Peptic Ulcer – Causes, Symptoms and More

What are peptic ulcers?

Peptic ulcers are open sores or holes that develop in the lining of the stomach, lower esophagus, or small intestine. They are generally formed due to of inflammation caused by the bacteria H. pylori, as well as from erosion from gastric acids. Peptic ulcers are a very common health complication.(1)

Peptic ulcers are of three types:

  • gastric ulcers: ulcers that develop in the stomach wall
  • esophageal ulcers: ulcers that occur inside the esophagus
  • duodenal ulcers: ulcers that develop in the upper portion of the small intestines, called as the duodenum

Causes of peptic ulcers

Several factors can lead to break down of esophageal, stomach and duodenal lining .These factors are:

  • Helicobacter pylori (H. pylori), a type of bacteria that can cause a stomach infection and inflammation
  • repeated use of NSAIDs such as aspirin (Bayer), ibuprofen (Advil), and other anti-inflammatory drugs (risk linked with this behavior raises in women and people over the age of 60)
  • smoking
  • excessive alcohol intake
  • radiation therapy
  • stomach cancer

Symptoms of peptic ulcers

The most common symptom of a peptic ulcer is burning abdominal pain that extends from the umbilicus to the chest, which can range from mild to severe. In some cases, the pain may don’t let you sleep at night. Small peptic ulcers may not show any symptoms in the initial stages.(2)

Other common signs of a peptic ulcer are:

Tests and exams for peptic ulcers

There are two types of tests available for the diagnosis of a peptic ulcer. They are called as upper endoscopy and upper gastrointestinal (GI) series.

Upper endoscopy

In this procedure, your doctor inserts a long tube attached with a camera, down your throat and into your stomach and small intestine to inspect the area for ulcers. This instrument also allows your doctor to remove tissue samples for examination.

Not all cases need an upper endoscopy. However, this procedure is suggested for people with a higher risk of stomach cancer. This includes people over the 45 years of age as well as people who experience:

Upper GI

If you don’t have trouble swallowing and have a low risk of stomach cancer, your doctor may suggest an upper GI test instead. For this action, you’ll drink a thick liquid called barium (barium swallow). Then a technician will take an X-ray image of your stomach, esophagus, and small intestine. The liquid will make it possible for your doctor to easily view and treat the ulcer.

Because H. pylori is a primary cause of peptic ulcers, your doctor will also perform a test to check for this infection in your stomach.

How to treat a peptic ulcer

Treatment will depend on the fundamental cause of your ulcer. If tests show that you have an H. pylori infection, your doctor will suggest a combination of medication. You’ll have to take the medications for up to two weeks. The medications include antibiotics to help treat infections and proton pump inhibitors(PPIs) to help lower stomach acid.

You may feel minor side effects such as diarrhea or an upset stomach from antibiotic plans. If these side effects cause noticeable discomfort or don’t get improve over time, consult with your doctor.

If your doctor finds out that you don’t have an H. pylori infection, they may suggest a prescription or over-the-counter PPI (such as Prilosec or Prevacid) for up to eight weeks to lower stomach acid and help your ulcer heal.

Acid blockers such as famotidine (Pepcid) can also lower stomach acid and ulcer pain. These medications are available as a prescription and also over the counter in smaller doses.

Your doctor may also recommend sucralfate (Carafate) which will coat your stomach lining and decrease symptoms of peptic ulcers.

Complications of a peptic ulcer

Ulcers can become severe over time if left untreated. They can result in other more serious health complications such as:

  • Perforation: A hole develops in the lining of the stomach or small intestine and results in an infection. A sign of a perforated ulcer is quick, severe abdominal pain.
  • Internal bleeding: Bleeding ulcers can lead to remarkable blood loss and thus need hospitalization. Signs of a bleeding ulcer include lightheadednessdizziness, and black tarry stools.
  • Scar tissue: This is thick tissue that develops after an injury. This tissue makes it hard for food to proceed through your digestive tract. Signs of scar tissue are vomiting and weight loss.

All three complications are severe and may need surgery. Look for urgent medical attention if you feel the following symptoms:

  • quick, sharp abdominal pain
  • fainting, too much sweating, or confusion, as these may be signs of shock
  • blood in vomit or stool
  • abdomen that’s hard to the touch
  • abdominal pain that increases with movement but improves with lying completely still

How to prevent peptic ulcers

Certain lifestyle habits and changes can lower your risk of developing peptic ulcers. These include:

  • not drinking more than two alcoholic drinks in a day
  • not mixing alcohol with medication
  • washing your hands repeatedly to avoid infections
  • avoiding or limiting your use ofNSAIDs such as ibuprofen, aspirin, and naproxen (Aleve)

Maintaining a healthy lifestyle by stopping smoking cigarettes and other tobacco use and taking a balanced diet rich in fruits, vegetables, and whole grains will help you prevent developing a peptic ulcer.

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