about 4 million cases per year. Some estimates say that 1 in 10 people will have one at some point in their lives. Thats because many of the causes that contribute to stomach ulcers are common in Western life. Fortunately, these causes are usually easy to trace and to reverse, giving ulcers a chance to heal and your stomach lining a chance to repair.
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Treating Helicobacter Pylori Infection
If your stomach ulcer’s caused by a Helicobacter pylori bacterial infection, you’ll be given:
- a course of antibiotics
- a medication called a proton pump inhibitor
This is also recommended if it’s thought your stomach ulcer’s caused by a combination of an H. pylori infection and non-steroidal anti-inflammatory drugs .
How Is A Peptic Ulcer Diagnosed
Your doctor will ask about your symptoms, whether you take NSAIDs and other drugs, and medical history. Theyâll also check you for bloating in the belly and pain. That may be enough to make a diagnosis.
The only way your doctor can tell for sure if you have an ulcer is to look. They may use a series of X-rays or a test called an endoscopy. This test allows them to pass a thin, bendy tube down your throat and into your stomach and small intestine. The tube has a camera at the end so they can check the lining for ulcers. They may also take a small piece of the lining to test for H. pylori. Blood, breath, and stool sample tests also can screen for the bacteria.
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What Does A Stomach Ulcer Feel Like
The classic symptoms of peptic ulcers are stomach pain and indigestion. Ulcer pain feels like burning or gnawing inside your stomach, which is between your breastbone and your belly button. It may improve temporarily when you eat or drink or when you take an antacid, medication to reduce stomach acid. It may feel worse between meals and at night when stomach acid builds up without food to digest. It may also make you feel like you dont want to eat.
How do I know if I have an ulcer or gastritis?
Gastritis and gastric ulcers share many symptoms and often go hand in hand. Gastritis can be a precursor to stomach ulcers, caused by the same conditions that will eventually cause ulcers, including H. pylori infection and mucous erosion. You may also have both.
Both gastritis and stomach ulcers can cause stomach pain, as well as symptoms of indigestion. Usually, the pain from an ulcer will feel more localized like its coming from one particular spot. But since some ulcers are silent, you might not feel it if you do have one.
If you have symptoms of either gastritis or stomach ulcer, you should seek medical care. Gastritis can lead to ulcers if it hasnt already. It can also indicate an infection or other condition that needs to be treated. Medical testing can quickly determine the causes of your stomach pain.
How can I tell if I have ulcer pain or heartburn?
Causes And Treatments For Stomach Ulcers In Adults
Disclaimer: Results are not guaranteed*** and may vary from person to person***.
Stomach ulcers in adults have a lot of possible causes, but one cause that is often overlooked is stress. Even if you are healthy and have no other health problem, simply being stressed out could be causing painful stomach ulcers to occur.
Stomach ulcers are sores in the lining of your stomach or small intestine. The stomach lining and small intestine have a layer of mucus which protects them from acidic digestive juices. If this mucus is reduced, our digestive juices can eat away at our stomach lining or small intestine, creating those pain-inducing stomach ulcers we want to avoid.
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What Is A Stomach Ulcer
A stomach ulcer, also called a gastric ulcer, is an open sore that develops in your stomach lining. You can also get one in your duodenum, the first part of the small intestine that your stomach feeds into. Duodenal ulcers and stomach ulcers are both types of peptic ulcers. Theyre named for pepsin, one of the digestive juices that are found in the stomach and that sometimes leak into the duodenum. These juices are a contributing factor in peptic ulcer disease.
Peptic ulcers occur when the protective mucous lining in your stomach and duodenum has been eroded, allowing gastric acids and digestive enzymes to eat away at your stomach and duodenal walls. This eventually results in open sores that are continually irritated by the acid. If left untreated, they can begin to cause serious complications, such as internal bleeding. Over time, they can even wear a hole all the way through. This is a medical emergency.
Can Peptic Ulcers Be Prevented
Doctors arent sure how H. pylori bacteria spread from person to person. The bacteria have been found in saliva , so kissing may be one way. They also may spread through food, water, or contact with vomit thats infected with the bacteria.
Regular use of NSAIDs can cause gastrointestinal problems and bleeding in some people. Acetaminophen does not cause stomach ulcers and is a good alternative to NSAIDs.
As with many infections, washing your hands well and often is an important part of ulcer prevention. This is extra important after you use the bathroom and before you eat. And take good care of your body by exercising regularly and not smoking or drinking.
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What Kind Of Doctor Treats Peptic Ulcers
- If you suspect you may have a peptic ulcer, you may first be diagnosed by your family practitioner or internist.
- Children or teenagers may see a pediatrician.
- For further treatment you will likely be referred to a gastroenterologist, a specialist in disorders of the digestive tract.
- If you have an emergency such as vomiting or severe abdominal pain you will be seen by an emergency medicine specialist in an emergency room.
- In the rare case where surgery is needed, you may see a general surgeon.
What Are The Symptoms Of A Bleeding Ulcer
Bleeding ulcers dont always cause pain. Sometimes the first signs of a bleeding ulcer are signs of anemia. These include:
- Dizziness or lightheadedness.
You might have a heavier bleed if you notice:
- Blood in your poop, or black poop that resembles tar.
- Bloody vomit.
These symptoms require urgent medical attention.
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How Soon After Treatment Will I Feel Better
If you take all medicines as prescribed and avoid irritating the ulcer with NSAIDs, alcohol or smoking, your ulcer should heal well within a few weeks. Surgical cases may take a few weeks more. Your healthcare provider will follow up with you at the end of your course of medication to make sure the ulcer has healed and any infection has cleared. They will probably take follow-up tests, including an upper endoscopy to look at the site of the ulcer and tests for H. pylori, if you had it, to make sure the infection is gone.
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:
- feeling full and bloated, or belching
- not being able to tolerate fatty foods
Sometimes, stomach ulcers can lead to more serious symptoms, such as:
- a sudden sharp pain in the stomach that gets worse
- vomiting blood
- blood in your stool or black, tarry stools
- weight loss
If you have any of these symptoms, see a doctor immediately.
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What Natural Home Remedies Help Peptic Ulcer Pain
Home care for peptic ulcers often centers on neutralizing the stomach acid.
- Don’t smoke, and avoid coffee and alcohol. These habits increase gastric acid production and weaken the mucosal barrier of the GI tract promoting ulcer formation and slowing ulcer healing.
- Don’t take aspirin or nonsteroidal anti-inflammatory medications. Acetaminophen is a good substitute for some conditions. If acetaminophen doesn’t help, talk to your health-care professional about alternatives.
- If your symptoms are mild, try an over-the-counter antacid or nonprescription histamine blocker to neutralize stomach acid. Usually stronger prescription medications are needed.
What Are Some Ulcer Symptoms
Some people with ulcers dont experience any symptoms. But signs of an ulcer can include:
- Gnawing or burning pain in your middle or upper stomach between meals or at night.
- Pain that temporarily disappears if you eat something or take an antacid.
In severe cases, symptoms can include:
- Dark or black stool .
- Severe pain in your mid- to upper abdomen.
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What About Complicated Ulcers
While most ulcers are successfully treated with medication, some complicated ulcers may require surgery. Ulcers that are bleeding, or that have perforated your stomach or intestinal wall, will need to be surgically repaired. An ulcer that is malignant, or obstructing a passageway, will need to be surgically removed. In severe cases, an ulcer that keeps coming back may be treated by surgery to cut off some of the nerve supply to the stomach that produces stomach acid.
How Do Nsaids Cause A Peptic Ulcer
To understand how NSAIDs cause peptic ulcer disease, it is important to understand how NSAIDs work. Nonsteroidal anti-inflammatory drugs reduce pain, fever, and inflammation, or swelling.
Everyone has two enzymes that produce chemicals in your bodys cells that promote pain, inflammation, and fever. NSAIDs work by blocking or reducing the amount of these enzymes that your body makes. However, one of the enzymes also produces another type of chemical that protects the stomach lining from stomach acid and helps control bleeding. When NSAIDs block or reduce the amount of this enzyme in your body, they also increase your chance of developing a peptic ulcer.
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Causes Of Stomach Ulcers
Stomach ulcers happen when theres damage to the layer that protects the stomach lining from the acids in your stomach.
This is usually a result of:
- an infection with Helicobacter pylori bacteria
- taking anti-inflammatory medicines , such as ibuprofen or aspirin particularly if they’re taken for a long time or at high doses
It used to be thought that stress or certain foods might cause stomach ulcers, but there’s little evidence to suggest this is the case.
Stomach ulcers can affect anyone but are more common in people aged 60 or over. Men are more affected than women.
Mayo Clinic Q And A: How Is A Peptic Ulcer Treated
DEAR MAYO CLINIC: Last year,I was diagnosed with heartburn due to a peptic ulcer. My doctor suggested that I see a specialist. Who should I see, and what type of treatment is available?
ANSWER: Many people will note that they have “heartburn,” and it is important to know that such a symptom could be related to one of several issues in the digestive tract, including peptic ulcer disease. This is where visiting with a health care professional who specializes in disorders of the gastrointestinal tract a gastroenterologist can help.
Once diagnosed and treated, ulcers usually heal within several months. But a gastroenterologist can help you find the underlying cause of your ulcer and decide on the best treatment going forward.
A peptic ulcer is an open sore on the inside lining of the stomach or the upper part of the small intestine. Peptic ulcers are not rare, and their frequency can depend on age, gender, other medical issues, medications and geography.
It’s possible to have a peptic ulcer and not have any symptoms, although they may cause stomach pain. In some people, a peptic ulcer isn’t identified until they experience symptoms related to a complication from an ulcer, such as bleeding or a hole in the lining of the stomach or bowel.
H. pylori is a bacterium that can live in the mucous layer covering the lining of the stomach. It doesn’t always lead to health problems, but it can sometimes trigger inflammation of the stomach’s inner layer, producing an ulcer.
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Is There A Peptic Ulcer Diet Plan
No particular diet is helpful for people with peptic ulcers. At one time, a bland diet and avoidance of spicy or greasy foods was recommended. Milk and dairy food have been used in the past for ulcer symptoms, but have not been proven to be effective. We now know diet has little effect on ulcers. In some people, however, certain foods seem to aggravate stomach ulcer symptoms. Keep a food diary with your intake and the resulting symptoms and avoid eating any foods that aggravate symptoms.
What Tests Are There For A Stomach Ulcer
If your doctor thinks you may have a stomach ulcer, the initial tests will include some blood tests. These tests will help to check whether you have become anaemic because of any bleeding from the ulcer. The blood test will also check to see that your liver and pancreas are working properly.
The main tests that are then used to diagnose a stomach ulcer are as follows:
- A test to detect the H. pylori germ is usually done if you have a stomach ulcer. The H. pylori bacterium can be detected in a sample of stool , or in a ‘breath test’, or from a blood test, or from a biopsy sample taken during a gastroscopy. See the separate leaflet called Helicobacter Pylori for more details.
- Gastroscopy is the test that can confirm a stomach ulcer. Gastroscopy is usually done as an outpatient ‘day case’. You may be given a sedative to help you to relax. In this test, a doctor looks inside your stomach by passing a thin, flexible telescope down your gullet . The doctor will then be able to see any inflammation or ulcers in your stomach.
- Small samples are usually taken of the tissue in and around the ulcer during gastroscopy. These are sent to the laboratory to be looked at under the microscope. This is important because some ulcers are caused by stomach cancer. However, most stomach ulcers are not caused by cancer.
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How Are Ulcers Diagnosed
Your healthcare provider may be able to make the diagnosis just by talking with you about your symptoms. If you develop an ulcer and youre not taking NSAIDs, the cause is likely an H. pylori infection. To confirm the diagnosis, youll need one of these tests:
Endoscopy
If you have severe symptoms, your provider may recommend an upper endoscopy to determine if you have an ulcer. In this procedure, the doctor inserts an endoscope through your throat and into your stomach to look for abnormalities.
H. Pylori tests
Tests for H. pylori are now widely used and your provider will tailor treatment to reduce your symptoms and kill the bacteria. A breath test is the easiest way to discover H. pylori. Your provider can also look for it with a blood or stool test, or by taking a sample during an upper endoscopy.
Imaging tests
Less frequently, imaging tests such as X-rays and CT scans are used to detect ulcers. You have to drink a specific liquid that coats the digestive tract and makes ulcers more visible to the imaging machines.
When Should I Call My Healthcare Provider
See your healthcare provider right away if you have any of these symptoms:
- Vomiting blood or dark material that looks like coffee grounds
- Extreme weakness or dizziness
- Blood in your stools
- Nausea or vomiting that doesnt get better, or gets worse
- A sudden, severe pain that may spread to your back
- Losing weight without even trying
Untreated peptic ulcers may cause other health problems. Sometimes they bleed. If they become too deep, they can break through your stomach.
Ulcers can also keep food from going through your stomach.
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