Stomach Ulcer Diagnosis And Conventional Treatment
If you suspect you have a stomach ulcer, see your doctor to first rule out other causes of your pain. In order to diagnose a stomach ulcer, your doctor may perform an endoscopy, which allows the doctor to view the inside lining of the esophagus, stomach and small intestine. Once a diagnosis is verified, treatment options can begin.
Your doctor will likely take your medical history and perform a physical exam along with a blood test, plus ask you about your past use of medications and possibly do an X-ray to locate a stomach ulcer. Testing the blood for H. pylori, plus doing a urea breath test and/or stool test to look for the presence of H. pylori antigens, are common ways to diagnose an ulcer.
The goal of stomach ulcer treatments is to help reduce pain and inflammation in the digestive tract, boost the immune system to fight H. pylori bacteria, prevent complications, and lower the chance for future ulcers from forming or returning.
Today, conventional treatment options for stomach ulcers include:
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.
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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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:
How Does Hpylori Cause A Peptic Ulcer
The H.pylori bacteria can weaken the protective mucous lining we have in our stomach and duodenum. This weakening lets the acid seep through. Both the bacteria and the acid will begin to irritate the lining and cause a sore or an ulcer.
The H.pylori can easily survive in the stomach not only because it is gram-negative but also because it secretes an enzyme that neutralize the acids which might be detrimental to the bacteria itself. The H. pylori has a very specific shape that allows it to burrow in the stomachs lining.
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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.
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.
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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 Stomach Ulcers Are Treated
With treatment, most stomach ulcers will heal within a month or two. The treatment recommended for you 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 their stomach produces and allow the ulcer to heal naturally.
If an H. pylori infection is responsible for the ulcers, antibiotics will also be used to kill the bacteria, which should prevent the ulcer coming back.
If the ulcers are caused by the use of NSAIDs, PPIs are usually prescribed and your doctor will discuss whether you should keep using NSAIDs.
Alternative medication to NSAIDs, such as paracetamol, may be recommended.
Stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed.
Read more about treating stomach ulcers.
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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.
What Kind Of Doctor Treats Peptic Ulcers
- If you suspect you may have a peptic ulcer, you may first be diagnosed by your family practitioner or internist.
- Children or teenagers may see a pediatrician.
- For further treatment you will likely be referred to a gastroenterologist, a specialist in disorders of the digestive tract.
- If you have an emergency such as vomiting or severe abdominal pain you will be seen by an emergency medicine specialist in an emergency room.
- In the rare case where surgery is needed, you may see a general surgeon.
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Purpose Of Stomach Ulcer Surgery
Peptic ulcers can cause pain, stomach discomfort, abdominal cramps, decreased appetite, hematemesis, gastrointestinal bleeding, iron deficiency anemia , and malnutrition.
Generally, the condition can be effectively treated with medication and lifestyle changes, rather than with surgical intervention. Smoking and alcohol use can contribute to stomach ulcers, and stopping these habits can help an ulcer heal. Sometimes dietary modifications, like avoiding spicy foods, can help control symptoms.
Treatments for gastric ulcers include proton pump inhibitors and antibiotics to eradicateHelicobacter pylori, a bacteria that is commonly associated with stomach ulcers.
Surgical management may be needed for complications of peptic ulcer disease or for treatment of a stomach ulcer that doesn’t improve despite conservative management.
Issues that may warrant surgical intervention for the treatment of peptic ulcer disease include:
These issues can cause persistent and serious health problems. Stomach ulcer surgery would be done to alleviate your symptoms and prevent consequences to your overall health.
Antacids And H2 Blockers
Antacids neutralize existing acid in the stomach. Antacids such as Maalox, Mylanta, and Amphojel are safe and effective treatments. However, the neutralizing action of these agents is short-lived, and frequent dosing is required. Magnesium containing antacids, such as Maalox and Mylanta, can cause diarrhea, while aluminum containing agents like Amphojel can cause constipation. Ulcers frequently return when antacids are discontinued.
Studies have shown that a protein released in the stomach called histamine stimulates gastric acid secretion. Histamine antagonists are drugs designed to block the action of histamine on gastric cells and reduce the production of acid. Examples of H2 blockers are cimetidine , nizatidine , and famotidine . While H2 blockers are effective in ulcer healing, they have a limited role in eradicating H. pylori without antibiotics. Therefore, ulcers frequently return when H2 blockers are stopped.
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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.
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.
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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.
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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What Are The Symptoms Of A Peptic Ulcer Does It Cause Pain
Ulcers do not always cause symptoms. Sometimes, a serious complication such as bleeding or a sudden, bad upper abdominal pain is the first sign of an ulcer.
The most common symptom of peptic ulcers is abdominal pain.
- The pain is usually in the upper middle part of the abdomen, above the belly button and below the breastbone.
- The ulcer pain can feel like burning, or gnawing, and it may go through to the back.
- Pain often comes several hours after a meal when the stomach is empty.
- The pain is often worse at night and early morning.
- It can last anywhere from a few minutes to several hours.
- The ulcer pain may be relieved by food, antacids, or vomiting.
Other symptoms of peptic ulcers include the following:
- Loss of appetite
- Loss of weight
Severe ulcers may cause bleeding in the stomach or duodenum. Bleeding is sometimes the only symptom of an ulcer. This bleeding can be fast or slow. Fast bleeding reveals itself in one of the following ways:
- Vomiting of blood or dark material that looks something like coffee grounds: This is an emergency and warrants an immediate visit to an emergency department.
- Blood in the stool or black, tarry, sticky-looking stools
Slow bleeding is often more difficult to detect, because it has no dramatic symptoms.
- The usual result is low blood cell count .
- The symptoms of anemia are tiredness , lack of energy , weakness, rapid heartbeat , and pale skin .
Ulcers With Other Causes
up to 90 percent of peptic ulcers are caused by H. pylori and NSAID use. But, a recent review in the Asian Pacific Journal of Cancer Prevention states that ulcers without H. pylori infection or NSAID use are increasing.
The study, which took place in Thailand, suggests that other factors, including alcohol, other infections, medications, or diseases, including stomach and intestinal cancer, may be to blame.
People with symptoms of a peptic ulcer may undergo a test known as an upper endoscopy. A doctor passes a lighted, flexible tube with a camera through the mouth and into the stomach. In some cases, it is possible to treat a bleeding ulcer during the endoscopy.
Doctors often treat ulcers with medications that block or reduce stomach acid. These medicines include:
- Proton pump inhibitors dexlansoprazole , esomeprazole , omeprazole , lansoprazole , pantoprazole , and rabeprazole .
- H2 blockers cimetidine , famotidine , and nizatidine .
People who take NSAIDs and who are diagnosed with a peptic ulcer may need to stop taking the NSAID.
When a doctor diagnoses a person with a H.pylori infection, they will prescribe antibiotics and other medicines to kill the bacteria. H. pylori is tricky to kill, so to ensure that the treatment is successful, a person must take all medicines as prescribed, even if they feel better.
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