When To Go To The Healthcare Provider
Pain in the body means that something is wrong. If you experience pain after eating only every once in a while and it is not debilitating, you may want to mention it to your healthcare provider the next time that you see them.
But if you are experiencing pain after eating on a fairly frequent basis, it is essential that you make an appointment right away with your healthcare provider to ensure that you get an accurate diagnosis and come up with a treatment plan.
If the pain is severe, debilitating, and accompanied by jaundice, fever, rapid heart rate, chills, or severe vomiting, you should seek emergency care.
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.
Peptic Ulcer Disease Vs Angina
Usually, it’s not particularly difficult for a healthcare provider to distinguish chest pain caused by peptic ulcer disease from angina caused by coronary artery disease . The characteristics of the two types of pain are usually quite different.
Peptic ulcer pain is not induced by exercise and relieved by rest . The gnawing pain accompanied by bloating and nausea is quite different from that of typical angina.
Nonetheless, because angina itself can have a noncardiac presentation, it may become important to do confirmatory tests to pin down the diagnosis.
Endoscopy is the favored method of diagnosis of peptic ulcer disease, especially in people who have evidence of bleeding or have had severe symptoms.
Testing for the presence of Helicobacter pylori may also be helpful. X-rays of the upper digestive system may also be recommended.
If your healthcare provider is concerned about the possibility of CAD, a stress test may be helpful in distinguishing between these two problems.
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What Are The Symptoms Of Peptic Ulcers
Each persons symptoms may vary. In some cases ulcers dont cause any symptoms.
The most common ulcer symptom is a dull or burning pain in your belly between your breastbone and your belly button . This pain often occurs around meal times and may wake you up at night. It can last from a few minutes to a few hours.
Less common ulcer symptoms may include:
- Feeling full after eating a small amount of food
- Bloody or black stool
- Vomiting blood
Peptic ulcer symptoms may look like other health problems. Always see your healthcare provider to be sure.
Pain Below Breastbone Causes Symptoms
Posted by Dr. Chris
Any pain in the chest area, whether high up or lower down, slightly to the left or right of the midline, is naturally a cause for concern especially among adults. Considering that the vital organs like the heart and lungs are located here, breastbone pain is usually taken seriously. For some people like those who are obese, have a history of heart disease and smoke heavily, the concern is much greater. However, it is important to note that the abdomen starts much higher than most of us realize. Pain lower down in the chest area may actually be abdominal pain.
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What Is Peptic Ulcer Disease
Peptic ulcer disease is a condition in which painful sores or ulcers develop in the lining of the stomach or the first part of the small intestine . Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing stomach acid to damage the tissue.
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.
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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.
What Is The Treatment For Peptic Ulcers
The choice of treatment depends on whether or not the ulcer is caused by infection with H pylori. Correct diagnosis is key to whether a treatment works or not. If the bacteria are the cause, treatment focuses on killing the infection. Regardless of whether the bacteria are the cause, reducing acid in the stomach is another important focus of treatment.
The following treatments are recommended for ulcers:
- Lifestyle changes: Quit smoking, avoid alcohol, aspirin, and NSAIDs
- Acid-blocking medications
- Medications that protect the lining of the stomach and duodenum
- “Triple-therapy” or “dual-therapy” regimens for ulcers caused by H pylori
No single medication works to get rid of H pylori infection. Two combinations have been found that work well in most people.
These treatments are generally given for two weeks.
Once H pylori bacteria are eradicated from a person’s digestive tract, usually it will not come back. The ulcers usually heal completely and do not return.
Treatment for bleeding ulcers depends on the severity of blood loss and includes:
It is important to remember that treatment may not work if the diagnosis is not correct. If the doctor diagnoses an ulcer, it is important to determine whether the ulcer is caused by infection with H pylori.
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When To Seek Medical Advice
You should visit your GP if you think you may have a stomach ulcer.
Seek urgent medical advice if you experience any of the following symptoms:
- 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.
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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Treatment Of Peptic Ulcers
Its really important to get the right treatment if youre diagnosed with a peptic ulcer. If treated properly, duodenal ulcers will heal in around four weeks and stomach ulcers in eight.
Treating the underlying cause lowers the chance of your ulcer coming back. This usually means getting rid of the H. pylori or stopping taking NSAIDs.
Treating Helicobacter Pylori Infection
If your stomach ulcer’s caused by a Helicobacter pylori bacterial infection, you’ll be given:
- a course of antibiotics
- a medication called a proton pump inhibitor
This is also recommended if it’s thought your stomach ulcer’s caused by a combination of an H. pylori infection and non-steroidal anti-inflammatory drugs .
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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.
Hypersensitivity Of The Esophagus
A hypersensitive esophagus causes upper chest pain and heartburn after eating. Its stimulus may be mechanical, chemical, or emotional.
- Mechanically, the esophagus can be stimulated by swallowed bolus, air, or refluxed stomach content.
- Gastric acid, bile, and inflammatory mediators can cause chemical stimulation.
- Emotional stimulation may be due to stress, anxiety, or panic attack causing chest pain.
Sometimes the chest pain can be so severe, that you may feel like you have underlying heart disease. If pain is severe and mimicking a heart attack, proper evaluation and consultation are necessary.
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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.
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.
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Complications Of A Peptic Ulcer
Untreated ulcers can become worse over time. They can lead to other more serious health complications such as:
- Perforation: A hole develops in the lining of the stomach or small intestine and causes an infection. A sign of a perforated ulcer is sudden, severe abdominal pain.
- Internal bleeding:Bleeding ulcers can result in significant blood loss and thus require hospitalization. Signs of a bleeding ulcer include lightheadedness, dizziness, and black stools.
- Scar tissue: This is thick tissue that develops after an injury. This tissue makes it difficult for food to pass through your digestive tract. Signs of scar tissue include vomiting and weight loss.
All three complications are serious and may require surgery. Seek urgent medical attention if you experience the following symptoms:
- sudden, sharp abdominal pain
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.
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Causes Of Stomach Ulcers
A stomach ulcer can be caused by a variety of factors, including:
- Helicobacter pylori bacteria is thought to be responsible for around 60 per cent of stomach ulcers and at least 90 per cent of duodenal ulcers.
- Certain medications which include aspirin or clopidogrel, taken regularly to help prevent heart attack or stroke, and drugs for arthritis. Anti-inflammatory medications are thought to cause around two fifths of stomach ulcers.
- Cancer stomach cancer can present as an ulcer, particularly in older people.
Peptic Ulcers Are Often Symptomless
About 30 percent of 60 year olds with confirmed peptic ulcer disease have no abdominal pain.24 This means 1 in 3 old people without the slightest hint of the major symptom of peptic ulcers actually have them.
As if it was not already challenging to diagnose what cannot be seen, sometimes individuals suffering from peptic ulcers do not experience any symptoms.
Older people and children are, unfortunately, at a higher risk of belonging to this no-symptoms niche. This increases the likelihood of a delayed diagnosis and grave complications like perforation and internal bleeding.
Another group of individuals who may struggle with identifying peptic ulcers are those who are heavily dependent on NSAIDs. Even though abdominal pain is the most prominent indicator of peptic ulcers, such is not always the case. To our dismay, 1 in 3 people with peptic ulcers dont have any abdominal pain, particularly those popping NSAIDs.252627 This resonates with research findings that NSAIDs mask the symptoms of peptic ulcers.28 It is, thus, advisable to exercise caution if you need to regularly take these painkillers to treat other conditions.
Having no symptoms or weak symptoms, hence, does not rule out the possibility of peptic ulcers.
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Ulcers And Back Pain:
In some cases, abdominal pain caused by ulcers may radiate to the back and result in mid to low back pain. Usually, such pain lasts for a short duration, but some people experience intermittent back pain for a few days or even weeks. Excruciating and persistent back pain could be a sign of a perforating peptic ulcer that penetrates the pancreas. This condition needs immediate medical assistance in order to avoid further complications. Those who experience back pain due to ulcers may not be able to recall any event or injury that triggered such pain. Sometimes, they may relate the pain with intake of food.
Living With Peptic Ulcer Disease
Most ulcers heal within about 8 weeks. Peptic ulcers come and go. You have to do what you can to reduce your risk. If you smoke or chew tobacco, ask your doctor about how to quit. Eat a well-balanced diet. Avoid foods that cause discomfort. These include alcohol, coffee, caffeinated soda, fatty foods, chocolate, and spicy foods. Avoid eating late at night. Talk to your doctor about alternatives to NSAIDs. Take all medicines with plenty of water.
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What Are Peptic Ulcers
Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or small intestine. Theyre usually formed as a result of inflammation caused by the bacteria H. pylori, as well as from erosion from stomach acids. Peptic ulcers are a fairly common health problem.
There are three types of peptic ulcers:
- gastric ulcers:ulcers that develop inside the stomach
- esophageal ulcers:ulcers that develop inside the esophagus
- duodenal ulcers: ulcers that develop in the upper section of the small intestines, called the duodenum
Different factors can cause the lining of the stomach, the esophagus, and the small intestine to break down. These include:
- Helicobacter pylori , a type of bacteria that can cause a stomach infection and inflammation
- frequent use of aspirin , ibuprofen , and other anti-inflammatory drugs
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.
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