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.
How Will My Doctor Treat My Stomach Ulcer
Most stomach ulcers take 1-2 months to heal and your doctor/gastroenterologist will prescribe you the treatment based on the cause of your ulcer.
- Your doctor will assess your family history, dietary history, diseases, and medication history and examine your tummy to address the cause of your stomach ulcer.
- Your doctor will discuss with you the side effects of the painkillers and analgesics, which you may be taking, and whether you should keep using them or stop them.
- Your doctor may advise you to stop smoking, stop alcohol consumption, lose some weight, and avoid some trigger foods, such as spicy and fatty food.
- Your doctor may prescribe an alternative painkiller, analgesic, or anti-inflammatory medications, such as Paracetamol.
- Your doctor will prescribe you proton pump inhibitors and antacids to reduce the amount of acid production and some antibiotics for up to 2 weeks to treat H pylori infection.
- Your doctor will prescribe probiotics, which will help to grow good bacteria in your gut and may be useful in killing H pylori bacteria.
- Your doctor may prescribe you bismuth supplements.
- Your doctor may have another endoscopy to check stomach ulcers several weeks after treatment to make sure that the ulcer is gone because a very small number of stomach ulcers might contain cancer.
If the underlying cause is not addressed properly, the stomach ulcer may recur even after the treatment.
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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Choice Of Surgical Procedure For Bleeding Peptic Ulcers
The choice of surgical procedure for bleeding peptic ulcers, when required, has not been adequately examined in the era following routine eradication of Helicobacter pylori and high-dose PPI therapy. Many surgeons maintain that under-running of ulcers alone combined with acid suppression using high-dose PPI therapy is safer than definitive surgery by either gastric resection or vagotomy. Two randomised studies looking at the different surgical procedures used to control bleeding peptic ulcers have been reported,42,43 but both predate the PPI and routine H. pylori eradication era and therefore their results must be interpreted with considerable caution. One of these was a multicentre study comparing minimal surgery versus definitive ulcer surgery in patients with gastric and duodenal ulcers.42 The trial was terminated, however, because of the high rate of fatal re-bleeding in the minimal surgery group .
In cases of a massive duodenal ulcer, it may be necessary to exclude the ulcer, perform a distal gastrectomy and close the distal duodenum. This can be a challenging procedure in an elderly, unstable patient, particularly where duodenal thickening and scarring prevent safe stump closure. In this situation it may be better to anticipate a controlled duodenal fistula by closing the duodenal stump around a Foley catheter rather than attempting more complex closures, such as with the Billroth I reconstruction.
Vahn A. Lewis, in, 2017
Gi Bleeding In The Elderly
In the elderly , hemorrhoids and colorectal cancer are the most common causes of minor bleeding. Peptic ulcer, diverticular disease, and angiodysplasia are the most common causes of major bleeding. Approximately 35% to 45% of all cases of acute upper GI hemorrhage occur in elderly persons. These patients increasingly account for the 10% of deaths that result from a bleeding episode each year.4
Elderly patients tolerate massive GI bleeding poorly. Diagnosis must be made quickly, and treatment must be started sooner than in younger patients, who can better tolerate repeated episodes of bleeding.9
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When To Seek Medical Advice
Visit your GP if you experience persistent symptoms of a stomach ulcer.
Contact your GP or GP out of hours service immediately, or go to your nearest emergency department, if you develop signs of a serious complication, including:
- vomiting blood the blood can appear bright red or have a dark brown, grainy appearance, similar to coffee grounds
- passing dark, sticky, tar-like stools
- a sudden, sharp pain in your tummy that gets steadily worse
These could be a sign of a serious complication, such as internal bleeding .
What To Expect At Home
You have peptic ulcer disease . You may have had tests to help diagnose your ulcer. One of these tests may have been to look for bacteria in your stomach called Helicobacter pylori . This type of infection is a common cause of ulcers.
Most peptic ulcers will heal within about 4 to 6 weeks after treatment begins. Do not stop taking the medicines you have been prescribed, even if symptoms go away quickly.
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Ulcers With Other Causes
study from 2012 , H. pylori and NSAIDs are the most prevalent causes of peptic ulcers. However, a newer review in the Asian Pacific Journal of Cancer Prevention states that ulcers without H. pylori infection or NSAID involvement are increasing.
The study, which took place in Thailand, suggests that other factors such as alcohol, other infections, medications, or diseases including stomach and intestinal cancer, may be to blame.
Quickly treating peptic ulcers, especially bleeding peptic ulcers, is the best way to avoid complications. If a person does not seek treatment for the ulcers, certain conditions can arise, such as:
- Severe internal bleeding: This can lead to hemorrhaging and is a medical emergency.
- Perforation: This is when the lining of the stomach splits open. This rare and severe complication can lead to stomach bacteria infecting the lining of the abdomen. This is called peritonitis.
- Gastric outlet obstruction: This is when a scarred or swollen stomach ulcer stops food from getting into the digestive system.
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.
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Diagnosis Of Ulcers In Horses
If you suspect your horse has a gastric ulcer, make an appointment with your veterinarian. An ulcer can be serious, and sometimes fatal if medical attention is not given in time. Your medical professional will ask questions pertaining to his health history, look closely at his clinical signs, perform blood work, urinalysis, biochemistry profile, and other laboratory testing in order to rule out any other illnesses and come to a preliminary diagnosis.
Your doctor may perform specific diagnostic testing using enhanced diagnostic equipment. He may use a gastroscope, which is an approximately 2 meters-long endoscope into the stomach of your horse. This is currently the most accurate and definitive diagnostic test used to confirm the presence of a stomach ulcer or ulcers.
This test will confirm the specificities of the ulcers, such as size, severity, and precise location. Typically, ulcers are found in the upper portion of the organ however, ulcers can also be found in the lower section, including the duodenum. The ulcer will be classified between the areas of 0-4, with a 4 having severe lesions. He will communicate with you the extent of the ulcer and let you know the options for treatment.
Treatment For A Stomach Ulcer
Special diets are now known to have very little impact on the prevention or treatment of stomach ulcers. Treatment options can include:
- medication including antibiotics, to destroy the H. pylori colony, and drugs to help speed the healing process. Different drugs need to be used in combination some of the side effects can include diarrhoea and rashes. Resistance to some of these antibiotics is becoming more common
- subsequent breath tests used to make sure the H. pylori infection has been treated successfully
- changes to existing medication the doses of arthritis medication, aspirin or other anti-inflammatory medication can be altered slightly to reduce their contributing effects on the stomach ulcer.
- reducing acid tablets are available to reduce the acid content in the gastric juices
- lifestyle modifications including quitting cigarettes, since smoking reduces the natural defences in the stomach and impairs the healing process.
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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 Peptic Ulcers Are Treated
A peptic ulcer is a sore or lesion that forms in the lining of the stomach or duodenum, the first part of the small intestine. Peptic ulcers are caused by Helicobacter pylori , a bacterium that lives in the mucous lining of the stomach and intestine. Symptoms of these ulcers include pain, discomfort, heartburn, nausea, or gas, though some people may not experience any symptoms at all.
Treatment of peptic ulcers include antibiotics to clear H. pylori, prescription and over-the-counter medicines to manage symptoms, and lifestyle modifications to help ulcers heal.
A peptic ulcer is one of the most common gastrointestinal tract issues seen by healthcare providers an estimated 5% to 10% of all people will experience one in their lifetime.
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What Are The Symptoms Of A Peptic Ulcer
Youâll most likely feel a burning pain or discomfort between your belly button and breastbone. You might especially notice it on an empty stomach — such as between meals or at night. The pain may stop for a little while if you eat or take an antacid, but then return. The pain can last for a few minutes or a few hours, and may come and go for many days or weeks.
Other symptoms may include:
Small ulcers may not cause any symptoms. But if you notice any of these signs, talk to your doctor.
What Are The Symptoms Of Any Complications
Stomach ulcers can cause various complications but these are much less common now because of more effective treatments. However, complications can be very serious and include:
Bleeding from the ulcer
- This can range from a trickle to a life-threatening bleed.
- If there is sudden heavy bleeding then this will cause you to vomit blood and make you feel very faint.
- Less sudden bleeding may cause you to vomit and the vomit looks coffee-coloured because the stomach acid has partly broken down the blood.
- A more gradual trickle of blood will pass through your gut and cause your stools to look very dark in colour or even black .
PerforationThis is the term used to describe the ulcer having gone all the way through the wall of the stomach. Food and acid in the stomach then leak out of the stomach. This usually causes severe pain and makes you very unwell. Stomach perforation is a medical emergency and needs hospital treatment as soon as possible.
Stomach blockageThis is now rare. An ulcer at the end of the stomach can cause the outlet of the stomach to narrow and cause an obstruction. This can cause frequent severe vomiting.
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Bleeding Peptic Ulcer: Treatment
A peptic ulcer is a sore in the lining of your stomach or duodenum . Your ulcer is bleeding or at high risk of bleeding. This means that you need treatment right away. Treatment can include medicines. It may also include a procedure such as endoscopy, angiography, or surgery. Your provider will work with you to decide which treatments are best for you. Read on to learn more about each type of treatment.
What Causes Gi Bleeding
Many conditions can cause GI bleeding. A doctor can try to find the cause of your bleeding by finding its source. The following conditions, which are listed in alphabetical order, include possible causes of GI bleeding:
Angiodysplasia. Angiodysplasia is when you have abnormal or enlarged blood vessels in your GI tract. These blood vessels can become fragile and bleed.
Benign tumors and cancer.Benign tumors and cancer in the esophagus, stomach, colon, or rectum may cause bleeding when they weaken the lining of the GI tract. A benign tumor is an abnormal tissue growth that is not cancerous.
Colitis. Ulcers in the large intestine are a complication of colitis. Ulcerative colitis is an inflammatory bowel disease that can cause GI bleeding.
Colon polyps.Colon polyps can cause GI bleeding. You can have more than one colon polyp at a time. Some types of polyps may be cancerous or can become cancerous.
Diverticular disease.Diverticular disease can cause GI bleeding when small pouches, or sacs, form and push outward through weak spots in your colon wall.
Esophageal varices.Esophageal varices can cause GI bleeding. Esophageal varices are usually related to a chronic liver condition called cirrhosis.
Esophagitis. The most common cause of esophagitis is gastroesophageal reflux . GER happens when your lower esophageal sphincter is weak or relaxes when it should not. Stomach acid can damage your esophagus and cause sores and bleeding.
Gastritis. Some common causes of gastritis include
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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.
What Does A Stomach Ulcer Feels Like
Stomach ulcer pain usually begins in the upper middle part of the abdomen, above the belly button and below the breastbone. The pain may feel like burning or gnawing that may go through to the back. The onset of the pain may occur several hours after a meal when the stomach is empty. Patients have reported paint to be worse at night as opposed to the morning. Pain duration may vary from a few minutes to several hours. Pain may be relieved by foods, antacids or vomiting.
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Signs Of Bleeding Stomach Ulcer And Tests
Posted by Dr. Chris
Stomach ulcers are a common digestive problem and can cause significant discomfort. Sometimes these ulcers, which are open sores, may bleed. This can continue intermittently for weeks and even months. However, in some cases it can arise suddenly and be severe. As with any blood loss, this can be dangerous. For high risk patients like the elderly it can even lead to death if there is extensive blood loss without medical treatment.
What Is Stomach Ulcer
A stomach ulcer , also known as an ulcer or peptic ulcer , is a type of sore that forms in the lining of the stomach. Ulcer symptoms include abdominal pain , sometimes bleeding, and other digestive symptoms. The most common cause of ulcer is infection associated with the bacteria Helicobacter Pylori . Other risk factors for ulcers include alcohol use and long-term use of various medications. Various digestive system diseases have also been associated with the development of ulcers.
Symptoms of stomach ulcers may be constant or irregular, and the course of the disease varies from person to person. If Helicobacter Pylori is the cause of the ulcer, you will continue to experience symptoms unless the infection is treated. Some people with ulcers have no symptoms, while others may have heartburn , severe nausea, and vomiting.
If the cause of the stomach ulcer is Helicobacter Pylori bacteria, then the ulcer can be successfully treated with antibiotics. For ulcers not related to bacteria, treatment may be antacids or other medications that your doctor will prescribe. You can also reduce your risk of infection by washing fresh foods before consuming them and following common-sense hygiene practices by taking care of yourself.
You should see a doctor if you experience severe, writhing stomach pain , blood in your stools , or tarry stools and similar ulcer symptoms. If you are being treated for ulcers but still have symptoms, it is still very important to see your doctor.
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