Causes Of Stomach Ulcers
Stomach ulcers happen when theres damage to the layer that protects the stomach lining from the acids in your stomach.
This is usually a result of:
- an infection with Helicobacter pylori bacteria
- taking anti-inflammatory medicines , such as ibuprofen or aspirin particularly if they’re taken for a long time or at high doses
It used to be thought that stress or certain foods might cause stomach ulcers, but there’s little evidence to suggest this is the case.
Stomach ulcers can affect anyone but are more common in people aged 60 or over. Men are more affected than women.
Symptoms Of Stomach Ulcers
A number of symptoms are associated with stomach ulcers. The severity of the symptoms depends on the severity of the ulcer.
The most common symptom is a burning sensation or pain in the middle of your abdomen between your chest and belly button. Typically, the pain will be more intense when your stomach is empty, and it can last for a few minutes to several hours.
Other common signs and symptoms of ulcers include:
- dull pain in the stomach
- heartburn, which is a burning sensation in the chest)
- pain that may improve when you eat, drink, or take antacids
- anemia, whose symptoms can include tiredness, shortness of breath, or paler skin
- dark, tarry stools
- vomit thats bloody or looks like coffee grounds
Talk to your doctor if you have any symptoms of a stomach ulcer. Even though discomfort may be mild, ulcers can worsen if they arent treated. Bleeding ulcers can become life-threatening.
Symptoms Of Peptic Ulcers
Not all peptic ulcers cause symptoms, but the most common one is upper abdominal pain or discomfort. People with peptic ulcers can feel this gnawing or burning pain just below the rib cage.
About 70 percent of ulcers are asymptomatic, or silent, Dr. Yalamanchili says. Older patients are more likely to have vague symptoms or none at all. If there is pain, the timing of its development in relation to eating can offer clues about where the ulcer is located.
With a stomach ulcer, eating worsens pain by inducing acid production in the stomach. Pain may be felt within 15 minutes to half an hour, Dr. Yalamanchili says.
For duodenal ulcers, eating may provide temporary relief of pain due to the buffering effect of food in the GI tract, so the pain occurs later, usually two to three hours after eating or during the night, she says.
Other symptoms of peptic ulcers include bloating, nausea, a feeling of fullness, weight loss or bleeding.
Causes of Peptic Ulcers
H. pylori causes 90 percent of duodenum ulcers and 70 to 90 percent of stomach or gastric ulcers, Dr. Yalamanchili says. H. pylori is the most common chronic bacterial infection in humans, and most people dont even know that they have it.
People are often infected with H. pylori in childhood. It is spread through person-to-person contact and through contaminated food or water. Poor hygiene can be a risk factor for contracting H. pylori.
Tylenol is not an NSAID, so it is a good choice for people prone to ulcers.
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What Should I Do If I Think I Have A Stomach Ulcer
Always seek medical care for a stomach ulcer. While you may be able to manage symptoms temporarily with over-the-counter medications, these wont heal the ulcer. You need to identify and treat the underlying cause. An untreated ulcer can lead to serious complications, even if your symptoms are mild. The major cause of stomach ulcers, H. pylori infection, can also lead to other complications.
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What Is A Stomach Ulcer
A stomach ulcer, also called a gastric ulcer, is an open sore that develops in your stomach lining. You can also get one in your duodenum, the first part of the small intestine that your stomach feeds into. Duodenal ulcers and stomach ulcers are both types of peptic ulcers. Theyre named for pepsin, one of the digestive juices that are found in the stomach and that sometimes leak into the duodenum. These juices are a contributing factor in peptic ulcer disease.
Peptic ulcers occur when the protective mucous lining in your stomach and duodenum has been eroded, allowing gastric acids and digestive enzymes to eat away at your stomach and duodenal walls. This eventually results in open sores that are continually irritated by the acid. If left untreated, they can begin to cause serious complications, such as internal bleeding. Over time, they can even wear a hole all the way through. This is a medical emergency.
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When To Call A Healthcare Provider
If the ulcer is large or deep, growing in size, incredibly painful, or if you have any signs of infection , you notice a bad smell coming from your ulcer, or you’re running a fever, call your healthcare provider right away.
You’ll also want to call your healthcare provider if your ulcer, no matter how minor, isn’t showing signs healing after a week to 10 days.
In most cases, the ulcer will be dressed to protect the wound. However, if your ulcer is draining considerably, your healthcare provider may recommend leaving the wound uncovered. Dressing the ulcer if it’s draining considerably can impede healing.
If your ulcer is painful, pain medication can be prescribed. Antibiotics may also be prescribed either prophylactically to prevent infection or to treat an already infected wound.
Debridement is done to remove dead tissue from more serious ulcers. For deep ulcers or those that aren’t healing after a long period of time, skin grafts may be needed. In the most severe cases, part of the foot, leg, or other appendage may have to be amputated.
Restoring good circulation is key in treating and preventing ulcers. This includes elevating the legs, wearing compression stockings, reducing pressure on ulcer-prone areas, superficial vein surgery. Leg ulcers, in particular, are incredibly likely to reoccur, so compression stockings are often needed to be worn for life.
When To Contact A Doctor
Anyone who thinks they may have an ulcer in their stomach should consult a doctor. Any stomach symptoms that last for more than a few days or keep happening need evaluation and treatment.
Symptoms of anemia, such as tiredness and breathlessness, may signal a slow-bleeding ulcer. More serious bleeding is an urgent medical problem, as people may vomit up blood, or stools are black and sticky.
Perforation 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.
What Natural Home Remedies Help Peptic Ulcer Pain
Home care for peptic ulcers often centers on neutralizing the stomach acid.
- Donât 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.
- Donât take aspirin or nonsteroidal anti-inflammatory medications. Acetaminophen is a good substitute for some conditions. If acetaminophen doesnât 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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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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How Do Nonsteroidal Anti
NSAIDS are a type of medication used often for headaches, period pains, and other pains. They can also help reduce fever and inflammation. Examples include aspirin and ibuprofen. Many NSAIDs are available without a prescription.
They lower the stomachs ability to make a protective layer of mucus. This it more susceptible to damage by stomach acid. NSAIDs can also affect the flow of blood to the stomach, reducing the bodys ability to repair cells.
What Is A Duodenal Ulcer
Duodenal ulcers are a common cause of abdominal pain. Once treated, they usually get better in a matter of weeks.
A duodenal ulcer is a sore that forms in the lining of the duodenum. Your duodenum is the first part of your small intestine. This is the part of your digestive system that food travels through, after it leaves your stomach.
You can get an ulcer in your stomach as well as in your duodenum. Stomach ulcers and duodenal ulcers are both types of peptic ulcers. If you have either of these, you have what’s called ‘peptic ulcer disease’.
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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.
Diagnosis And Treatment Of A Peptic Ulcer
If your doctor suspects a peptic ulcer, he or she will order an upper endoscopy. During this procedure, a gastroenterologist passes a thin, flexible tube through the mouth and into the stomach and small bowel. A tiny camera allows the doctor to see the GI tract from within.
If that ulcer is actively bleeding or has high-risk features of bleeding, then treatments can be applied through the endoscope to stop the bleeding, Dr. Yalamanchili says. These treatments include clips that clamp bleeding blood vessels, cautery devices to burn the bleeding blood vessel shut, injectable medicines to slow bleeding and sprays that induce clotting.
Ulcers caused by H. pylori are typically treated with antibiotics, drugs called proton pump inhibitors and over-the-counter medicines such as Pepto Bismol.
When NSAIDs are causing the ulcer, patients are told to discontinue the drugs. If they cant discontinue these medications for medical reasons, a doctor can prescribe a special acid-reducing medication in combination with the NSAID to lower the risk of bleeding.
If you are experiencing the symptoms of a peptic ulcer, contact your doctor. If you dont have one, you can find one here.
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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.
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.
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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.
Diagnosis Of A Stomach Ulcer
Diagnosing a stomach ulcer is done using a range of methods, including:
- Endoscopy a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia. The endoscope is fitted with a small camera so the physician can see if there is an ulcer.
- Barium meal a chalky liquid is drunk and an x-ray is performed, showing the stomach lining. These tests are less common nowadays, but may be useful where endoscopy is unavailable.
- Biopsy a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found.
- C14 breath test this checks for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.
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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.
Is Your Persistent Stomach Pain An Ulcer
Its normal to have a stomachache every now and then. Maybe you ate something that isnt agreeing with you or youre having a stressful day. These run-of-the-mill pains usually resolve on their own or with basic treatment.
But if you experience daily abdominal pain, or pain that comes and goes frequently, you could have a more serious problem, such as a peptic ulcer.
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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. Don’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.
Causes And Risk Factors Of Peptic Ulcers
For a long time, it was believed that spicy foods or stress led to peptic ulcers but doctors now know that this isnât the case.
In fact, the most common causes of ulcers are:
- Helicobacter pylori, a type of bacteria that can infect your stomach
- Use of nonsteroidal anti-inflammatory drugs , such as aspirin, Advil or Motrin , and Aleve , which can wear away at the mucus layer of the digestive tract
Certain factors can put a person at a greater risk of developing a peptic ulcer, including:
- Taking high doses of NSAIDs
- Using NSAIDs continuously over a long period of time
- Having a history of ulcer disease
- Taking corticosteroids, medications that may be prescribed to treat asthma, arthritis, or lupus
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