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Stomach Ulcer
Also Known as Peptic Ulcer
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A stomach ulcer is also known as a peptic ulcer and involves having open sores eroding into the inside lining of the stomach. Such ulcers can also develop in the esophagus or in the small intestine, in the upper part. Most people with peptic ulcers develop abdominal pain as their primary symptom. Most peptic ulcers are caused by a bacterial infection called Helicobacter pylori or H. pylori. Stomach ulcers are relatively common, affecting ten percent of the American population at some point in people's lives.
As mentioned, the most common symptom of peptic ulcer is burning pain in the stomach region, which is in the upper stomach. The pain can also be felt as low as the navel or as high as the breastbone. It can last just a few minutes or several hours in duration. When your stomach is empty, the pain tends to be worse and you tend to feel the pain worse at night. Certain foods that buffer stomach acid make the symptoms go away as does the taking of TUMS or other antacid. The pain can go away for several weeks and then return again for days or weeks again.
Other symptoms include the vomiting of tarry liquid or fresh blood, having black or tarry stools from bleeding in the ulcer that passes through the digestive tract, nausea, weight loss that cannot be explained and a reduction in your appetite.
It used to be thought that spicy foods and stress cause stomach or peptic ulcers. Now doctors know that it is most likely caused by the H. pylori bacterium. The bacterium lives in the mucus layer of the stomach and, in some cases, is asymptomatic. In other cases, however, it inflames the lining of the stomach, esophagus or duodenum, causing an erosion or ulcer to occur. A total of twenty percent of people under the age of thirty are infected with H. pylori. Half of all people older than age 60 are infected with H. pylori. No one knows how H. pylori spreads from person to person. It may be from food or water or from direct contact with an infected individual.
Those who take nonsteroidal anti-inflammatory medications are at increased risk of getting peptic ulcers. These irritate the lining of the stomach and create erosions. These include ibuprofen, ketoprofen, naproxen and others, like aspirin. Always take these types of medications with food. Don't take these types of medications if you know you have a stomach ulcer. Smoking also contributes to stomach ulcers as does the heavy drinking of alcohol. Stress doesn't cause peptic ulcers but it does contribute to the worsening of a stomach ulcer if you already have one. Stress can be emotional or physical, such as a surgery or a traumatic injury.
Complications of stomach ulcers include slow or fast internal bleeding that can lead to anemia or the need for a blood transfusion. You can get an infection that has eroded through the stomach wall entirely, so the infection is in the bowel and abdominal cavity. You can get a large amount of scar tissue that can cause you to have problems passing food through the digestive tract, leading to nausea and vomiting from inability to take in much food.
Tests for peptic or stomach ulcers begin with a test for the presence of H. pylori antibodies. This is a blood test. There is also a breath test that detects the presence of H. pylori. It involves drinking a slightly radioactive liquid that is broken down by H. pylori. The radioactivity shows up an hour later in the breath test. The breath test is a good test to see if the H. pylori infection is being treated effectively by antibiotics. There is also a stool test that checks for H. pylori in the system.
There are studies that look at the ulcer itself. One of them is an upper GI x-ray that outlines the esophagus, stomach, and duodenum using radio-opaque dye. An endoscopy looks directly at the ulcer with a camera at the end of a long tube.
There is a two stage approach to getting rid of stomach ulcers. These include killing off the H. pylori bacteria and lowering the level of gastric acid, which worsens the ulcer and prevents healing. Antibiotic therapy includes amoxicillin, Biaxin, metronidazole (Flagyl) and bismuth. There are combination medications including Helidac and Prevpac that contain antibiotics and an acid suppressing medication together. Antibiotics should take about two weeks to work and you should take acid blockers, antacids or proton pump inhibitors for several weeks to months after that to promote healing.