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.
What Triggers Stomach Ulcer Symptoms
Stomach ulcers are irritated by stomach acid. Some people notice this irritation more after they eat, and some people notice it more on an empty stomach. There are also certain irritants that seem to make ulcer symptoms worse and make them more difficult to heal. Smoking and alcohol are the biggest ones.
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 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.
Asthma Gerd And Breathlessness
Many patients with asthma report heartburn and shortness of breath, as well as regurgitation and dysphagia . This may be, in part, due to the pressure incurred by wheezing and coughing, which can be strong enough to push stomach acid up into the esophagus.
No matter the cause, the link between GERD and asthma is now obvious. Thats why doctors are now on the lookout for GERD in asthmatic patients, especially if:
- they developed asthma in adulthood.
- episodes appear after eating, exercising, or lying down right after a meal.
- their condition continues to worsen despite treatment.
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When Should I See A Doctor If I Think I Have A Peptic Ulcer
- 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.
How Do Pain Relief Drugs Work
In a certain way, all pain is in your head. When we feel pain, it’s the result of an electrical signal being sent from the nerves in a part of your body to your brain.
But the whole process isn’t electrical. When tissue is injured , the cells release certain chemicals in response. These chemicals cause inflammation and amplify the electrical signal coming from the nerves. As a result, they increase the pain you feel.
Painkillers work by blocking the effects of these pain chemicals. The problem is that you can’t focus most pain relievers specifically on your headache or bad back. Instead, it travels through your whole body. This can cause some unexpected side effects.
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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.
Medical Mystery: What Caused Chest Pain Shortness Of Breath In Older Man
The patient was visibly winded, and his exam showed evidence of fluid in his lungs and legs. It appeared that he had developed congestive heart failure.
I was looking forward to seeing one of my favorite patients last week. This 89-year-old Indian American man was added to my schedule as an urgent visit.
He had had a pacemaker implanted at Temple Hospital just the week before and a visiting nurse was sent to check on him after his operation. The nurse had called and said the man was short of breath and seemed to be retaining fluid just four days after his pacemaker operation.
The man came to the visit accompanied by his son, who has been more involved in his care since his wife died last year. He was visibly winded when I saw him, and his exam showed evidence of fluid in his lungs and legs. It appeared that he had developed congestive heart failure in the last few days a new problem for him.
Several decisions needed to be made right away. One option was to have him hospitalized for an invasive test called a cardiac catheterization. This would exclude a heart attack, and help guide treatment. But because he was 89 years old, anxious to avoid another invasive test, and staying with his son who was managing his care, I elected not to put him in the hospital.
Instead, I ordered several outpatient tests and started him on a diuretic called Lasix twice a day and a potassium supplement.
But what caused him to become sick so soon after his new pacemaker was implanted?
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When Should You Call Or See A Doctor
If you think you have a stomach ulcer, call your doctor. Together you can discuss your symptoms and treatment options. If you dont already have a physician, you can use the Healthline FindCare tool to find a provider near you.
Its important to get a stomach ulcer taken care of because without treatment, ulcers and H. pylori can cause:
- bleeding from the ulcer site that can become life-threatening
- penetration, which occurs when the ulcer goes through the wall of the digestive tract and into another organ, such as the pancreas
- perforation, which occurs when the ulcer creates a hole in the wall of the digestive tract
- obstruction in the digestive tract, which is due to swelling of inflamed tissues
- stomach cancer, specifically
Symptoms of these complications can include those listed below. If you have any of these symptoms, be sure to call you doctor right away:
What Tests Will Be Done To Diagnose A Peptic Ulcer
Endoscopy. An upper endoscopy exam is expedient because allows healthcare providers to see inside your digestive tract and also take a tissue sample to analyze in the lab. The test is done by passing a thin tube with a tiny camera attached down your throat and into your stomach and duodenum. Youll have medication to numb your throat and help you relax during the test. Your healthcare provider may use the endoscope to take a tissue sample to test for signs of mucous damage, anemia, H. pylori infection or malignancy. If they take a sample, you wont feel it.
Imaging tests. Imaging tests to look inside the stomach and small intestine include:
- Upper GI series. An upper GI X-ray exam examines the stomach and duodenum through X-rays. Its less invasive than an endoscopy. For the X-ray, youll swallow a chalky fluid called barium, which will coat your esophagus, stomach and duodenum. The barium helps your digestive organs show up better in black and white images.
- CT scan. Your healthcare provider might recommend a CT scan if they need to see your organs in more detail. A CT scan can show complications such as a perforation in the stomach or intestinal wall. For the test, youll lie on a table inside a scanner machine while X-rays are taken. You may drink or have an injection with contrast fluid to make your organs show up better in images.
Tests for H. pylori. Your healthcare provider might want to test you separately for H. pylori infection. Tests may include:
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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.
How Are Stomach Ulcers Treated
Ulcers can heal if they are given a rest from the factors that created them. Healthcare providers treat uncomplicated ulcers with a combination of medicines to reduce stomach acid, coat and protect the ulcer during healing and kill any bacterial infection that may be involved. Medicines may include:
- Antibiotics. If H. pylori was found in your digestive tract, your healthcare provider will prescribe some combination of antibiotics to kill the bacteria, based on your medical history and condition. Commonly prescribed antibiotics include tetracycline, metronidazole, clarithromycinand amoxicillin.
- Proton pump inhibitors . These drugs help reduce stomach acid and protect your stomach lining. PPIs include esomeprazole,dexlansoprazole,lansoprazole, omeprazole,pantoprazole and rabeprazole.
- Histamine receptor blockers . These reduce stomach acid by blocking the chemical that tells your body to produce it . H2 blockers include famotidine, cimetidine and nizatidine.
- Antacids. These common over-the-counter medicines help to neutralize stomach acid. They may bring some symptom relief, but they arent enough to heal your ulcer. They also might interfere with some antibiotics.
- Cytoprotective agents. These medicines help to coat and protect your stomach lining. They include sucralfate and misoprostol.
- Bismuth Subsalicylate. This over-the-counter medicine, commonly found as Pepto-Bismol, can help coat and protect your ulcer from stomach acid.
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Diagnosis And Treatment Of A Peptic Ulcer
If your doctor suspects a peptic ulcer, he or she will order an upper endoscopy. During this procedure, a gastroenterologist passes a thin, flexible tube through the mouth and into the stomach and small bowel. A tiny camera allows the doctor to see the GI tract from within.
If that ulcer is actively bleeding or has high-risk features of bleeding, then treatments can be applied through the endoscope to stop the bleeding, Dr. Yalamanchili says. These treatments include clips that clamp bleeding blood vessels, cautery devices to burn the bleeding blood vessel shut, injectable medicines to slow bleeding and sprays that induce clotting.
Ulcers caused by H. pylori are typically treated with antibiotics, drugs called proton pump inhibitors and over-the-counter medicines such as Pepto Bismol.
When NSAIDs are causing the ulcer, patients are told to discontinue the drugs. If they cant discontinue these medications for medical reasons, a doctor can prescribe a special acid-reducing medication in combination with the NSAID to lower the risk of bleeding.
If you are experiencing the symptoms of a peptic ulcer, contact your doctor. If you dont have one, you can find one here.
What Is The Difference Between A Stomach Ulcer And A Peptic Ulcer
A peptic ulcer is a sore on the lining of your stomach, small intestine, or esophagus. A gastric ulcer develops in the stomach a duodenal ulcer develops in the first part of the small intestine and an esophageal ulcer develops in the lower part of the esophagus.
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Sharp Back Pain And Ulcer Symptoms
Peptic ulcer refers to an open sore that forms on the inside lining of small intestine , stomach, or sometimes in the lining of lower esophagus. It is a fairly common health condition.
Thoughit is usually mild and treatable, it may turn into serious if left untreated.Poorly controlled ulcer may become worse over time and lead to other healthproblems.
Normally,acids in the digestive tract are required to help digest foods. But if they areproduced too much, they could be counterproductive and cause some healthproblems. The open sore of ulcer could occur when the amount of acid increaseshigher than normal which then damages the wall of the duodenum and stomach .
Pepticulcers are associated with a number of triggering-factors. One of the main onesis bacteria H. pylori infection, though not all people with this infectiondevelop peptic ulcer. The following risk factors may also have a role to breakdown the lining of your stomach and duodenum:
Pepticulcer can also cause some of the following vogue symptoms:
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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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.