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Peptic Ulcers

What are Peptic Ulcers?

A peptic ulcer is a serious condition that affects people over 30 years and which are open sores developed in your stomach mucosa (gastric ulcers) and in the upper portion of your small intestine (duodenal ulcers). Peptic ulcers are caused by the aggressive stimulus caused by the bacterium Helicobacter pylori (H. pylori) and pain killers, including aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).

Peptic Ulcers Signs and Symptoms

Peptic ulcers don’t always cause symptoms. However, when they do, the most common and typical symptom is stomach pain and burning sensation between meals. Some other symptoms related to peptic ulcers include:

  • Bloating sensation
  • Heartburn
  • Nausea and vomiting

Also, symptoms like vomiting blood, feeling faint, unexplained weight loss and dark blood in stools might indicate a perforated peptic ulcer, which is a very serious and deathly complication.

Peptic Ulcers Common Causes

Your stomach is normally covered by a mucus-lined barrier that protects it from aggressions like digestive juice. Certain conditions cause the increase of acid or the decreased of the mucus barrier, which leads to the development of the progressive destruction of the stomach mucosa and the eventual open sore that cause the typical symptoms of peptic ulcers.

Some of the conditions and risk factors related to peptic ulcers include:

  • pylori infection
  • Frequent use of painkillers like aspirin and NSAIDs (ibuprofen, naproxen, ketoprofen, and others)
  • Combination with other medications like steroids, anticoagulants antidepressants, and alendronate

Although alcohol, smoking, and stress are not direct causes of peptic ulcers, they do can make your symptoms more severe.

Peptic Ulcers Diagnosis

Your doctor might suspect you have a peptic ulcer based on your symptoms and physical exam. However, additional tests are required to make a proper diagnosis, including:

  • Lab tests to detect H. pylori, which can be performed either as breath tests, blood tests or tissue sample tests.
  • Upper endoscopy. Your doctor will introduce a large tube attached to a tiny camera through your mouth, in order to look inside your upper digestive tract for signs of an ulcer. Additionally, your doctor might take a tissue sample (biopsy) to detect the presence of H. pylori or any other abnormality like malignant cells.

Peptic Ulcers Treatment

The most important part about the treatment of peptic ulcers is treating the underlying cause if detected and possible. Additionally, your doctor might recommend some other treatment option to reduce your symptoms and to improve the healing of the ulcer.

Medication used to treat peptic ulcers include:

  • Antibiotic medication to eradicate H. pylori. Your doctor might recommend a combination of some antibiotics such as clarithromycin, amoxicillin, and metronidazole.
  • Medication to block the acidic stomach production. These drugs include proton pump inhibitors like omeprazole, esomeprazole or lansoprazole, which block the action of the stomach cells that produce acid, promoting your mucosal healing and need to be taken for a long period at high doses.
  • Antacids, in order to neutralize your stomach acid.

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FAQ

What are Ulcers?

An ulcer is a sore (open and painful wound). The most common are peptic ulcers which tend to form in the inner lining of the stomach or upper small intestine which is the duodenum and they cause a burning, sharp stomach pain. Stomach ulcers develop when the stomach’s digestive juices – which contain an enzyme known as pepsin and hydrochloric acid – irritate and damage tissue.

What causes stomach ulcers?

Stomach ulcers can be caused by either of the following:

  • An infection with the bacterium H. pylori (Helicobacter pylori)
  • Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin

Which are the symptoms of stomach ulcers?

The most common symptom of stomach ulcers is pain or a burning sensation in the middle of the abdomen between the chest and the belly button, and it can last for a few minutes to several hours. It is more intense when the stomach is empty.

Other symptoms of stomach ulcers include:

  • Dull pain in the stomach
  • Avoiding eating because of the pain
  • Weight loss
  • Vomiting or nausea
  • Feeling easily full
  • Bloating
  • Acid reflux or burping
  • Heartburn
  • Pain that can improve when you drink, eat or take antacids
  • Dark, tarry stools
  • Vomit that looks like coffee grounds or it’s bloody
  • Anaemia

How are stomach ulcers treated?

Treatment for stomach ulcers depends on the underlying cause. Most cases can be treated with a doctor’s prescription, but a few cases may require surgery.

If the stomach ulcer is a result of H. pylori, you will be given antibiotics and proton pump inhibitors (PPIs) which block the stomach cells from producing acid. You will also be advised to stop using all NSAIDs and encouraged to take probiotics.

Some rare cases may need surgery and the surgery can include:

  • Removing the entire ulcer
  • Tying off a bleeding artery
  • Patching over the ulcer site with tissue from another part of the intestine
  • Reducing the stomach acid production by cutting off the nerve supply to the stomach

What to eat and what to avoid eating with a stomach ulcer.

Foods that are good for you when you have a stomach ulcer include probiotics such as yogurt and buttermilk. Fruits and vegetables such as kale, carrots, broccoli, red/green peppers, grapes, cabbage juice, kiwi fruit, and apricots. All these are rich in vitamin C and bioflavonoids.

Foods to avoid stomach ulcers include spicy food such as peppers, chilies, and hot sauces. Greasy and fried food such as tea, tobacco, coffee, colas, and chocolates should be eliminated. Citrus foods can cause discomfort in the stomach of an ulcer patient.

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