What Causes Peptic Ulcers
Ulcers form when digestive juices damage the walls of the stomach or small intestine. If the mucus layer gets too thin or your stomach makes too much acid, your gut will feel it. The two major causes are:
- Bacteria. Itâs called Helicobacter pylori , and as many as half of us carry it. Most people infected with H. pylori do not get ulcers. But in others, it can raise the amount of acid, break down the protective mucus layer, and irritate the digestive tract. Experts arenât sure how H. pylori infection spreads. They think it may pass from person to person through close contact, like kissing. You may also get it from unclean food and water.
- Certain pain relievers. If youâve been taking aspirin often and for a long time, youâre more likely to get a peptic ulcer. The same is true for other nonsteroidal anti-inflammatory drugs . They include ibuprofen and naproxen. NSAIDs block your body from making a chemical that helps protect the inner walls of your stomach and small intestine from stomach acid. Other types of pain meds, such as acetaminophen, wonât lead to peptic ulcers.
- Smoking cigarettes and drinking alcohol also can make you more likely to get ulcers. Stress and eating a lot of spicy food donât cause ulcers, as experts once thought. But they can make ulcers worse and harder to treat.
What Are Some Ulcer Symptoms
Some people with ulcers dont experience any symptoms. But signs of an ulcer can include:
- Gnawing or burning pain in your middle or upper stomach between meals or at night.
- Pain that temporarily disappears if you eat something or take an antacid.
In severe cases, symptoms can include:
- Dark or black stool .
- Severe pain in your mid- to upper abdomen.
How To Diagnose Ulcers
- Urea breath test:
The patient is diagnosed using a urea breath test where a specific drink is given to patient which gets broken down by H.pylori bacteria and the breath is then analyzed to see if he/she has H.pylori infection.
- Stool antigen test/Blood test
A blood test is done to analyze whether it contains antibodies to H.pylori which is nowadays replaced by stool antigen test.
This is done to look inside the stomach directly and detect whether or not it contains an ulcer. The process involves passing an endoscope with a camera at one end into the mouth and the duodenum. A mild sedative may be given before the procedure and an anesthetic may be sprayed onto the throat to make the procedure more comfortable.
The images captured by the camera usually confirm or rule out the ulcer. However, sometimes a small tissue sample may also be needed to be taken and tested for the same. This is usually an outpatient procedure and the patient is usually sent home the same day.
Endoscopy is another procedure to diagnose ulcers. PPIs and H2 receptor antagonists are used to reduce acid levels until the swelling goes down. If an obstruction is caused by scar tissue, it may either need endoscopic balloon inflation.
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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.
What Are The Causes Of Ulcers
Causes of ulcers are as follows:
- Stomach Ulcers are more likely to develop in people having a sedentary lifestyle or poor eating habits.
- Oesophageal ulcers often result from exposure to medications such as certain antibiotics or anti-inflammatories and alcohol abuse.
- Ulcers also form as a result of excessive stomach acid secretion, consuming fatty and oily foods, alcohol, caffeine and tobacco. All of these factors contribute to a build-up of stomach acids which decay the protective lining of the stomach, esophagus and duodenum.
- According to a recent theory, bacterial infection is also one of the causes of peptic ulcers. For example, H.pylorii is present in 80% of stomach ulcers and 90% of duodenal ulcers.
- Overuse of over-the-counter painkillers such as ibuprofen, aspirin or naproxen, alcohol consumption, psychological stress and smoking exacerbate the formation of ulcers, especially in those with H.pylori.
- Stomach ulcers are more probable to occur in elderly people. With advancing age, the pylorus relaxes and allows excess bile to seep up into the stomach which erodes the stomach lining.
- People with type A blood group are more prone to get cancerous stomach ulcers.
- Duodenal ulcers develop in those who have an O blood group type. This is because people of this blood group are unable to produce certain substances on the surface of blood cells that protect the lining of the duodenum.
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Read The Package Insert
Admit it: When you buy a bottle of over-the-counter pain reliever, you likely throw out the printed insert along with the empty box. But you really should get in the habit of reading it. Find out what side effects you should look for. Look at the list of possible drug interactions or ask your pharmacist or doctor to go over it with you.
Nsaid Drugs And Stomach Ulcers
A group of painkillers known as NSAIDs carries a risk of stomach ulcers. The two best-known NSAIDs are aspirin and ibuprofen.
The risk of ulcers increases if the drugs are taken in high doses, or regularly for a long time.
Stronger NSAIDs, such as those that need a prescription, are riskier for stomach ulcers than those that can be bought over-the-counter .
People should always check labels and talk to a pharmacist or a doctor about any concerns with using painkillers. They may recommend an alternative such as acetaminophen.
Do The Medicines Cause Side Effects
Because you have to take so many medicines at the same time, you may have some side effects. Minor side effects of H. pylori medicines include a black color on your tongue, black stools, diarrhea, nausea, and headaches. Some of the medicines leave a bad taste in your mouth. These side effects are usually minor and go away on their own.
You can cure H. pylori infection only if you take the medicines just the way your doctor tells you. If you forget to take some of your medicines or stop taking them because of side effects, the infection will not be cured. You may get another ulcer in the future. Let your doctor know right away if you have side effects with your medicines or if you have any questions about how to take them. Your doctor may suggest something to make the side effects better, or may give you different medicines.
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Known Risk Factors And Symptoms Of Ulcers
The primary causes of ulcers include infection, poor blood circulation, trauma, poor blood circulation, and vitamin deficiencies. Certain conditions, such as cancer and diabetes, can also cause ulcers. However, clinical symptoms and risk factors are unique for each type of ulcer. Here are some common types of ulcers, as well as their risk factors and symptoms.
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What Is An Ulcer
An ulcer is the result of an imbalance in digestive fluids. It occurs when the linings of the stomach or the small intestines become deeply eroded.
Ulcersrange from quite small to an inch or more in size.
Stomach ulcers are also known as gastric ulcers. Just as pepticulcers are any ulcers that affect both the stomach and small intestines.
The stomach produces a strong acid to help digest food and protect against microbes. To protect the tissues of the body from this acid, it also secretes a thick layer of mucus. If the mucus layer is worn away and stops functioning effectively, the acid can damage the stomach tissue causing an ulcer.
In some cases, the body produces too much stomach acid. As a result, the mucous lining becomes damaged or worn away. When this happens, the acid may damage the lining of the digestive tract and cause an ulcer sore.
Peptic ulcer remains a common problem in the United States. Around 10% of people will have peptic ulcer disease at some point in their life.
- Medical Author: Melissa Conrad Stöppler, MD
Medically Reviewed on 9/10/2019
Related Symptoms & Signs
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.
How Are Rectal Ulcers Diagnosed
Your doctor will examine you and ask about habits that may have caused your symptoms . To check for rectal ulcers, doctors use physical examination, tests and imaging studies. These tests include:
- Anoscopy: Your doctor may use a tool called an anoscope to examine you. An anoscope is a short tube that your doctor inserts into your anus. Your doctor uses a light to see through the tube and check for ulcers or lesions inside your rectum.
- Sigmoidoscopy: Doctors insert a flexible instrument into your rectum during a sigmoidoscopy. The thin device has a camera on the end. With it, your doctor can see inside your rectum and the lower part of the colon.
- Colonoscopy: To look at the entire colon, doctors insert a long scope with a camera. Like a sigmoidoscopy, a colonoscopy is an outpatient procedure . It is a more invasive test than a sigmoidoscopy.
- Rectal ultrasound: During this test, doctors insert a small probe in your rectum. The probe uses sound waves to show images of the inside of the rectum so your doctor can see ulcers and other growths.
- Biopsy: Your doctor may take a biopsy of the tissue surrounding the ulcer and send it to a lab. The lab tests the tissue for other conditions, such as cancer.
What Are The Symptoms Of Gastric Ulcers
Gastric ulcers symptoms depend upon the severity of symptoms. The most common symptom is a burning sensation in the abdomen. A gastric ulcer pain after eating a meal or during nighttime. Also, many people with ulcers don’t even have symptoms.
Ulcers may cause severe Gastric Ulcer Symptoms such as:
Summary: Gastric ulcers signs are painful sores in the lining of the stomach which include a number of symptoms depending upon the severity of the disease.
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What Are The Long Term Effects Of Ulcers
The ulcers, when left untreated for a long time, can lead to the following situations:
- Bleeding: Patients may experience internal bleeding and blood loss, leading to anemia and blood in vomiting or stools. This may require hospitalization or transfusion.
- Infection: The ulcer when left untreated can perforate through the walls of the stomach or small intestine and can cause serious infection in the abdominal cavity region.
- It can lead to the blockage of the passage of the food via the digestive tract and thus can lead to symptoms of vomiting, nausea, weight loss, swelling in the intestine, etc.
What Natural Home Remedies Help Peptic Ulcer Pain
Home care for peptic ulcers often centers on neutralizing the stomach acid.
- Don’t smoke, and avoid coffee and alcohol. These habits increase gastric acid production and weaken the mucosal barrier of the GI tract promoting ulcer formation and slowing ulcer healing.
- Don’t take aspirin or nonsteroidal anti-inflammatory medications. Acetaminophen is a good substitute for some conditions. If acetaminophen doesn’t help, talk to your health-care professional about alternatives.
- If your symptoms are mild, try an over-the-counter antacid or nonprescription histamine blocker to neutralize stomach acid. Usually stronger prescription medications are needed.
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What Are The Symptoms Of Rectal Ulcers
Symptoms of a rectal ulcer usually develop gradually. They often appear along with other symptoms, such as constipation.
Some people with rectal ulcers feel like they always need to have a bowel movement, even after going to the bathroom. Other signs of a rectal ulcer are:
- Pain in the anal area, especially when having a bowel movement.
- Bloody stool.
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.
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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.
- 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.
Can An Ulcer Be Cured
Ulcers, commonly referred to as ââGastric ulcersââ or ââPeptic ulcersââ are open sores whose developmental sites are stomach and duodenum. The treatment of ulcers depend upon its cause and it usually gets healed in a month or two. Recommended treatment involves medication such as Antibiotics and Proton Pump inhibitors in case of bacterial infection or the same in combination with NSAIDS.
Alternative medications include H2-receptor antagonists, antacids etc. In addition, avoiding stress, alcohol, smoking, spicy foods etc. may help.
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When To Get Treatment
An increase in inflammation causes a flare, and the nature of inflammation means that you should treat it as quickly as you can. Inflammation grows exponentially, because inflammation itself causes an increase in inflammation. The longer you leave it untreated, the worse it will get. In addition, untreated inflammation not only leads to the symptoms associated with ulcerative colitis, it can also increase your risk of developing complications such as colorectal cancer down the line. Pay attention to your symptoms, and visit your physician if you notice that they change or increase even a small amount.
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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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.