Nov 02, 2021

A Guide to Understanding Stomach Ulcers

One in ten people will experience an ulcer in their stomach or small intestine during their lifetime. And while they can be easily cured if properly handled, stomach ulcers can lead to severe complications if left untreated. 

Understanding the signs and symptoms, ways to prevent, and treatment options for stomach ulcers can be greatly beneficial to your overall health. We've created this guide to help you identify the warning signs of an ulcer and understand what you can do about it.  

What is a stomach ulcer?

A type of peptic ulcer disease, stomach ulcers (also called gastric ulcers), are painful sores in the stomach lining. 

These sores occur when the thick layer of mucus that protects your stomach from digestive juices becomes compromised and decreases in thickness. As the lining gets thinner, the digestive acids are able to eat away at the tissues that line the stomach, causing an ulcer.

What are the signs and symptoms of a stomach ulcer?

Several symptoms are associated with stomach ulcers, and their severity depends on how serious the ulcer is and how far it has progressed.

A burning sensation/pain in the middle of your abdomen (between your chest and belly button) is the most common sign of a stomach ulcer. The pain typically intensifies when your stomach is empty and can last for a few minutes to several hours.

Other common signs and symptoms include:

  • pain in the stomach

  • weight loss

  • not wanting to eat

  • nausea or vomiting

  • vomit that looks like coffee grounds or is bloody

  • feeling full quickly or bloated

  • burping/acid reflux

  • heartburn

  • pain that may show improvement when eating, drinking, or taking antacids

  • anemia (tiredness, shortness of breath, and/or pale skin)

  • dark, tarry stool

What complications can occur if stomach ulcers are left untreated?

Stomach ulcers can cause serious health complications if left untreated. Therefore, it's imperative to consult with your healthcare provider if you are exhibiting any signs of an ulcer as soon as possible. 

Internal bleeding

Bleeding inside the body can occur with an untreated ulcer. This bleeding can occur through a slow loss of blood that can potentially lead to anemia or more severe blood loss that may even require hospitalization and/or a blood transfusion. Signs of severe blood loss can include black or bloody vomit or stools.

Perforation in your stomach wall 

Untreated ulcers can eat a hole through the wall of your stomach, increasing your chances of developing a severe infection of your abdominal cavity known as peritonitis.

Obstruction

A stomach ulcer can block the passage of food through the digestive tract, causing you to become and feel full quicker, vomit, and lose weight either through swelling from inflammation or scarring.

Gastric cancer

Research shows people who become infected with the H. pylori bacteria have an increased risk of gastric cancer.

What causes stomach ulcers?

Two common causes can break down the stomach's defense against the acid it produces to digest food, leading to an ulcer. 

Helicobacter pylori (H. pylori) 

H. pylori is a type of bacteria that lives in the stomach lining. It's pretty common, and many people never develop ulcers or infections from it. However, in certain cases, the bacteria can irritate the stomach lining and can cause damage to the stomach lining from stomach acid.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are medicines used to treat pain, fever, and inflammation (swelling). These medicines include:

Many people take NSAIDs without having any or only minor side effects. But the risk of stomach ulcers can form if intake of NSAIDS are increased, if they are taken for a prolonged period of  time or in high doses.

Lifestyle habits

There's little evidence that spicy foods, stress, or alcohol can cause stomach ulcers. However, they can make symptoms worse. 

Smoking can not only increase your risk of developing stomach ulcers, but also make treatment less effective. 

How are stomach ulcers diagnosed?

Your doctor will review your symptoms, medical history, and any prescription or over-the-counter medications you're taking.

They may order a blood, stool, or breath test to rule out an h. pylori infection. The breath test requires you to drink a clear liquid and breathe into a bag, which is then sealed off. If the breath sample contains higher-than-normal carbon dioxide levels, it means h.pylori is present

Other tests used to diagnose stomach ulcers include:

  • Barium swallow: A thick white liquid is ingested to cover the upper gastrointestinal tract, allowing your doctor to see your stomach and small intestine on X-rays.

  • Endoscopy (EGD): A thin, lighted tube is inserted through the mouth and into the stomach to help look for ulcers, bleeding, and anything that looks abnormal.

  • Endoscopic biopsy: A small portion of the stomach tissue is removed and analyzed in a lab. 

What treatments are available for stomach ulcers?

Treatment options vary depending on the cause of your ulcer and the severity of symptoms. While most ulcers can be treated with a prescription from your doctor, some cases may require surgery. 

Nonsurgical treatment options

If your stomach ulcer is the result of h. pylori, you'll need an antibiotic, like amoxicillin, and drugs called proton pump inhibitors (PPIs). PPIs, like Prevacid, Prilosec, and Protonix, block the stomach cells that produce acid.

In addition, your healthcare provider may also recommend:

  • H2 receptor blockers, like Pepcid and Tagamet

  • stopping use of all NSAIDs

  • follow-up endoscopy

  • probiotics 

  • bismuth supplement, like Pepto Bismol

Symptoms of an ulcer may subside quickly after starting treatment. Even if you begin to feel better, you should always take all medication prescribed by your doctor to eliminate all bacteria.

Surgery

A stomach ulcer may require surgery if it:

  • returns

  • doesn't heal with other treatments

  • causes extreme internal bleeding

  • tears through your stomach

  • keeps food from moving out of your stomach into your small intestine

Surgical treatment may include:

  • removal of the entire ulcer

  • taking tissue from another part of the intestines and patching it over the ulcer site

  • tying off a bleeding artery

  • cutting off the nerve supply to the stomach to reduce the production of stomach acid

Are stomach ulcers preventable?

To prevent the spread of h. pylori, wash your hands with soap and water regularly. Also, be sure to clean all food properly and to cook it thoroughly as needed.

To prevent ulcers caused by NSAIDs, limit how long and how much you take, or stop using these medications altogether. If you need to take NSAIDs, you should:

  • never exceed the recommended dosage and try to take the least amount

  • stop taking them as soon as you no longer need them

  • avoid drinking alcohol while taking them

  • always take with food and plenty of water

Final thoughts

If you think you have a stomach ulcer, call your doctor right away. Only a medical diagnosis can confirm if your symptoms are due to an ulcer. Your healthcare provider will be able to help decide what treatment plan will work best. 

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