How Do Tumors From Zes Cause Peptic Ulcers
Zollinger-Ellison syndrome is a rare disorder that happens when one or more tumors form in your pancreas and duodenum. The tumors release large amounts of gastrin, a hormone that causes your stomach to produce large amounts of acid. The extra acid causes peptic ulcers to form in your duodenum and in the upper intestine.
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.
How Can I Tell If I Have A Stomach Ulcer
Do you often have a dull or burning pain in your stomach that lasts anywhere from a few minutes to several hours? Does the pain seem to flare up when your stomach is empty? Have you been taking Advil, Aleve or aspirin for a long time? If your answer to these questions is yes, you might have a peptic ulcer.
At Westchester Health, we have a number of patients who come to us wanting to know if the pain theyre feeling might be an ulcer, and if so, is there is anything they can do to relieve that pain. To help them, and anyone else whos experiencing this kind of discomfort, understand stomach ulcers, what causes them and what can be done to reverse the condition, we offer this informational blog.
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Will Surgery Cure A Peptic Ulcer
Medical therapy works in most people with peptic ulcers. Sometimes, medical therapy does not work, or a person can’t take the therapy for some reason. Surgery is an alternative to medical therapy for these people.
Surgical operations often used in peptic ulcers include the following:
- Vagotomy: Cutting the vagus nerve, which transmits messages from the brain to the stomach, can reduce acid secretion. However, this can also interfere with other functions of the stomach. A newer operation cuts only the part of the nerve that affects acid secretion.
- Antrectomy: This is often done in conjunction with a vagotomy. It involves removing the lower part of the stomach . This part of the stomach produces a hormone that increases production of stomach acid. Adjacent parts of the stomach may also be removed.
- Pyloroplasty: This procedure also is sometimes done with vagotomy. It enlarges the opening between the stomach and duodenum to encourage passage of partially digested food. Once the food has passed, acid production normally stops.
- Tying off an artery: If bleeding is a problem, cutting off the blood supply to the ulcer can stop the bleeding.
Who Is More Likely To Get Ulcers
One in 10 people develops an ulcer. Risk factors that make ulcers more likely include:
- Frequent use of nonsteroidal anti-inflammatory drugs , a group of common pain relievers that includes ibuprofen .
- A family history of ulcers.
- Illness such as liver, kidney or lung disease.
- Regularly drinking alcohol.
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How Are Peptic Ulcers Diagnosed
Your healthcare provider will look at your past health and give you a physical exam. You may also have some tests.
Imaging tests used to diagnose ulcers include:
- Upper GI series or barium swallow. This test looks at the organs of the top part of your digestive system. It checks your food pipe , stomach, and the first part of the small intestine . You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on an X-ray.
- Upper endoscopy or EGD . This test looks at the lining of your esophagus, stomach, and duodenum. It uses a thin lighted tube called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your health care provider can see the inside of these organs. A small tissue sample can be taken. This can be checked for H. pylori.
You may also have the following lab tests to see if you have an H. pylori infection:
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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Could I Have An Ulcer And Not Know It
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Around 25 million people will have a stomach ulcer in their lifetime, according to the Centers for Disease Control and Prevention. Despite their prevalence, the symptoms of an ulcer can frequently be mistaken for other conditions, like heartburnand some people may not show any signs at all. Its also unlikely that stress or your diet is the culprit. If youre concerned that your stomach pain could be something more serious, read on to find out the causes, proper treatment and prevention methods for peptic ulcers.
How Are Stomach Ulcers Treated
If you have a stomach ulcer, you may be given:
- a combination of antibiotic medicines to eradicate the Helicobacter pylori bacteria if it is present
- medicines that reduce the amount of acid the stomach produces, such as proton pump inhibitors
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:
- stop smoking
- eat plenty of fruit and vegetables, and make sure there is enough iron in your diet
- avoid foods that make symptoms worse, such as fatty meals, alcohol, tomatoes, spicy foods, coffee, chocolate or hot drinks
- lose weight if you are overweight
- take an antacid
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Peptic Ulcer Disease Can Be Caused By These Factors Sometimes In Combination
If Your Ulcer Was Caused By An Anti
If possible, you should stop taking the anti-inflammatory medicine. This allows the ulcer to heal. You will also normally be prescribed an acid-suppressing medicine for several weeks. This stops the stomach from making acid and allows the ulcer to heal. However, in many cases, the anti-inflammatory medicine is needed to ease symptoms of arthritis or other painful conditions, or aspirin is needed to protect against blood clots. In these situations, one option is to take an acid-suppressing medicine each day indefinitely. This reduces the amount of acid made by the stomach and greatly reduces the chance of an ulcer forming again.
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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
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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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 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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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:
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What Is An Ulcer
Your stomach has digestive juices that contain hydrochloric acid and other enzymes. The stomach lining is coated with mucus to withstand the acidity without being damaged. Sometimes the lining of your stomach wears down due to the action of bacteria and other factors. When this happens, the digestive juices damage the stomach lining causing a sore known as an ulcer.
An ulcer is a sore that occurs in the inner lining of the stomach or upper small intestine, also called the duodenum. When it is in the stomach, it is a gastric ulcer. If it is in the duodenum, then it is called a duodenal ulcer. They are both types of peptic ulcer.
For many years, it was thought that ulcers were caused by stress, alcohol, or spicy food. However, modern research shows they are usually caused by a specific bacterial infection in the stomach and upper intestine, certain medicines, and smoking.
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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.
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 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
- Alcohol
- Cigarettesmoking
- 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.
Burning Pain In Your Abdomen
This may seem like a no-brainer but the most common sign that people experience when they have a stomach ulcer is a persistent burning pain in their abdomen. This sensation occurs when juices in the stomach used for digestion come into contact with the open sore. For the most part, the pain is felt from the breastbone to navel and is often worse at night than during the day. On the other hand, if you are someone who frequently skips meals, you may find that you experience this pain much throughout the daytime.
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What Causes A Peptic Ulcer
Causes of peptic ulcers include
- long-term use of nonsteroidal anti-inflammatory drugs , such as aspirin and ibuprofen
- an infection with the bacteria Helicobacter pylori
- rare cancerous and noncancerous tumors in the stomach, duodenum, or pancreasknown as Zollinger-Ellison syndrome
Sometimes peptic ulcers are caused by both NSAIDs and H. pylori.