What is peptic ulcer disease?
Stomach ulcers are sores on the inner lining of the stomach. They are also called gastric ulcers. They can be painful but treatable. However, if they're left untreated, they can cause complications like internal bleeding.
But how do you know if you have an ulcer? Here’s all you need to know about stomach ulcer symptoms, causes, diagnosis, and treatment.
Peptic ulcer disease occurs when the inner lining of the stomach or small intestine has sores or ulcers. Ulcers develop when the stomach lining is weakened or damaged.
A stomach ulcer is a peptic ulcer found in the stomach. A duodenal ulcer is when it is located in the duodenum, where the small intestine starts.
What causes stomach ulcers?
The most common causes of stomach ulcers are Helicobacter pylori (H. pylori) — a bacterial infection — and the use of non-steroidal anti-inflammatory drugs or NSAIDs.
Stomach ulcers form when the stomach's inner lining becomes weak or damaged. Factors like H. pylori bacteria, medicines like NSAIDs, and certain health conditions can weaken the stomach lining. Then stomach acids (digestive juices) further break down the stomach lining, causing sores or stomach ulcers.
H. pylori bacteria live in your digestive tract and can infect your stomach. When they grow in number, they damage the stomach lining and cause ulcers. Non-steroidal anti-inflammatory drugs or NSAIDs like aspirin, ibuprofen, naproxen, or diclofenac can also weaken the stomach lining. Too much spicy food, alcohol, stress, and smoking can also increase the risk of stomach ulcers.
Conditions like Zollinger-Ellison syndrome and multiple endocrine neoplasia increase stomach acid levels and can cause stomach ulcers.
How do you know if you have an ulcer?
The telltale sign of a stomach ulcer is a dull, aching, or burning pain in your stomach. You may also feel pain anywhere from your belly button to your chest. Some people experience referred pain radiating to their backs.
Other stomach ulcer symptoms include:
- Pain that goes away after eating an antacid
- Nausea or vomiting
- Burping or bloating after eating
- Stomach pain after eating
- Loss of appetite
- Weight loss
- Passing stools that look like tar or are mixed with dark red blood
Stomach ulcer symptoms can vary from person to person. Stomach pain can last from a few minutes to a few hours and can keep coming and going for weeks. Antacids or indigestion medicines may relieve the pain temporarily. The pain can return if the ulcer is not treated.
How to diagnose stomach ulcers?
If you have stomach ulcer symptoms, visit your doctor. They’ll check your symptoms and ask you about your medical history and the medicines you take. Your doctor will physically examine you to check for stomach pain or bloating. They’ll also order lab tests to check for signs of stomach ulcers.
Stomach ulcer diagnosis involves the following tests:
H. pylori tests
Your doctor will order a urea breath test to check for H. pylori infection. You’ll be asked to drink a liquid containing urea. Urea is a waste product of protein breakdown in your body. H. pylori bacteria convert urea into carbon dioxide. Carbon dioxide is the gas that you breathe out.
So, your doctor will collect your breath sample and check its carbon dioxide levels. If you have an H. pylori infection in your stomach, you’ll breathe out higher levels of carbon dioxide.
Your doctor may also order a blood test or a stool test to check for H. pylori infection.
Your doctor will do a blood test to measure your gastrin levels. Gastrin is a hormone that releases stomach acid in your gut.
Doctors use x-ray tests like barium contrast radiography or upper gastrointestinal series to check for stomach ulcers. You’ll have to drink a liquid called barium solution. It will coat your stomach. It helps your doctor look inside your stomach and check for ulcers with a series of x-ray images.
Computerized tomography or CT scan
A CT scan uses x-rays to take images of your stomach and view them on a computer. You’ll have to drink a liquid solution or contrast medium. You’ll have to lie inside the CT machine. It’ll take x-rays of your stomach, which will appear on the computer. Your doctor will check these images for stomach ulcer diagnosis.
Endoscopy involves inserting an endoscope or a flexible tube with an attached camera into your stomach. Your doctor will insert it through your mouth. The camera helps the doctor closely look at the stomach lining for ulcers.
Your doctor will use endoscopy to insert a biopsy tool into your stomach. This helps the doctor take a sample of your stomach cells. These cells are tested in a lab for infection, damage, and other signs of stomach ulcers.
Do stomach ulcers go away?
Stomach ulcers usually go away in a few months. They can be easily treated to get rid of painful symptoms. But the treatment and recovery depend on the underlying cause. Stomach ulcer treatment involves the following:
- Antacids. Antacids calm the stomach acid and relieve stomach ulcer symptoms temporarily.
- Triple therapy. This involves the antibiotics amoxicillin and clarithromycin or levofloxacin to destroy H. pylori bacteria. It also includes a drug called a proton pump inhibitor (PPI) to decrease stomach acid production.
- Sequential therapy. This involves taking a PPI and amoxicillin for 5 days. Then, you’ll have to take a PPI and the antibiotics clarithromycin and metronidazole or tinidazole for 5 days.
- Quadruple therapy. Triple therapy plus the antibiotic metronidazole or tinidazole.
- Other medicines. Your doctor may give you histamine H2 receptor antagonists instead of PPIs and cyclooxygenase-2 (COX-2) inhibitors instead of painkillers.
- Lifestyle changes. You can speed up your recovery by limiting alcohol and spicy food intake. You must also control stress and quit smoking to heal your ulcers.
What are the complications of stomach ulcers?
Stomach ulcer symptoms may go away after some time. But the ulcer may still be there. Don’t ignore the symptoms.
Stomach ulcers are easily treatable. Delaying treatment can result in complications. The ulcer can burn through the stomach lining. It can also cause bleeding or hemorrhage.
If you notice symptoms, seek immediate stomach ulcer diagnosis and treatment to avoid complications.
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Health Solutions From Our Sponsors
American Family Physician: "Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection."
John Hopkins Medicine: "Peptic Ulcer Disease," "Peptic Ulcer Disease Treatment."
National Institute of Diabetes and Digestive and Kidney Diseases: "Diagnosis of Peptic Ulcers (Stomach Ulcers)," "Symptoms & Causes of Peptic Ulcers (Stomach Ulcers)."
NHS: "Causes," "Symptoms," "Treatment."
University of Michigan Health: "Peptic Ulcer Disease."
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