What Are Mouth Ulcers
Mouth ulcers, also known as canker sores or aphthous ulcers, are small but painful lesions inside the mouth.
These lesions may make eating, drinking, and talking uncomfortable. They are not contagious and usually heal within a few days to a week.
Mouth ulcers may develop after an accidental injury to the soft tissue lining in the mouth. However, other mouth ulcers may appear naturally.
In addition, people with a known family history of canker sores are more susceptible to developing mouth ulcers.
Mouth ulcers are self-healing. If the sore increases in size and becomes more painful, you may need immediate medical attention. If an ulcer does not go away on its own, it might be a sign of mouth cancer.1
When Should I Go To Er
Seek emergency care if you have:
- Severe pain that doesnt go away.
- Signs of blood in your poop or bloody vomit.
- Signs of severe blood loss, such as paleness and faintness.
A note from Cleveland Clinic
Stomach ulcers are common and treatable, but they should be taken seriously. Even when they dont cause symptoms, they arent a good sign. A stomach ulcer means that your natural stomach acid is overwhelming your protective stomach lining. Thats a situation that can only get worse if it isnt managed. Lifestyle changes may help, but youll still need to treat the underlying cause. Its probably either NSAID use or a common bacterial infection. Your healthcare provider can help prescribe the right medicines for your condition.
How Do H Pylori Cause A Peptic Ulcer And Peptic Ulcer Disease
H. pylori are spiral-shaped bacteria that can cause peptic ulcer disease by damaging the mucous coating that protects the lining of the stomach and duodenum. Once H. pylori have damaged the mucous coating, powerful stomach acid can get through to the sensitive lining. Together, the stomach acid and H. pylori irritate the lining of the stomach or duodenum and cause a peptic ulcer.
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How Are Stomach Ulcers Diagnosed
Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications youre taking.
To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, youll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.
Other tests and procedures used to diagnose stomach ulcers include:
- Barium swallow: You drink a thick white liquid that coats your upper gastrointestinal tract and helps your doctor see your stomach and small intestine on X-rays.
- Endoscopy : A thin, lighted tube is inserted through your mouth and into the stomach and the first part of the small intestine. This test is used to look for ulcers, bleeding, and any tissue that looks abnormal.
- Endoscopic biopsy: A piece of stomach tissue is removed so it can be analyzed in a lab.
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
- blood in your stool or black, tarry stools
If you have any of these symptoms, see a doctor immediately.
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How Do Doctors Treat An Nsaid
If NSAIDs are causing your peptic ulcer and you dont have an H. pylori infection, your doctor may tell you to
- stop taking the NSAID
- reduce how much of the NSAID you take
- switch to another medicine that wont cause a peptic ulcer
Your doctor may also prescribe medicines to reduce stomach acid and coat and protect your peptic ulcer. Proton pump inhibitors , histamine receptor blockers, and protectants can help relieve pain and help your ulcer heal.
How Can My Doctor Diagnose My Stomach Ulcer
Depending on the availability and cost, following the test, your doctor may ask for
- Antibody blood test
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If Your Ulcer Was Caused By Helicobacter Pylori
Most stomach ulcers are caused by infection with H. pylori. Therefore, a main part of the treatment is to clear this infection. If this infection is not cleared, the ulcer is likely to return once you stop taking acid-suppressing medication. For more information, see the separate leaflet called Helicobacter Pylori.
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What Questions Should I Ask My Doctor
If you have stomach ulcers, you may want to ask your doctor:
- What pain reliever can I use instead of an NSAID?
- How will I know if the H. pylori infection is gone?
- How do we find out if the ulcer has healed?
- What can I do relieve symptoms at home during treatment?
A note from Cleveland Clinic
Contrary to commonly held beliefs, ulcers arent caused by stress or foods you eat. Most of time, bacteria causes them. Doctors can treat the bacteria with antibiotics and other medications.
If youve been popping a lot of antacids lately, youre constantly snacking to get rid of a gnawing pain in your stomach or you have any other signs of an ulcer, the best thing you can do for your health is talk to your provider. Treatment can heal an ulcer in a matter of weeks.
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What Causes An Ulcer And Whos At Risk
Dr. Terry Simpson, Weight Loss Surgeon and Culinary Medicine Specialist with Dignity Health St. Johns Hospital says, The vast majority of stomach ulcers are caused by a bacteria called Helicobactor pylori which was discovered in the 1980s. Prior to this time we thought ulcers were caused by stress, or acid, or many things. For the discovery of this bacteria the Nobel Prize was awarded. Because it is caused by a bacteria, it can be spread by kissing. So even if you get your H pylori treated, if your sweetie doesnt you can get re-infected. So the risks are those who have the infection, which is present in many people.
Other things that can cause ulcers include a lot of over-the-counter pain relievers such as aspirin and non-steroidal anti-inflammatory drugs . Tylenol does not cause ulcers. Smoking and vaping are high risk behaviors for ulcers. We know from many studies that heavy smokers are more likely to get duodenal ulcers than non smokers. The duodenum is the first bit of bowel past the stomach. Cancers can also cause ulcers. We used to think that dieting caused ulcers, but it doesnt. Certain foods can be worse for ulcer pain, especially alcohol, spicy foods, and fatty foods.
MD FACS General Surgeon and Gastrointestinal specialist at Dignity Health St. Mary Hospital, CEO of Lalezari Surgical adds, Anyone can be affected by ulcers but it is more common in patients taking chronic non-steroidal anti-inflammatory medications, corticosteroid medications and smokers.
What Is Best Treatment For Stomach/duodenal Ulcers
There are several ways to treat stomach and duodenal ulcers. One of the most common causes of stomach ulcers is Helicobacter pylori.
This bacterium is more prevalent in some populations than others. But even in people who have antibodies to H. pylori, the bacteria can cause ulcers.
This is because H. pylori can live in the stomach without causing an ulcer, but it can also cause ulcers in the small intestine.
However, there is no definitive test to tell if someone is infected, and treatment can be both time-consuming and expensive.
There are many different types of ulcers, and many different ways to treat them. Ulcers can be mild and can go away on their own, or they can be more severe and require medical help.
Luckily, there are a number of ways to help treat stomach and duodenal ulcer. Treatments include taking antacids , avoiding foods that cause stomach pain, and even surgery.
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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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How Is A Peptic Ulcer Treated
Some peptic ulcers heal on their own. But if you donât treat them, the ulcers tend to come back.
They can erode the blood vessel wall in your stomach or small intestine. The ulcers also can eat a hole through the lining and get infected. Or they can cause swelling, which may block food from moving from your stomach into your small intestine.
If H. pylori is the culprit, your doctor may prescribe a mix of antibiotics to kill it. If aspirin and other NSAIDs are behind the ulcer, you may need to cut down on them, stop taking them altogether, or switch to another pain reliever.
Your doctor may also give you antacids to fight stomach acid, or prescribe medicine to lessen the acid your body makes. Prescription drugs called cytoprotective agents can help protect the lining of the stomach or small intestine so the ulcer can heal.
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How Stomach Ulcers Are Treated
Treatment will depend on what caused the ulcer.
Most people will be prescribed a medication called a proton pump inhibitor to reduce the amount of acid in their stomach.
Youll also need antibiotics if your ulcers were caused by a H. pylori infection.
Stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed.
What Does A Stomach Ulcer Feel Like
Stomach ulcer pain usually begins in the upper-middle parts of the abdomen, above the belly button, and below the breastbone. Heartburn covers a broader area and tends to be higher in the chest. The pain is often very similar to heartburn and may feel like burning or gnawing that may go through to the back. The onset of the pain may occur several hours after a meal when the stomach is empty.
You could have heartburn and ulcer pain at the same time. Pain may vary from a few minutes to several hours. Usually, people complain that their heartburn is worse at night. It can be relieved with foods, antacids, or even vomiting. If you suspect you have a stomach ulcer, seek medical attention as soon as possible to prevent any complications. These symptoms could only worsen with time if your ulcer goes untreated. Getting these symptoms diagnosed by a trained gastroenterologist for timely treatment is crucial for your overall health.
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Blast Fatigue With Iron
Ulcerative colitis patients who suffer from frequent flare-ups accompanied by bleeding ulcers and bloody diarrhea risk becoming anemic. Anemia is a condition that results from low hemoglobin or healthy red blood cells .This is why its so common for UC patients to suffer from fatigue. Luckily, an increase in iron rich foodssuch as eggs , spinach, fish, artichokes, raisins, and lean meats can increase blood iron levels and waning energy levels.
What Ulcer Treatments Are Available
If your ulcer is bleeding, your doctor may treat it during an endoscopy procedure by injecting medications into it. Your doctor could also use a clamp or cauterization to seal it off and stop the bleeding.
For most people, doctors treat ulcers with medications, including:
- Proton pump inhibitors : These drugs reduce acid, which allows the ulcer to heal. PPIs include Prilosec®, Prevacid®, Aciphex®, Protonix® and Nexium®.
- Histamine receptor blockers : These drugs also reduce acid production and include Tagamet®, Pepcid®, Zantac® and Axid®.
- Antibiotics: These medications kill bacteria. Doctors use them to treat H. pylori.
- Protective medications: Like a liquid bandage, these medications cover the ulcer in a protective layer to prevent further damage from digestive acids and enzymes. Doctors commonly recommend Carafate® or Pepto-Bismol®.
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Signs That You May Have A Stomach Ulcer
A number of symptoms are associated with stomach ulcers, says the website Healthline. The severity of the symptoms depends on the severity of the ulcer. The most common symptom is a burning sensation or pain in the middle of your abdomen between your chest and belly button. Typically, the pain is more intense when your stomach is empty, can last for a few minutes to several hours, and comes and goes for several days, weeks or months.
Advice On Taking Nsaids
If your stomach ulcer has been caused by taking NSAIDs, your GP will want to review your use of them.
You may be advised to use an alternative painkiller not associated with stomach ulcers, such as paracetamol.
Sometimes an alternative type of NSAID that’s less likely to cause stomach ulcers, called a COX-2 inhibitor, may be recommended.
If you’re taking low-dose aspirin to reduce your risk of embolism , your GP will tell you whether you need to continue taking it.
If you do need to keep taking it, long-term treatment with a PPI or H2-receptor antagonist may be prescribed alongside the aspirin to try to prevent further ulcers.
It’s important to understand the potential risks associated with continued NSAID use.
You’re more likely to develop another stomach ulcer and could experience a serious complication, such as internal bleeding.
Page last reviewed: 14 January 2022 Next review due: 14 January 2025
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What Are The Symptoms Of A Peptic Ulcer
A dull or burning pain in your stomach is the most common symptom of a peptic ulcer. You may feel the pain anywhere between your belly button and breastbone. The pain most often
- happens when your stomach is emptysuch as between meals or during the night
- stops briefly if you eat or if you take antacids
- lasts for minutes to hours
- comes and goes for several days, weeks, or months
Less common symptoms may include
- feeling sick to your stomach
Even if your symptoms are mild, you may have a peptic ulcer. You should see your doctor to talk about your symptoms. Without treatment, your peptic ulcer can get worse.
Diagnosis Of A Stomach Ulcer
Diagnosing a stomach ulcer is done using a range of methods, including:
- Endoscopy a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia. The endoscope is fitted with a small camera so the physician can see if there is an ulcer.
- Barium meal a chalky liquid is drunk and an x-ray is performed, showing the stomach lining. These tests are less common nowadays, but may be useful where endoscopy is unavailable.
- Biopsy a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found.
- C14 breath test this checks for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.
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What Is The Best Alcohol To Drink With A Stomach Ulcer
Moreover, they asked about their drinking habits, and how often they smoked and drank coffee. In fact, the results suggest a possible protection against H if moderate amounts of alcohol are consumed. According to the study in The American Journal of Gastroenterology, the patients were infected with H. pylori.
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Other Causes And Factors
Other causes are rare. For example, some viral infections can cause a stomach ulcer. Crohns disease may cause a stomach ulcer in addition to other problems of the gut.
Stomach cancer may at first look similar to an ulcer. Stomach cancer is uncommon but may need to be ruled out if you are found to have a stomach ulcer.
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What Are The Symptoms
Symptoms of a peptic ulcer can include a burning, aching, or gnawing pain between the belly button and the breastbone, and belly pain that is temporarily relieved by taking an antacid. Symptoms can also include back pain, loss of appetite, bloating, nausea, and vomiting. Some people have no symptoms.
What Is A Peptic Ulcer
A peptic ulcer is a sore in your stomach or small intestine. It happens when the juices that help break down food damage the lining of your stomach or intestine. Ulcers usually affect people who are 25 to 64 years of age.
The two main causes are a germ called Helicobacter pylori and anti-inflammatory pain medicines like aspirin, ibuprofen , and naproxen . Steroids and medicines for osteoporosis also may cause ulcers.
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