Diagnosing An Esophageal Ulcer
Your provider will ask about your symptoms and health history. He or she will also give you a full exam. Tests will be done as well. These can include:
Upper endoscopy. This is done to see inside your esophagus. This lets your provider check for ulcers. During the test, an endoscope is used. This is a thin, flexible tube with a tiny camera and light on the end. The scope is placed into your mouth. It is then guided down the esophagus. Small brushes may be passed through the scope to loosen cells from the lining of the esophagus. Other tools may also be passed through the scope to remove tiny tissue samples . These samples are then sent to a lab for study.
Barium swallow. This is done to take X-rays of your esophagus. This helps your provider check for ulcers. For this test, youll drink a chalky liquid that contains a substance called barium. The barium coats your esophagus so that it will show up clearly on X-rays.
Blood tests. These check for infection, such as HSV-1 and CMV in the esophagus. For a blood test, a small sample of your blood is taken and sent to a lab.
What Is Esophageal Ulcer
Esophagus, commonly known as the food pipe is the organ through which the food passes from the pharynx to the stomach. The walls of the esophagus mucosa which secrete mucus help in the smooth flow of food through the pipe. These walls might get irritated or eroded by the series of acid secreted by the stomach walls. There are circumstances when the stomach acid may enter into the lower part of the esophagus, thus damaging the walls there. Rapid forceful contraction of the stomach walls can also pull back the acidic stomach contents to the esophagus. This might result in the formation of an esophageal ulcer. As the condition of inflammation progresses, this can result into fibrosis and stricture formation. This subsequently narrows down the walls of esophagus which makes the movement of food through the esophagus very difficult. Based on the causative factor of the esophageal tissue damage and esophagitis , it might lead to esophageal cancer if the condition worsens.
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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Common Warning Signs Of Ulcers
Ulcers are a common medical issue that affects about one in ten people in America. They occur when acid in the digestive tract eats away at the inner surface of the esophagus, stomach or small intestine. The acid can create a painful open sore that may bleed. You can get them anywhere on your body for any reason, but the most common form of ulcers occur in your stomach.
Although there is no single cause for an ulcer, many factors can increase your risk of stomach ulcers including painkillers, excessive drinking of alcohol and smoking tobacco. Luckily, ulcers are easy to treat once you recognize the symptoms of them. Here are five common signs of a stomach ulcer:
Abdominal Pain: A burning sensation may occur in your stomach. The pain will come and go in waves and is often accompanied by bloating. Many may confuse this feeling with acid reflux or other similar diseases. If the abdominal pain starts after you eat, keeps you up at night, and lasts a prolonged period it might be an ulcer.
Nausea: Due to the imbalance in your digestive system, mild to severe nausea may occur, either first thing in the morning on an empty stomach, or after eating. Because of nausea that will occur, rapid weight loss also comes in conjunction with it as well.
Bloating: A feeling of heaviness and fullness can occur in the stomach, usually the same feeling you get after drinking a full glass of water.
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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What Causes Esophageal Ulcers
The most common cause of esophageal ulcers is a bacterial infection called Helicobacter pylori , which damages the lining of the esophagus. Patients with gastroesophageal disease are also at greater risk for the development of esophageal ulcers.
Additional medical and lifestyle factors that may contribute to the development of esophageal ulcers include:
- Certain medications such as potassium
- Excessive alcohol consumption
- Frequent use of nonsteroidal anti-inflammatory drugs , such as ibuprofen
- Other bacterial, fungal, or viral infections, especially in people with compromised immune systems
Stress and spicy foods do not cause ulcers as previously thought, but they may aggravate an existing ulcer.
Stomach Ulcer Remedies: 10 Ways To Heal And Reduce Inflammation
An ulcer is a kind of erosion or open sore on the surface of an organ or tissue. Ulcers generally occur in the esophagus, stomach, and duodenum and are known as peptic ulcers.
Types of Peptic Ulcers
- Gastric ulcer: A peptic ulcer in the stomach is called a gastric ulcer.
- Duodenal ulcer: A duodenal ulcer is a type of peptic ulcer that develops in the first part of the small intestine .
- Esophageal ulcer: An esophageal ulcer develops in the lower part of the esophagus.
A peptic ulcer is among the most common forms of stomach disease. About 4 million Americans suffer from this condition every year.
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Who Suffers From Bleeding Ulcer
Some people are more susceptible to develop the condition and this is because they have the risk factors of bleeding ulcers. It is very important for high-risk people to act accordingly upon experiencing the symptoms of bleeding ulcer. Studies showed that the condition is more common in people who are:
- Affected by H. pylori infection
The H. pylori bacteria have been known to affect the normal production of stomach lining which protects the stomach from getting harmed by the stomach acid.
- Living an unhealthy lifestyle
Drinking alcohol and smoking have been associated with gastrointestinal problems because they have components that stimulate irritation to the lining of the upper digestive tract.
- Taking certain medications
The continuous intake of offending medications like NSAIDs, corticosteroid and anticoagulants can irritate the digestive tract and result in the ulcer to bleed.
- Eating spicy foods regularly
Spicy foods have been associated to bleeding ulcers because of their ability to irritate the digestive tract.
Stress has long been associated with the emergence of various health problems, including bleeding ulcers whether it is due to emotional or physical stress.
Heartburn Chest Pain And Indigestion
A sensation of burning or pain behind the breastbone is common, and often begins after a large meal. This can be a challenging symptom as heartburn is also a symptom of acid reflux , a common risk factor for esophageal cancer. For those who have acid reflux, a change in the quality or severity of heartburn symptoms may signal the presence of cancer.
Along with burning, some people feel chest pressure and fear they are having a heart attack.
Because heart disease in women often presents with vague symptoms, such as those just discussed, symptoms of burning and pressure in the chest should always be evaluated by a healthcare provider.
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How Is Esophagitis Diagnosed
Once your doctor has performed a thorough physical examination and reviewed your medical history, there are several tests that can be used to diagnose esophagitis. These include:
- Endoscopy: A long, flexible lighted tube called an endoscope is used to look at the esophagus.
- Biopsy: A small sample of the esophageal tissue is removed and sent to a laboratory to be examined under a microscope.
- Barium X-ray: X-rays are taken of the esophagus after the patient drinks a barium solution. Barium coats the lining of the esophagus and is visible on X-ray. This enables doctors to view abnormalities of the esophagus.
Enhancing Healthcare Team Outcomes
The management of an esophageal ulcer is with an interprofessional team that consists of a thoracic surgeon, gastroenterologist, radiologist, and an internist. Treatment of esophageal ulcers secondary to GERD is aimed at acid suppression, controlling acid secretion, promoting peristalsis and mucosal wall healing.
Treatment of drug-induced esophageal ulcer includes discontinuation of the offending medications and administering proton pump inhibitors. Antituberculous medications with Isoniazid, rifampicin, ethambutol, and pyrazinamide for 6 to 9 months can be used for esophageal ulcers caused by tuberculosis.
Antimicrobial agents are used for treating mucosal damage caused by infectious esophagitis. Infection caused by cytomegalovirus is treated with ganciclovir whereas fluconazole is the preferred choice in the treatment of esophageal candidiasis.
Finally, severe cases of esophageal injury are managed by intubation with a nasogastric tube, administration of intravenous fluids, chemoprophylaxis with antibiotics, pain relief with analgesics and treating the ulcer with H2 receptor antagonists and PPIs. The prognosis for patients with esophageal ulcer depends on the immune status, comorbidity, age, and cause. For those who comply with treatment, the prognosis is good.
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Peptic Ulcer Facts And Picture
- Peptic ulcer are sores in the lining of the esophagus, stomach or duodenum.
- The main symptom of a stomach or duodenal ulcer is upper abdominal pain, which can be dull, sharp, or burning .
- Other associated symptoms may include:
- acid reflux or heartburn and
- feeling satiated when eating.
- a course of antibiotics
- a medication called a proton pump inhibitor
What Are The Treatment Options For Esophageal Ulcers
Before treating an esophageal ulcer, it is important for the doctor to know what caused it. In most cases, esophageal ulcers are treated with drugs, while on rare occasions surgery is needed. Sometimes these ulcers, like peptic ulcers, are caused by gastroesophageal reflux disease . Generally, there are two types of drugs that are used to treat esophageal ulcers in that case-drugs that fight bacteria and those that control acid. These drugs include:
- Antibiotics, which fight the H. pylori bacteria that may be responsible for the ulcer.
- Antacids, which neutralize the stomach’s acidity, allowing for faster ulcer healing and reducing the painful symptoms of esophageal ulcers.
- Proton pump inhibitors, which shut down the stomach acid “”pumps.””
- Acid blockers, which decrease the amount of acid in the affected area.
Stomach surgery may also be used to prevent acid from backing up from the stomach into the esophagus.
An esophageal ulcer may also be a rare side effect from drugs like used to treat cancer or HIV infection. In this case the doctor will have to decide whether to try a different drug so the ulcer can heal. Surgery may be required if the ulcer does not heal on its own, but this is not typical.
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When Should I Call My Healthcare Provider
See your healthcare provider right away if you have any of these symptoms:
- Vomiting blood or dark material that looks like coffee grounds
- Extreme weakness or dizziness
- Nausea or vomiting that doesnt get better, or gets worse
- A sudden, severe pain that may spread to your back
- Losing weight without even trying
Untreated peptic ulcers may cause other health problems. Sometimes they bleed. If they become too deep, they can break through your stomach.
Ulcers can also keep food from going through your stomach.
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Causes Of Esophageal Ulcer
The bottom of the esophagus has a valve known as the lower esophageal sphincter. The valve is generally closed which prevents the stomach acid from flowing back to the esophagus. Whenever the food passes through the food pipe and reaches the stomach, this valve relaxes so that the food rushes into the stomach. During the repeated inflammation of the mucous walls, the valve might get weakened. This might result in the leak of the acid into the food pipe that triggers a burning sensation in the chest. This medical condition is known as gastroesophageal reflux disease . Cigarette smoking damages the lower esophageal sphincter thus, allowing more acid to damage the walls of the esophagus.
GERD is the most common cause of the esophageal ulcers. However, other bacterial or fungal infections in the esophagus leading to vomiting can also be a reason for esophageal ulcers. Consumption of alcohol can also cause or worsen ulcerations. The following foods and beverages are known to trigger heartburn in people thus, causing inflammation to the walls of the esophagus:
- Beverages containing alcohol
Symptoms Of Esophageal Ulcers
The presence of an esophageal ulcer most commonly features with dull or burning pain. This pain is characteristic of all peptic ulcers. The pain may be localized at the back of the breastbone or it may radiate towards the neck, throat, and upper part of the chest or in extreme cases even towards the facial area. The pain may last anywhere from a few minutes to even several hours and it is usually intermittent, meaning you will experience the pain in bouts rather than constantly.
When they are healing, ulcers tend to form scar tissue. This scar tissue may cause a narrowing of the esophagus that can lead to additional symptoms and signs such as difficulties with swallowing. In the beginning, the patient may complain about problems with swallowing of solid food and in severe cases they may even have difficulties when they attempt to swallow liquids. In rather rare cases, patients with esophageal ulcers may even experience breathing difficulties.
Additional symptoms of esophageal ulcers are a sore throat and excessive production of saliva.
Some ulcers may be so deep that they affect underlying blood vessels and cause bleeding. Bleeding is not such a common symptom of esophageal ulcers. It is more a complication of an esophageal ulcer. The blood originating from the esophagus is mixed with the stool, giving it a black coloration. In severe bleeding, a patient may even vomit blood.
What Is An Esophagus Ulcer
An esophagus ulcer is an open sore that forms on the lining of the esophagus, the tube that goes from the throat to the stomach. Some people who have an esophagus ulcer experience nausea, vomiting, abdominal pain, or chest pain. The most common causes are gastroesophageal reflux disease , anti-inflammatory medications, smoking, herpes, and human papillomavirus.
Patients with an esophagus ulcer often experience recurring problems. Over time, these ulcers can cause the esophagus to narrow, causing painful and difficult swallowing. Barretts esophagus can develop in patients who have recurring ulcers in the esophagus caused by GERD. Barretts esophagus is a condition where the lining of the esophagus changes, causing chest pain, heartburn, bloody vomit, and difficulty swallowing.
Esophagus ulcers are usually diagnosed by x-ray after the patient drinks a barium solution that allows the doctor to see the outline of the digestive tract clearly. Endoscopes, flexible tubes with a camera and a light, can also be inserted into the throat to look for ulcers. Once a patient is diagnosed, a doctor may check for GERD. GERD patients usually have to take medications and control their diet to help relieve symptoms.