How Are Stomach Ulcers Diagnosed
Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications youre taking.
To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, youll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.
Other tests and procedures used to diagnose stomach ulcers include:
- Barium swallow: You drink a thick white liquid that coats your upper gastrointestinal tract and helps your doctor see your stomach and small intestine on X-rays.
- Endoscopy : A thin, lighted tube is inserted through your mouth and into the stomach and the first part of the small intestine. This test is used to look for ulcers, bleeding, and any tissue that looks abnormal.
- Endoscopic biopsy: A piece of stomach tissue is removed so it can be analyzed in a lab.
How Do I Know If I Have An Ulcer
Describing your symptoms may lead your doctor to suspect that you have a peptic ulcer, but it wonât likely help determine the type, because the symptoms of stomach and duodenal ulcers are so similar. The doctor will do tests like these to figure out which specific type of ulcer you have:
- Endoscopy. This is the most accurate diagnostic test to diagnose a peptic ulcer. The doctor puts a flexible tube down your throat to see inside your esophagus , stomach, and duodenum. This allows the doctor to see the cause of bleeding and test for any bacterial infection. During this exam, your doctor may also do a biopsy to check for cancer.
- Barium swallow. If you can’t have an endoscopy, this test, also called an upper GI series of X-rays, can help your doctor identify and locate the ulcer and determine its type and severity. The test requires you to drink a “barium milkshake,” which has a liquid that will show up on an X-ray. They may ask you to eat only bland, easy-to-digest foods for 2-3 days before the test. After drinking the chalky liquid, you lie down on a tilting exam table. This evenly spreads the barium around your upper digestive tract and lets the X-ray take pictures at different angles.
Could I Have An Ulcer And Not Know It
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Around 25 million people will have a stomach ulcer in their lifetime, according to the Centers for Disease Control and Prevention. Despite their prevalence, the symptoms of an ulcer can frequently be mistaken for other conditions, like heartburnand some people may not show any signs at all. Its also unlikely that stress or your diet is the culprit. If youre concerned that your stomach pain could be something more serious, read on to find out the causes, proper treatment and prevention methods for peptic ulcers.
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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.
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.
What Is The Treatment For Ulcers
If you have ulcer symptoms, see your doctor. Prompt treatment can prevent excessive bleeding and other complications.
Ulcers are usually diagnosed after an upper GI endoscopy . An endoscope is a long flexible tube with a light and camera on the end. The tube is inserted into your throat, then to the esophagus, stomach, and upper part of the small intestine. Learn how to prepare for an endoscopy here.
Generally performed as an outpatient procedure, it allows the doctor to locate and identify problems in the stomach and upper intestine.
Bleeding ulcers must be addressed quickly, and treatment can start during the initial endoscopy. If bleeding from ulcers is found during the endoscopy, the doctor can:
- inject medication directly
- cauterize the ulcer to stop the bleeding
- clamp off the bleeding vessel
If you have an ulcer, youll be tested for H. pylori. This can be done using a tissue sample taken during the endoscopy. It can also be accomplished with noninvasive tests such as a stool sample or breath test.
If you have the infection, antibiotics and other drugs can help fight the bacteria and ease symptoms. To be certain you get rid of it, you must finish taking the medication as directed, even if your symptoms stop.
If your ulcers are the result of taking too many NSAIDs, work with your doctor to find another medication to treat pain.
Over-the-counter antacids sometimes relieve symptoms. Ask your doctor if its okay to take antacids.
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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.
Take An Nsaid That Has A Lower Risk Of Ulcers
You may consider choosing a specific NSAID, such as salsalate, which may have a lower risk of gastrointestinal bleeding compared to other NSAIDs.
There is also data that suggests Celebrex, a COX-2 inhibitor, may have a lower risk of bleeding from the large intestine. Talk to your healthcare provider to see if Celebrex would be a good option for you. It’s worth noting, however, that Celebrex has been tied to heart risks. It’s a balanceweighing risks and benefits.
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Foods That Help Prevent Stomach Ulcers
While fairly common, ulcers can be painful and cause lasting damage if not treated. Most ulcers are caused by an infection from Helicobacter pylori bacteria which damages the protective lining of your stomach allowing acid to essentially burn your stomach. Common symptoms include indigestion, abdominal pain, and heartburn. The health experts at Envolve, an integrated healthcare solutions company, are pleased to share five foods that may help fight against the ulcer-causing bacteria.
1. Binge Blueberries. Small, but powerful, blueberries contain flavonoids, which are polyphenols that help protect the stomach lining by increasing stomach mucus that halts the growth of H. pylori. Besides warding off ulcers, this berry also may help strengthen heart health, lower blood pressure, and increase bone strength.
2. Have Honey. You might not think of this natural sweetener providing health benefits but it does! Honey may prevent acid reflux, improve cholesterol and suppress coughs and aids in the prevention and healing of wounds including ulcers. If youre unsure of what kind to buy, try raw or Manuka honey as they have the most antibacterial effects.
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Vomiting Undigested Food With Traces Of Fresh Blood
A feeling of sickness with an urge or inclination to vomit may accompany the onset of bleeding stomach ulcers. This may happen in a repeated series of events from one time to another. If a person is affected to the point of displaying vomiting episodes, the vomitus is characterized as undigested food with traces of fresh blood.
The fresh blood content of the vomitus is usually bright red in color. This is a serious symptom that may indicate a person is experiencing a bleeding ulcer. A vomitus with bright red traces of fresh blood specifies that the ulcer is currently bleeding at the moment or has just started bleeding.
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Avoid Steroid Drugs Or Blood Thinners With Nsaids
Avoid steroid drugs , if possible, in combination with NSAIDs. If your healthcare provider has prescribed prednisone for you, make sure you let them know if you’re already taking an NSAID. They might decide to add a PPI to your medication regimen to reduce your risk of developing an ulcer.
Talk to your healthcare provider about reducing your risk of developing bleeding ulcers while taking NSAIDs. It’s an important conversation.
When To Seek Medical Attention
If you notice any of the symptoms, consult your doctor. Even when the discomfort is mild, ulcers get worse as time passes. If the ulcer is not treated, the pain will become progressively more severe.
In some cases, the ulcer might become life-threatening. The symptoms of a severe ulcer condition include:
- Passing dark, sticky stools
The bleeding can be bright red or even have a dark brown appearance similar to coffee grounds.
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What If An Ulcer Doesnt Heal Or Comes Back After Treatment
- check for and treat any factors that could be causing the ulcer, such as an H. pylori infection.
- recommend you quit smoking, if you smoke. Smoking can slow ulcer healing.
- recommend or prescribe more medicines to help heal the ulcer.
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Noninvasive Tests For Gastrointestinal Bleeding
When ulcers are suspected, the doctor will order tests to detect bleeding. These may include a rectal exam, complete blood count, and fecal occult blood test . The FOBT tests for hidden blood in stools. Typically, the patient is asked to supply up to six stool specimens in a specially prepared package. A small quantity of feces is smeared on treated paper, which is then exposed to hydrogen peroxide. If blood is present, the paper turns blue.
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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.
How Do You Know If Youre Not Receiving The Right Treatment
Anyone with a chronic condition such as ulcerative colitis should keep records of their care and closely monitor their symptoms. In particular, Bonthala recommends keeping an eye on your bowel movements, including the frequency, whether they are loose, if theres blood or mucus present, and if you suddenly experience constipation all of which could be signs that you need to change your treatment regimen.
If you suddenly develop intolerances to foods you used to stomach just fine, thats another sign that you may be undertreated.
Bonthala says your doctor should monitor your inflammation levels by testing for high levels of C-reactive protein in your blood. Your doctor can also test your stool for fecal calprotectin, a substance that your body produces when your intestines are inflamed.
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When To Seek Medical Help
Its important to see a healthcare provider if youre experiencing several of the above-listed symptoms. An ulcer can lead to complications if left untreated.
Get emergency treatment if you:
- Experience sudden sharp pain in your abdomen
- Develop a hard abdomen that hurts when you touch it
- Are throwing up blood
- Have blood in your stool
- Experience symptoms of shock like sweating profusely or confusion
What Should I Watch For While Using This Medication
It can take several days before your stomach pain gets better. Check with your care team if your condition does not start to get better, or if it gets worse.
Do not treat diarrhea with over the counter products. Contact your care team if you have diarrhea that lasts more than 2 days or if it is severe and watery.
You may need blood work done while you are taking this medication.
Using this medication for a long time may weaken your bones. The risk of bone fractures may be increased. Talk to your care team about your bone health.
Using this medication for a long time may cause growths in the stomach. They usually don’t cause any symptoms. They are usually not cancerous. Contact your care team if you notice pain or tenderness when you press your stomach, have nausea, or see bloody or black, tar-like stools.
This medication may cause a decrease in vitamin B12. You should make sure that you get enough vitamin B12 while you are taking this medication. Discuss the foods you eat and the vitamins you take with your care team.
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What May Interact With This Medication
Do not take this medication with any of the following:
This medication may also interact with the following:
This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.
Is There A Peptic Ulcer Diet Plan
No particular diet is helpful for people with peptic ulcers. At one time, a bland diet and avoidance of spicy or greasy foods was recommended. Milk and dairy food have been used in the past for ulcer symptoms, but have not been proven to be effective. We now know diet has little effect on ulcers. In some people, however, certain foods seem to aggravate stomach ulcer symptoms. Keep a food diary with your intake and the resulting symptoms and avoid eating any foods that aggravate symptoms.
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When Ulcer Surgery Is Required
Itâs a rare event these days, but an ulcer may require surgery to heal. Surgeons have a variety of procedures they can use, depending on the exact problem the ulcer has created.
A peptic ulcer is a small sore or lesion that forms in the stomach lining or that of the duodenum, the first part of your intestine. Most ulcers are due to an infection caused by a Helicobacter pylori infection and are treated with antibiotics, plus drugs that reduce the acid level in the stomach to help with healing.
Thanks to advances in ulcer treatment, surgery for ulcers is seldom necessary outside of an emergency situation.
Ulcer Treatment: Why Surgery Is Rare
Surgery used to be performed fairly routinely to take out the part of the stomach that makes acid, says Patrick I. Okolo, III, MD, MPH, chief of endoscopy at Johns Hopkins Hospital and assistant professor of gastroenterology and hepatology at Johns Hopkins University School of Medicine in Baltimore. However, proton pump inhibitors are so effective that we can achieve the same results with these medications alone and avoid surgery. Surgery is reserved only for people who are unable to take the drug, those the drug has not worked in, and those who have suffered a major complication. Examples are if the ulcer caused an obstruction in the stomach or duodenum that is preventing proper digestion or if it perforated, or went through, the stomach wall.
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How Are Duodenal Ulcers Treated
If your ulcer is caused by H pylori, the usual treatment is âtriple therapyâ. This involves taking 2 antibiotics and a medicine. The antibiotics kill the bacteria, while the medicine reduces the acid made by your stomach.
If you donât have an H. pylori infection, and you have been using anti-inflammatory drugs, you will need to stop taking them . You will also need to start taking a drug to reduce the acid production in your stomach.
You can make some other changes to improve your symptoms, such as:
- taking antacids
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When Should I See A Doctor If I Think I Have A Peptic Ulcer
- If you have burning pain in your upper stomach that is relieved by eating or taking antacids, call a health-care professional for an appointment. DonÃ¢t assume you have an ulcer. Certain other conditions can cause similar symptoms.
- If you vomit blood or have other signs of gastrointestinal bleeding, go to an emergency department right away. Peptic ulcers can cause massive bleeding, which requires blood transfusion or surgery.
- Severe abdominal pain suggests perforation or tearing of an ulcer. This is an emergency that may require surgery to fix a hole in your stomach.
- Vomiting and abdominal pain also can be a sign of an obstruction, another complication of peptic ulcers. This also may require emergency surgery.
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