How To Recognize Gerd
GERD is a plumbing problem. It starts at the bottom of the esophagus, the tube that carries food from your mouth to your stomach.
When the valve at the bottom of your esophagus doesnt close properly, acid backs up and causes a painful burning sensation in your chest and throat. When youve got GERD, acid is coming back up and bathing your esophagus, instead of staying in the stomach where its supposed to be, says Dr. Brocato. That gives you a sensation of food coming up and irritation in your throat.
GERD is very common. According to the National Institutes of Health, it affects about 20% of Americans.
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When To See The Doctor
Peptic ulcers will get worse if theyre not treated, so contact your doctor if you have symptoms or any signs that you could have one. Unfortunately, a lot of the time the way people find out they have an ulcer is by developing bleedstheyre taking a lot of aspirin or NSAIDS and they either start vomiting blood or have black tarry stool, says Marcus.
Your doctor may be able to diagnose a peptic ulcer by talking with you about your symptoms. Be sure to disclose the frequency of NSAID use.
However, some tests are usually used to confirm the diagnosis. For instance, to see if you have an H. pylori infection, your doctor will test your blood, breath or stool. They may also look inside your stomach and duodenum by doing an endoscopy or X-ray. An endoscopy is a procedure where a lighted tube is inserted through the throat and into the stomach to check for abnormalities.
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How Do You Check For An Ulcer
If you think you have peptic ulcer symptoms, visit your doctor. Theyll check your medical history and your symptoms. Theyll ask you about medicines you take, especially NSAIDs. Theyll do a physical exam to check for stomach pain and bloating. Theyll order some lab tests to check for ulcers.
Peptic ulcer diagnosis can follow:
Your doctor will do lab tests for peptic ulcer diagnosis. They may measure gastrin levels in your blood. Gastrin is a hormone that helps release stomach acid or digestive juices.
Theyll also check for H. pylori infection using these tests:
- Urea breath test. Your doctor will ask you to drink a liquid containing urea a waste product formed when protein breaks down in your body. H. pylori bacteria convert urea into carbon dioxide, which is the gas you breathe out. Your doctor will collect your breath sample. If you have an H. pylori infection in your stomach, your breath will have higher levels of carbon dioxide.
- Blood test. A blood test can help detect H. pylori infection.
- Stool test. Doctors use a stool test to detect H. pylori infection. Theyll check if your stool sample has the bacteria.
You may feel bloated and nauseous after the test. For a few days, you may have white or light-colored stools because of barium.
Your doctor may use gastrointestinal endoscopy along with a biopsy to diagnose peptic ulcer disease. Endoscopy and biopsy are parts of the same procedure:
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Diagnosis Of Peptic Ulcers
Your GP will want to find out if youve got a peptic ulcer and whats causing it, as this will help them decide on the right treatment. Treating your ulcer as soon as possible will reduce the risk of complications.
Your GP will ask about your symptoms and medical history. They may also feel your abdomen, to check for tenderness or pain.
Your GP will want to find out if your ulcer is caused by H. pylori or by taking NSAIDs. You should tell the doctor if youve been taking over-the-counter painkillers such as aspirin and ibuprofen regularly.
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How Are Esophageal Ulcers Caused
The main causes of esophageal ulcers are:
Exposure to stomach acid: This causes chronic inflammation and irritation of the esophagus, allowing ulcers to develop. Stomach acid exposure most often occurs in people with other gastrointestinal conditions. These can include hiatal hernias and GERD, or gastrointestinal reflux disease, more commonly referred to, as severe heartburn.
Medications: Certain drugs, including aspirin, ibuprofen, bisphosphonates, and some antibiotics, can cause esophagitis, or inflammation of the esophagus, and esophageal ulcers.
Infection: Ulcers caused by infection are less common, but the fungal infection known as candida, herpes, and the human papillomavirus have all been linked to esophageal ulcers.
Caustic injury: Esophageal ulcers may be caused by ingesting a corrosive substance. This type of injury mostly affects children, but it can also occur in adults who experience psychosis, suicidal tendencies, or who are abusing alcohol.
Certain types of gastric surgery or foreign bodies can also cause esophageal ulcers.
Early intervention is key to preventing complications from esophageal ulcers.
In cases of acid reflux, treatment may include:
- Medication, such as antacids, H-2-receptor blockers, and proton pump inhibitors .
- Dietary and lifestyle changes, to aid digestion.
- Surgery, for severe cases. Types of surgeries include to tighten the LES valve near the top of the stomach or to insert a magnetic device to help the LES valve function.
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Worried That You Might Have An Ulcer Please Come See Us
If youre experiencing any of the above signs or symptoms, or if your digestive tract is bothering you in any way or causing you pain, please call 232-1919 to make an appointment with one of our Westchester Health gastroenterologists. Well examine you, evaluate your symptoms, maybe perform some tests, and together with you, decide on the best treatment going forward, given your individual health needs. Whenever, wherever you need us, were here for you.
By Elie M. Abemayor, MD, Sc.M., a gastroenterologist with Westchester Health, member of Westchester Health Physician Partners
When To See A Doctor
Internal bleeding can be life-threatening and requires immediate action to prevent death or irreversible organ damage.
It is important to call 911 if you or someone you know shows signs of internal bleeding, including:
- Severe abdominal or chest pain
- Shortness of breath or trouble breathing
- Lightheadedness or fainting
- Changes in vision
- Changes in mental status
People should also be examined after any sort of trauma, including severe falls or blunt force injuries caused by car accidents or contact sports. These sometimes do not cause outward symptoms until later when the blood loss is severe.
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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.
Signs You May Have A Peptic Ulcer
posted: Jan. 15, 2019.
Peptic ulcers, or stomach ulcers, are breaks or holes in the lining of the stomach. An ulcer in the first part of the intestines is known as a duodenal ulcer. An ulcer in the stomach is known as a gastric ulcer. If you think you may have an ulcer, you should see a gastroenterologist. Gastroenterologists are specialists in the diagnosis and treatment of peptic ulcers. Here are 5 signs you may have a peptic ulcer. 1. Burning pain- The most common peptic ulcer symptom is a burning sensation or gnawing pain in the middle of your abdomen. The pain may come and go for several days or weeks. Even though discomfort may be mild, peptic ulcers can worsen if they arent treated. Taking antacids can relieve the discomfort, but it will keep coming back until the peptic ulcer is treated by a doctor.
2. Nausea- The symptoms of peptic ulcers may include nausea. Nausea is a feeling of sickness with an inclination to vomit. Nausea has many possible causes. Some common causes of nausea include appendicitis, infection, reactions to some medicines, migraines, food poisoning or intestinal blockage.
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Diagnosing Upper Gi Bleeding
To diagnose upper GI bleeding and figure out whats causing it, a doctor may perform the following tests:
- Endoscopy. Upper GI bleeding is most commonly diagnosed with an endoscopy. This procedure involves the use of a small camera located atop a long, flexible endoscopic tube the doctor places down your throat. The scope is then passed through your upper GI tract. The camera allows the doctor to see inside your GI tract and potentially locate the source of your bleeding.
- Enteroscopy. This procedure is performed if the cause of your bleeding isnt found during an endoscopy. An enteroscopy is similar to an endoscopy, except theres usually a balloon attached to the camera-tipped tube. When inflated, this balloon allows your doctor to open up the intestine and see inside.
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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.
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Burning Pain In The Abdomen
Persistent burning pain in the abdomen is one of the first signs of a stomach ulcer. The sensation of pain occurs when juices in the stomach, which help in digestion, come into contact with an open sore in the stomach lining.
In most cases, the pain is felt from the breast bone to the navel, and it often worsens during the night. If you skip meals, particularly breakfast, you may also experience this burning sensation in the stomach during the daytime.
If the dull and burning ache of the ulcer often turns into a sharp, stabbing pain, it is a sign that your ulcer is acting up and you need medical help. It could mean that the ulcer has caused a more critical problem like a perforation in the wall of your stomach or intestine, or a blockage in your digestive tract, and it is triggering intense pain.
Presence Of Blood In Stool
When the person uses the toilet, he may experience and be surprised with the presence of a blood in the stool discharge. It is one of the most well-known symptoms of a bleeding ulcer.
If the person goes for a long call of nature and notices dark red traces of blood in the feces, he should seek medical assistance. Blood traces in the stool of a given individual is reasonable enough to believe that he may be experiencing a problem of bleeding ulcers within the digestive track.
It is important to note that blood in the stool is an indicative sign and symptom of internal bleeding ulcers that needs to be confirmed through examinations by a medical professional.
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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.
- Drink alcohol in moderation, if at all.
What Are The Possible Complications Of Peptic Ulcer Disease
An ulcer left untreated may cause serious complications, including:
- Internal bleeding: While most people with ulcers wont have bleeding, this is the most common complication that can occur. A slow bleeding ulcer can cause anemia or even severe blood loss.
- Perforation: An ulcer that is continuously eroded by acid can eventually become a hole in the stomach or intestinal wall. This is intensely painful and also dangerous. It allows bacteria from the digestive tract to enter the abdominal cavity, which can lead to an infection of the abdominal cavity called peritonitis. From there, the infection is at risk of spreading to the rest of the body . This can lead to a life-threatening condition called .
- Obstruction: An ulcer in the pyloric channel, the narrow passageway that leads from the stomach into the duodenum, can become an obstruction that blocks the flow of food into the small intestine. This can happen after the ulcer has healed. Ulcers that have gone through a healing process may build up scar tissue that enlarges them. An ulcer that is big enough to obstruct the small intestine can stall the digestive process, with numerous side effects.
- Stomach cancer: Some gastric ulcers can become malignant over time. This is more likely when your ulcer is caused by H. pylori infection. H. pylori is a contributing cause of gastric cancer, though fortunately, this is uncommon.
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How Can I Prevent A Stomach Ulcer From Occurring Or Returning
- Reduce NSAID use, if possible. Consider whether acetaminophen might substitute. If you take NSAIDs for medical reasons, talk to your doctor about reducing your dosage or switching your medication. Your doctor may also prescribe another medicine to take with NSAIDs to protect your stomach lining.
- Reduce other irritants that may contribute to too much stomach acid or erode your stomach lining, including smoking and alcohol use.
- Take an H. pylori breath test to find out if you have an overgrowth of the bacteria.
What Triggers Stomach Ulcer Symptoms
Stomach ulcer symptoms are irritated by several triggers. They include:
- Stomach acid â some people notice it after they eat while others notice it more on an empty stomach
Our site is the source of information about the gastroenterology related conditions and procedures. This information is intended for patients looking to learn about our gastroenterology practice in New York and make an appointment to see one of our physicians. This information is only intended to provide guidance, not definitive medical advice. Please consult a doctor or GI specialist about your specific condition. Only a trained physician can determine an accurate diagnosis and proper treatment. Terms and conditions are subject to change.
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Smelly And Tarry Discharge
Another very important symptom that can give a hint that a person is suffering from a bleeding ulcer is the passing of a stinky smelling and tarry discharge from the rectum in the form of unusual dark stools. This can help identify signs of gastric ulcer currently in the course of bleeding which may have been actively bleeding for a significant period of time.
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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.
Call your GP immediately or go to the emergency department if:
- you have symptoms of severe bleeding
In the hospital, a doctor will do an endoscopy to identify the cause of the bleeding. They can give you treatment during the endoscopy to stop the bleeding.
Your doctor may do a specialised procedure with x-ray guidance to stop a bleeding ulcer. In rare cases, you may need surgery to repair the affected blood vessel.
You may also need blood transfusions to replace the blood you have lost.
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Youre More Bloated Than Usual
If you notice your stomach feeling particularly bloated, it may be more serious than a little bit of gasit could be one of the signs of an ulcer. According to RM Healthy, bloating is often one of the earliest ulcer symptoms, with patients especially complaining of pain in their midsection. Of course, bloating can also be caused simply by eating something your body doesnt agree with or not drinking enough water, but when combined with these other symptoms, its worth checking out.
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Your Appetite Went Mia
For many patients with ulcers, the condition can actually result in a loss of appetite. This drop in food intake, combined with occasional vomiting, may lead to unexpected weight loss. Some ulcer patients report eating their normal amount of food, yet still lose weight, so the ulcer itself may cause a drop on the scale, too.
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