What Is A Hiatal Hernia
The diaphragm is a comparatively large, wall-to-wall , highly stretchable muscle that separates the upper part of the human torso from the lower one .
This organ has multiple functions but two of the most important are:
This muscle provides a passageway through which the esophagus can connect to the stomach, allowing food to travel there from the mouth. Should any type of weakening occur to this muscle surrounding the hiatus, part of the stomach can push uncharacteristically through the diaphragm and into the thoracic cavity, what you get is what is called a hiatal hernia.
Interestingly, there are actually 2 types of hiatal hernias, a paraesophageal and a sliding type. Although the latter is more common than the former, paraesophageal hernias can have more severe symptoms both, however, may contribute to something called gastroesophageal reflux disease or GERD.
Things like being born with an overly-extended hiatus, excessive pressure being put on the stomach, constipation, coughing, previous surgeries & injuries, concomitant disease, lifting heavy objects and vomiting can contribute to the development of a hiatal hernia. While anyone may suffer from a hiatal hernia, they are more common among the overweight and the elderly.
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.
What Are The Complications Of Peptic Ulcers
Ulcers can cause serious problems if you dont get treatment.
The most common problems include:
- Bleeding. As an ulcer wears away the muscles of the stomach or duodenal wall, blood vessels may be hurt. This causes bleeding.
- Hole . Sometimes an ulcer makes a hole in the wall of your stomach or duodenum. When this happens, bacteria and partly digested food can get in. This causes infection and redness or swelling .
- Narrowing and blockage . Ulcers that are found where the duodenum joins the stomach can cause swelling and scarring. This can narrow or even block the opening to the duodenum. Food cant leave your stomach and go into your small intestine. This causes vomiting. You cant eat properly.
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Can You Prevent A Peptic Ulcer
While stress and spicy foods can make symptoms of a peptic ulcer worse, they donât seem to make you more likely to have one. But a few other things can raise your chances.
Be careful when you take pain relievers. Some people who have arthritis or other conditions that cause chronic pain take nonsteroidal anti-inflammatory drugs for weeks or months at a time to ease pain and swelling. These medicines can affect the mucus that protects your stomach against acid and make you more likely to have peptic ulcers.
These pain relievers include:
You’re more likely to get an ulcer while taking one of these if you:
- Are over age 65
- Are infected with H. pylori bacteria
- Take more than one NSAID at a time
- Have had a peptic ulcer in the past
- Also take a steroid drug or selective serotonin reuptake inhibitor
To lower your chances for peptic ulcers while you take NSAIDs:
- Use the lowest possible dose to control your symptoms, and stop taking them as soon as you no longer need them.
- Take your medicine with food.
- Don’t drink alcohol while youâre taking these medicines.
While you’re on NSAIDs, you can take medicine to lower the amount of acid your stomach makes. Drugs that can do that include:
- H2 blockers such as cimetidine , famotidine , and nizatidine
You can also take the drug misoprostol to boost the amount of protective mucus your stomach makes. But that can cause side effects like diarrhea and stomach cramps.
You can do some things to make an infection less likely:
How Do You Know If You Have A Hiatal Hernia
Many times, you may not even know that you have a hiatal hernia, there being few or merely mild symptoms. Such a hernia, though, is often discovered while undergoing medical imaging or an examination for unrelated conditions. They may be spotted with an endoscope, or with the use of medical imaging .
Then again, as the hernias grow in size or severity, the following symptoms may pop up:
- A fullness feeling in the chest
- Breathing difficulties or asthma
- Ulcers in the esophagus
- Chest pain that may mimic a heart attacki.e., as such, it can be intense, persistent & chronic
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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.
What To Do If You Have Stomach Cancer Or Ulcer Symptoms
- If you have burning pain in your upper stomach that is relieved by eating or taking antacids, call a health-care professional for an appointment. Don’t assume you have an ulcer. Certain other conditions can cause similar symptoms.
- If you vomit blood or have other signs of gastrointestinal bleeding, go to an emergency department right away. Peptic ulcers can cause massive bleeding, which requires blood transfusion or surgery.
- Severe abdominal pain suggests perforation or tearing of an ulcer. This is an emergency that may require surgery to fix a hole in your stomach.
- Vomiting and abdominal pain also can be a sign of an obstruction, another complication of peptic ulcers. This also may require emergency surgery.
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When To See A Doctor
Anyone who thinks they may have an ulcer in their stomach should consult their doctor. Any stomach symptoms that last for more than a few days or keep happening need evaluation and treatment.
A slow-bleeding ulcer can be signaled by symptoms of anemia, such as being tired and breathless. More serious bleeding is an urgent medical problem and can be signaled if blood is vomited up, or stools are black and sticky.
Perforation, or a hole in the stomach, is also an emergency. Without quick treatment, the wall of the stomach can become infected. Sudden stomach pain that gets worse can indicate perforation, and any signs of being very unwell with infection need treatment as soon as possible.
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 Is The Cause Of Peptic Ulcers
When you eat, your stomach produces hydrochloric acid and an enzyme called pepsin to digest the food.
- The food is partially digested in the stomach and then moves on to the duodenum to continue the process.
- Peptic ulcers occur when the acid and enzyme overcome the defense mechanisms of the gastrointestinal tract and erode the mucosal wall.
In the past it was thought that ulcers were caused by lifestyle factors such as eating habits, cigarettesmoking, and stress.
- Now it is understood that people with ulcers have an imbalance between acid and pepsin coupled with the digestive tract’s inability to protect itself from these harsh substances.
- Research done in the 1980s showed that some ulcers are caused by infection with a bacterium named Helicobacter pylori, usually called H pylori.
- Not everyone who gets an ulcer is infected with H pylori. Aspirin and nonsteroidal anti-inflammatory drugs can cause ulcers if taken regularly.
Some types of medical therapy can contribute to ulcer formation. The following factors can weaken the protective mucosal barrier of the stomach increasing the chances of getting an ulcer and slow the healing of existing ulcers.
- Aspirin, nonsteroidal anti-inflammatory drugs , and newer anti-inflammatory medications
- Radiation therapy:-used for diseases such as cancer
People who take aspirin or other anti-inflammatory medications are at an increased risk even if they do not have H pylori infection.
What Are Stomach Ulcers
There are two kinds of stomach ulcers: gastric ulcers and duodenal ulcers. Gastric ulcers are sores on the lining of your stomach. Duodenal ulcers are sores on the upper section of your small intestine.
Your body creates a protective layer of mucus to shield the linings of your stomach and small intestine from the harsh stomach acid required to break down food. When the mucus layer is worn away or doesnt function properly, the acid begins to damage the lining of the stomach or small intestine, creating an ulcer. Many people believe spicy foods or stress cause ulcers, but while these can exacerbate existing ulcers, they dont actually cause them.
Ulcers are usually caused by an infection from a common bacteria called helicobacter pylori or from the habitual use of nonsteroidal anti-inflammatory drugs, such as aspirin. Other factors, such as being older than age 50, smoking, genetics, steroid use, and frequent alcohol use, can increase your risk of developing an ulcer.
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What Treatments Are There For Ulcers
Your treatment will depend on the cause of your ulcer. For example, if our tests indicate that an infection caused by helicobacter pylori is what created your ulcer, well give you antibiotics to eliminate the bacteria.
Regardless of the cause, medications that help reduce the level of acid in your stomach can help the ulcer heal. And different lifestyle changes can accelerate healing as well, such as eliminating certain foods, abstaining from alcohol, and practicing stress management.
In severe cases, surgery may be required. Your provider at Prima Medicine will work with you to create a treatment plan for your situation.
If you have a stomach ulcer or want to see if you do, we can help. To learn more, book an appointment online or over the phone with Prima Medicine today.
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What Happens After Treatment
A repeat gastroscopy is usually advised a few weeks after treatment has finished. This is mainly to check that the ulcer has healed. It is also to be doubly certain that the ‘ulcer’ was not due to stomach cancer. If your ulcer was caused by H. pylori then a test is advised to check that the H. pylori infection has gone. This is done at least four weeks after the course of combination therapy has finished.
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How Common Are Stomach Ulcers
It’s not known exactly how common stomach ulcers are. They have become much less common since the 1980s because of much more effective treatments. So people with stomach ulcers now usually get better much more quickly.
The term ‘peptic ulcer’ is used to describe ulcers that are caused by too much acid in the stomach. This includes stomach ulcers and also ulcers in the first part of the gut known as the duodenum. Stomach ulcers are less common than duodenal ulcers.
What Tests Diagnose A Peptic Ulcer
To confirm a person has an ulcer a diagnostic imaging test will usually be ordered. The two most widely used tests are:
- Upper GI series : This is a type of X-ray. The patient is given a chalky liquid to drink that increases the contrast on the X-ray, making certain features easier to see. Because this liquid contains barium, this test is sometimes called a barium swallow.
- Endoscopy : An endoscope is a thin, flexible tube with a tiny camera at the end. The patient is given a mild sedative, and then the tube is passed through the mouth into the stomach. The doctor can see the lining of the stomach to diagnose a peptic ulcer. Tiny samples of the tissue will be taken , which are examined under a microscope.
If a diagnostic imaging test reveals an ulcer, the patient will most likely have a test to see if H pylori bacteria are present.
- It is important to be certain about this, because treatment of the H pylori is likely to heal the ulcer.
- Ulcers caused by H pylori are treated differently than ulcers caused by medications.
Three types of tests are available to detect H pylori.
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How Can I Prevent Ulcers
You may be able to prevent ulcers from forming if you:
- Talk to your doctor about alternatives to NSAID medications to relieve pain.
- Discuss protective measures with your doctor, if you cant stop taking an NSAID.
- Opt for the lowest effective dose of NSAID and take it with a meal.
- Quit smoking.
- Drink alcohol in moderation, if at all.
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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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.
What Are The Signs & Symptoms Of Peptic Ulcers
Stomach pain is the most common sign of an ulcer. It usually feels like sharp aches between the breastbone and the belly button. This pain often comes a few hours after eating. It can also happen during the night or early in the morning, when the stomach is empty. Eating something or taking acid suppressor medicine sometimes eases the pain.
Other symptoms of ulcers can include:
- loss of appetite
- burping or hiccupping a lot
- weight loss
- bloody or blackish bowel movements
Anyone who thinks they might have an ulcer needs to see a doctor. An ulcer thats not treated can grow larger and deeper. This can lead to other problems, such as bleeding in the digestive system or a hole in the wall of the stomach or duodenum, which can make someone very sick.
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Causes Of Stomach Ulcers
A stomach ulcer can be caused by a variety of factors, including:
- Helicobacter pylori bacteria is thought to be responsible for around 60 per cent of stomach ulcers and at least 90 per cent of duodenal ulcers.
- Certain medications which include aspirin or clopidogrel, taken regularly to help prevent heart attack or stroke, and drugs for arthritis. Anti-inflammatory medications are thought to cause around two fifths of stomach ulcers.
- Cancer stomach cancer can present as an ulcer, particularly in older people.
How Is An Ulcer Diagnosed
Your doctor will ask you about your symptoms. They may do an endoscopy. This procedure involves inserting a thin, flexible tube attached to a camera down your throat and into your stomach. Your doctor will test your blood, breath or stool for H. pylori. They also can test a sample of your stomach lining. Your doctor also will ask you if you regularly take aspirin or anti-inflammatory medicines.
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