Stomach Ulcer

What is a stomach ulcer?

Stomach ulcers, also known as gastric ulcers, are painful sores that develop on the stomach lining. They are a type of peptic ulcer disease, which includes any ulcers affecting both the stomach and small intestines. Stomach ulcers occur when the thick layer of mucus that protects the stomach from digestive juices is reduced. This reduction allows digestive acids to erode the tissues of the stomach lining, leading to an ulcer. While stomach ulcers can often be cured easily, they can become severe if not treated properly.

What are the misconceptions about stomach ulcers?

Hunger or skipping meals is not the cause of stomach ulcers, but it may aggravate symptoms if you develop one.

What causes stomach ulcers?

Stomach ulcers are primarily caused by:

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

In rare cases, a condition known as Zollinger-Ellison syndrome can lead to stomach and intestinal ulcers by increasing the body’s production of acid. This syndrome is believed to cause less than 1 per cent of all peptic ulcers.

What are the symptoms of stomach ulcers?

Stomach ulcers can present a variety of symptoms, with severity depending on the ulcer’s extent. The most common symptom is a burning sensation or pain in the middle of the abdomen, between the chest and belly button. This pain is usually more intense when the stomach is empty and can last a few minutes to several hours. Other common symptoms include:

• Dull stomach pain
• Weight loss
• Loss of appetite due to pain
• Nausea or vomiting
• Bloating
• Feeling full easily
• Burping or acid reflux
• Heartburn (a burning sensation in the chest)
• Pain that improves when you eat, drink, or take antacids
• Anaemia, with symptoms such as tiredness, shortness of breath, or pale skin
• Dark, tarry stools
• Vomit that is bloody or looks like coffee grounds

Consult a doctor if you experience any of these symptoms. While the discomfort might be mild, untreated ulcers can worsen and lead to life-threatening bleeding.

How are stomach ulcers diagnosed?

Diagnosis and treatment of stomach ulcers will be based on your symptoms and the ulcer’s severity. To diagnose a stomach ulcer, your doctor will review your medical history, symptoms, and any medications you’re taking. To rule out an H. pylori infection, a blood, stool, or breath test may be ordered. Other diagnostic tests and procedures include:

• Barium swallow: You’ll drink a thick white liquid (barium) that coats your upper gastrointestinal tract, making it easier for your doctor to see your stomach and small intestine on X-rays.
• Endoscopy (EGD): A thin, lighted tube is inserted through your mouth into the stomach and the first part of the small intestine to look for ulcers, bleeding, and any abnormal tissue.
• Endoscopic biopsy: A sample of stomach tissue is removed for analysis in a lab.
• Based on these evaluations, your doctor can determine the best course of treatment for your condition.

What is the treatment of stomach ulcers?

Treatment for stomach ulcers varies depending on the cause. Most ulcers can be managed with prescription medications, but surgery may be required in rare instances. Treating an ulcer promptly is crucial, so discuss a treatment plan with your doctor. If you have an actively bleeding ulcer, hospitalisation for intensive treatment, including endoscopy and IV ulcer medications, may be necessary, and a blood transfusion might also be required.

Nonsurgical treatment

For ulcers caused by H. pylori, you’ll need antibiotics and proton pump inhibitors (PPIs), which block stomach acid production. Additionally, your doctor may recommend:

• H2 receptor blockers: Medications that also block acid production.
• Stopping NSAID use: To prevent further irritation of the ulcer.
• Follow-up endoscopy: To ensure the ulcer is healing.
• Probiotics: Beneficial bacteria that may help eradicate H. pylori.
• Bismuth supplements: To protect the stomach lining.

Symptoms may subside quickly with treatment, but it’s important to complete the full course of medication, especially for H. pylori infections, to eliminate all bacteria.

Surgical treatment

In very rare cases, a complicated stomach ulcer will require surgery. This may be the case for ulcers that:

• Recurs frequently.
• Doesn’t heal.
• Bleeds.
• Perforates the stomach.
• Obstructs food passage from the stomach to the small intestine.

Surgery may include:

• Removing the entire ulcer.
• Patching the ulcer site with tissue from another part of the intestines.
• Tying off a bleeding artery.
• Severing the nerve supply to the stomach to reduce acid production.

Consult your doctor to determine the most appropriate treatment based on your specific condition.