What are peptic ulcers?
Peptic ulcers are open wounds or holes that grow inside the lining of the stomach, lower esophagus or small bowel. They are usually formed as a result of inflammation caused by H pylori, and erosion by stomach acids. Peptic ulcers are one of the most common complications.(1)
Peptic ulcers include 3 types:
- gastric ulcers: ulcers that grow within the lining of the stomach.
- esophageal ulcers: ulcers that take place within the esophagus.
- duodenal ulcers: ulcers that appear at the top of the small intestine, called duodenum.
Causes of peptic ulcers
Several factors may result in degradation of the esophagus, stomach and duodenal lining. These factors are as follows:
- Helicobacter pylori (H. pylori), a type of bacterial that may cause gastric infection and inflammation.
- repeatedly using NSAIDs such as aspirin (Bayer), ibuprofen (Advil) and other anti-inflammatory drugs (risk associated with this behaviour increases in women and persons over 60 years of age)
- drinking too much alcohol.
- radiation therapy
- stomach cancer
Symptoms of peptic ulcers
The most frequent symptom of a gastroduodenal ulcer is burning abdominal pain It extends from the umbilicus to the chest and can vary from mild to severe. In certain cases, the pain can prevent you from sleeping at night. Minor peptic ulcers may not exhibit symptoms in the early stages.(2)
Additional common signs of a peptic ulcer include:
Tests and exams for peptic ulcers
There are two types of tests available when diagnosing a gastroduodenal ulcer. They are referred to as upper endoscopic series and upper gastro-intestinal (GI) series.
During this procedure, your doctor inserts a long tube fixed with a camera, along the throat and in the stomach and small bowel to inspect the region for ulcers. This device can also be used by your doctor to collect tissue samples for examination.
Not all cases require an uppermost endoscopy. However, it is recommended for those at higher risk of stomach cancer. This includes people older than 45 as well as people who are experiencing:
- weight loss
- gastrointestinal bleeding
- difficulty swallowing
If you have no difficulty swallowing and are at low risk for stomach cancer, your doctor will recommend a higher GI test instead. To do this, you will drink a thick liquid called barium (barium swallow). Next, a technician will take an X-ray of your stomach, oesophagus and small bowel. The fluid will enable your physician to easily see and treat the ulcer.
Because H pylori is the main source of peptic ulcers, your doctor will also carry out a test to verify this infection in your stomach.
How to treat a peptic ulcer
Treatment will be dependent upon the root cause of your ulcer. If tests indicate that you are infected with H pylori, your doctor will suggest a combination of medications. You must take your medication for a maximum of two weeks. Medicines include antibiotics to help treat infections and proton pump (PPI) inhibitors to help reduce gastric acid.
You may experience minor side effects like diarrhea or stomach upset due to antibiotics. If these side effects cause significant discomfort or fail to improve over time, talk to your doctor.
If your doctor discovers that you are not infected with H pylori, they can recommend a prescription or over-the-counter PPI (such as l Prilosec or Prevacid) up to 8 weeks to reduce gastric acid and help your ulcer recover.
Acid inhibitors such as famotidine (Pepcid) can also decrease gastric acid and ulcerative pain. These drugs are available on prescription and over-the-counter at smaller dosages.
Your physician may also recommend sucralfate (Carafate) that coat your stomach mucosa and reduce the symptoms of peptic ulcers.
Complications associated with peptic ulcer.
Ulcers can become serious over time without treatment. They may lead to more serious health complications, including:
- Perforation: A hole forms in the lining of the stomach or small bowel and causes infection. An indication of perforated ulcer is rapid and severe abdominal pain.
- Internal bleeding: Bleeding ulcers may cause remarkable blood loss and therefore require hospitalization. Signs of a bleeding ulcer include lightheadedness, dizziness, and black tarry stools.
- Scar tissue: It is a thick tissue which forms after an injury. This tissue makes it difficult for food throughout your digestive tract. The scar signs are vomiting and losing weight.
All three complications are serious and can require surgical intervention. Check with your doctor if you have the following symptoms:
- quick and severe abdominal pain.
- fainting, too much sweat and confusion, because they are signs of shock.
- Blood in the vomit, stool.
- abdomen that’s hard to the touch
- abdominal pain that increases with movement, but gets better by staying completely still.
How to prevent peptic ulcers
Some lifestyle changes and changes may reduce your risk of developing gastroduodenal ulcers. These include:
- Do not drink more than two alcohol drinks per day.
- Do not mix alcohol and medicine.
- Wash hands several times to prevent infections.
- prevent or limit the use of NSAIDs like ibuprofen, aspirin and naproxen (Aleve)
Maintenance of a healthy lifestyle by quitting smoking cigarettes and other tobacco products and take a balanced diet rich in fruits, vegetables and whole grains to help you prevent the appearance of a gastroduodenal ulcer.