Fast Facts On Stomach Ulcers
- Stomach ulcers are common in the West and easy to treat but can become serious.
- The most common causes are bacteria and use of nonsteroidal anti-inflammatory drugs .
- The classic symptom of a stomach ulcer is indigestion.
- Treatment for stomach ulcers normally focuses on removing the cause.
The classic symptom of a stomach ulcer is indigestion, also called dyspepsia.
Indigestion causes pain or discomfort in the stomach area. This symptom can be mistaken for heartburn, which can occur at the same time.
Stomach ulcer symptoms tend to be more distinct than heartburn, but symptoms can still be vague.
An ulcer also tends to produce a burning or dull pain in the center of the abdomen. People sometimes describe the pain as a biting or gnawing pain. Some individuals may describe a hungry sensation.
Individuals may also be able to relieve pain by eating, drinking, or taking antacids.
Some stomach ulcers go unnoticed and show no typical indigestion-type pains. These ulcers are less common, and doctors tend them after they have started bleeding.
Some ulcers can cause a hole in the stomach wall. Health experts call this perforation, which is a severe condition.
Stomach ulcer symptoms often change over time and can be difficult to spot.
Dietary changes can help prevent stomach ulcers from developing.
What Are Stomach Ulcers
There are two kinds of stomach ulcers: gastric ulcers and duodenal ulcers. Gastric ulcers are sores on the lining of your stomach. Duodenal ulcers are sores on the upper section of your small intestine.
Your body creates a protective layer of mucus to shield the linings of your stomach and small intestine from the harsh stomach acid required to break down food. When the mucus layer is worn away or doesnt function properly, the acid begins to damage the lining of the stomach or small intestine, creating an ulcer. Many people believe spicy foods or stress cause ulcers, but while these can exacerbate existing ulcers, they dont actually cause them.
Ulcers are usually caused by an infection from a common bacteria called helicobacter pylori or from the habitual use of nonsteroidal anti-inflammatory drugs, such as aspirin. Other factors, such as being older than age 50, smoking, genetics, steroid use, and frequent alcohol use, can increase your risk of developing an ulcer.
How Are Peptic Ulcers Treated
Treatment will depend on the type of ulcer you have. Your healthcare provider will create a care plan for you based on what is causing your ulcer.
Treatment can include making lifestyle changes, taking medicines, or in some cases having surgery.
Lifestyle changes may include:
- Not eating certain foods. Avoid any foods that make your symptoms worse.
- Quitting smoking. Smoking can keep your ulcer from healing. It is also linked to ulcers coming back after treatment.
- Limiting alcohol and caffeine. They can make your symptoms worse.
- Not using NSAIDs . These include aspirin and ibuprofen.
Medicines to treat ulcers may include:
- Antibiotics. These bacteria-fighting medicines are used to kill the H. pylori bacteria. Often a mix of antibiotics and other medicines is used to cure the ulcer and get rid of the infection.
- H2-blockers . These reduce the amount of acid your stomach makes by blocking the hormone histamine. Histamine helps to make acid.
- Proton pump inhibitors or PPIs. These lower stomach acid levels and protect the lining of your stomach and duodenum.
- Mucosal protective agents. These medicines protect the stomachs mucus lining from acid damage so that it can heal.
- Antacids. These quickly weaken or neutralize stomach acid to ease your symptoms.
In most cases, medicines can heal ulcers quickly. Once the H. pylori bacteria is removed, most ulcers do not come back.
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H Pylori Infection Treatment
Patients infected with H. pylori will usually need PPIs and antibiotics. This treatment is effective in most patients, and the ulcer will start to disappear within days. When treatment is over, the individual will have to be tested again to make sure the H. pylori have gone. If necessary, they will undergo another course of different antibiotics.
You Have Heartburn At Most Meals
If you find yourself experiencing frequent heartburn, regardless of what you eat, an ulcer may be responsible. Many patients with ulcers describe feeling very intense chest pain, which often causes them to burp or hiccup more than usual after eating. In many cases, a simple over-the-counter antacid can be taken to temporarily alleviate some of the pain and gassiness, but if it persists day after day, its likely something more than a regular case of heartburn.
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Do Stomach Ulcers Go Away
Treatment Overview Left untreated, many ulcers eventually heal. But ulcers often recur if the cause of the ulcer is not eliminated or treated. If ulcers keep coming back, you have an increased risk of developing a serious complication, such as bleeding or a hole in the wall of your stomach or intestine.
How Common Are Stomach Ulcers
Stomach ulcers are very common in Western countries. In the United States, there are about 4 million cases per year. Some estimates say that 1 in 10 people will have one at some point in their lives. Thats because many of the causes that contribute to stomach ulcers are common in Western life. Fortunately, these causes are usually easy to trace and to reverse, giving ulcers a chance to heal and your stomach lining a chance to repair.
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.
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Black Or Dark Colored Stool
If you think you may have an ulcer, a good way to tell is to look at your stool. If you notice that when you use the restroom your stool is extremely dark in color, or even black, chances are you are right about what is ailing you. If this is the case, you should absolutely go to the hospital immediately.
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When To See A Doctor
For any type of internal ulcer you should contact your doctor if the pain does not go away after treatment or keeps returning regularly.
You should seek immediate medical attention if you begin to vomit blood, have tar-like or bloody stools, or have a sharp pain the comes on suddenly, and either doesnt go away or gets progressively worse.
For mouth ulcers, you should see a doctor or dentist if they dont clear up within two weeks after treating them with over-the-counter medications or if the pain significantly affects your ability to eat and drink.
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What Causes Peptic Ulcer Disease
The main cause is the bacterial infection, Helicobacter pylori . Another common cause is long-term use of nonsteroidal anti-inflammatory drugs . This includes aspirin, ibuprofen, and naproxen. In rare cases, the disease can be caused by cancerous and noncancerous tumors. A less common cause is a rare disorder called Zollinger-Ellison syndrome.
What Are The Signs You Have A Stomach Ulcer
The symptoms of a stomach ulcer are often similar to a regular upset stomach, says Andrew Boxer, MD, a gastroenterologist at Jersey City Medical Center in New Jersey. But usually, the symptoms of an ulcer will not go away.
The symptoms can vary widely. Some patients are completely asymptomatic, while some patients experience the worst pain of their life. There can also be anything in between, says Boxer. Some patients may see blood in their stool or even vomit blood. In rare instances, an ulcer can cause an obstruction, and the patient will have nausea and vomiting. Because ulcers can involve bleeding, some patients may show anemia or a lack of hemoglobin on a blood test.
The most common symptom is upper abdominal pain, says Alex Spinoso, MD, of Genesis Lifestyle Medicine in Las Vegas, Nevada. Occasionally the discomfort localizes to the right or left upper quadrants of the hypochondrium, the areas right below the chest on either flank where there are still ribs.
Typically, pain associated with a stomach ulcer happens two to five hours after a meal, when the stomach secretes acid and is mostly empty, and at night when acid secretion normally increases, says Spinoso. Without treatment, ulcer pain may last a few weeks, followed by symptom-free periods of weeks or months.
Nutritional Assessment On Peptic Ulcer
It aims to identify possible nutritional alterations and determine properintervention to ensure the individuals health. Malnutrition in this case may occurespecially when there is stenosis, which prevents normal ingestion of foods.
For nutritional assessment, some important indicators are used in this process, suchas the anthropometric, biochemical, and clinical evaluations. The anthropometricassessment consists of weight and height measurements that may be used in conjunctionin the assessment of the nutritional status by means of BMI , butthis method does not distinguishes losses of fat or lean mass. In addition, weightmay be concealed by hyper-hydration or de-hydration, thus not resulting in anaccurate determination of the nutritional status in these specific cases.
Total body bioelectrical impedance is a method used to measure the body mass, liquidvolume, and body fat, being recognized by the Brazilian Ministry of Health and theFood and a Food and Drug Administration as a valuable technique for thispurpose. Indirectcalorimetry is a non-invasive method to determine the nutritional needs and theutilization rate of energy substrates from oxygen consumption and carbon dioxideproduction obtained by analysis of the inhaled and exhaled air by the lungs.
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How Are Ulcers Diagnosed
To diagnose a peptic ulcer, doctors do an exam, ask about symptoms, and take a medical history. If you have stomach pain or other symptoms of an ulcer, the doctor will do some tests.
One test is called an upper gastrointestinal series. These are X-rays of the stomach, duodenum, and esophagus, the muscular tube that links the mouth to the stomach. A person drinks a liquid called barium while getting an X-ray. If theres an ulcer, it should show up on the X-ray.
Another common test to look for an ulcer is an endoscopy . A person is sedated for this procedure. Then, the doctor puts an endoscope a small, flexible tube with a tiny camera on the end down the throat and into the stomach and duodenum. The doctors can see the lining of the esophagus, stomach, and duodenum to check for possible ulcers.
A doctor also can do a blood test that looks for H. pylori bacteria. This may be important if the upper GI series showed an ulcer. The blood test can be done right in the doctors office. Sometimes doctors test a poop sample or a persons breath to check for the H. pylori bacteria.
Can Stomach Ulcers Just Go Away
Some ulcers follow a chronic pattern of healing temporarily on their own and then returning. This might happen if the factors contributing to your ulcer, such as NSAID use, smoking and alcohol, are temporarily reduced and then resumed. You wont completely heal your ulcer until you eliminate the cause, whether that is chronic NSAID use, H. pylori infection or an overactive stomach. Even after successful treatment, you can get another ulcer.
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How Will Your Doctor Diagnose Ulcers
Your doctor will start by asking about your medical history and symptoms. Let your doctor know when and where you most often have symptoms.
Gastric and duodenal ulcers can cause pain in different parts of your abdomen. A variety of tests will usually be recommended since abdominal pain has many causes.
If your doctor thinks H. pylori may be the source of your symptoms, the following tests can confirm or rule out this possibility:
- A blood test. The presence of certain infection-fighting cells could mean you have an H. pylori infection.
- A stool antigen test. In this test, a stool sample is sent to a lab for testing. The test looks for certain proteins in the stool related to H. pylori.
- A urea breath test. A urea breath test involves swallowing a pill that contains a special formulation of urea. You breathe into a collection bag before and after swallowing the pill, and then your carbon dioxide levels are measured. When H. pylori is present, the urea in the pill is broken down into a certain type of carbon dioxide that can be detected.
Burning Pain In The Abdomen
Persistent burning pain in the abdomen is one of the first signs of a stomach ulcer. The sensation of pain occurs when juices in the stomach, which help in digestion, come into contact with an open sore in the stomach lining.
In most cases, the pain is felt from the breast bone to the navel, and it often worsens during the night. If you skip meals, particularly breakfast, you may also experience this burning sensation in the stomach during the daytime.
If the dull and burning ache of the ulcer often turns into a sharp, stabbing pain, it is a sign that your ulcer is acting up and you need medical help. It could mean that the ulcer has caused a more critical problem like a perforation in the wall of your stomach or intestine, or a blockage in your digestive tract, and it is triggering intense pain.
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Youre More Bloated Than Usual
If you notice your stomach feeling particularly bloated, it may be more serious than a little bit of gasit could be one of the signs of an ulcer. According to RM Healthy, bloating is often one of the earliest ulcer symptoms, with patients especially complaining of pain in their midsection. Of course, bloating can also be caused simply by eating something your body doesnt agree with or not drinking enough water, but when combined with these other symptoms, its worth checking out.
Peptic Ulcer Disease Treatment
Your doctor may begin by prescribing medicine. Your doctor may suggest other treatments for other causes.
If you have H. pylori, your doctor will treat the infection with triple therapy. This is a combination of 2 antibiotics and bismuth subsalicylate . H. pylori can be stubborn. Take all your medicine as prescribed.
Your doctor may recommend medicines to neutralize your stomach acid. This will protect the lining in your stomach, too. These include:
- Protein pump inhibitors. This includes esomeprazole or lansoprazole .
- Histamine receptor blockers. This includes famotidine .
- Cytoprotective agents. This includes sucralfate .
If NSAIDs cause your ulcer, you may need to stop or reduce the amount you take. You may need to switch to another type of medicine for pain.
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How Do Nsaids Cause A Peptic Ulcer
To understand how NSAIDs cause peptic ulcer disease, it is important to understand how NSAIDs work. Nonsteroidal anti-inflammatory drugs reduce pain, fever, and inflammation, or swelling.
Everyone has two enzymes that produce chemicals in your bodys cells that promote pain, inflammation, and fever. NSAIDs work by blocking or reducing the amount of these enzymes that your body makes. However, one of the enzymes also produces another type of chemical that protects the stomach lining from stomach acid and helps control bleeding. When NSAIDs block or reduce the amount of this enzyme in your body, they also increase your chance of developing a peptic ulcer.
When Should I Go To Er
Seek emergency care if you have:
- Severe pain that doesnt go away.
- Signs of blood in your poop or bloody vomit.
- Signs of severe blood loss, such as paleness and faintness.
A note from Cleveland Clinic
Stomach ulcers are common and treatable, but they should be taken seriously. Even when they dont cause symptoms, they arent a good sign. A stomach ulcer means that your natural stomach acid is overwhelming your protective stomach lining. Thats a situation that can only get worse if it isnt managed. Lifestyle changes may help, but youll still need to treat the underlying cause. Its probably either NSAID use or a common bacterial infection. Your healthcare provider can help prescribe the right medicines for your condition.
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Nsaids And Stomach Ulcers
The risk of ulcers increases if the drugs are taken in high doses or regularly for a long time.
Stronger NSAIDs, such as those available on prescription, carry a greater risk of stomach ulcers than those that people can buy over the counter.
A person should always check labels and consult a pharmacist or a doctor about any concerns regarding using pain relief medication. They may recommend an alternative, such as acetaminophen.
You Have Pain Specifically In Your Upper Abdomen
One of the most common ulcer symptoms is a severe pain in the upper abdomen, according to Neil Sengupta, MD, a gastroenterology specialist at the University of Chicago. Ulcers can develop anywhere in the upper digestive track, but Dr. Sengupta says we often think about those occurring in the stomach or small intestine, where we feel pain. This pain usually occurs between the breastbone and belly button, and can bring on a burning, aching, or dull feeling. The sensation may begin as a light, mild pain but often progresses into something more serious as the ulcers develop.
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