Stomach Ulcer Basics

Stomach Ulcer Basics

A stomach ulcer, also known as a gastric ulcer, is a sore that forms on the stomach lining. It is a type of peptic ulcer, including ulcers that occur in the upper part of the small intestine (duodenal ulcers). Understanding the basics of stomach ulcers is essential for recognising symptoms, seeking appropriate treatment, and preventing complications.

What is a Stomach Ulcer?

A stomach ulcer is a break or lesion in the mucosal lining of the stomach. Normally, the stomach lining protects itself from the harsh acidic environment necessary for digestion. However, when this protective barrier is compromised, the acidic digestive juices can damage the stomach lining, leading to an ulcer.

Causes and Risk Factors

Several factors can contribute to the development of stomach ulcers:

1. Helicobacter pylori (H. pylori) Infection:

   • A bacterium that infects the stomach lining.
   • It weakens the protective mucous coating, allowing acid to damage the stomach tissue.

2. Nonsteroidal Anti-Inflammatory Drugs (NSAIDs):

   • Regular use of NSAIDs like ibuprofen, aspirin, and naproxen can irritate or inflame the stomach lining.

3. Excessive Acid Production:

   • Conditions like Zollinger-Ellison syndrome can cause the stomach to produce too much acid.

4. Lifestyle Factors:

   • Smoking increases the risk of ulcers and hinders healing.
   • Excessive alcohol consumption can erode the stomach lining.

5. Stress and Diet:

   • While not direct causes, stress and spicy foods can exacerbate symptoms and slow healing.

Common Symptoms

Stomach ulcers may present with various symptoms, which can range from mild to severe:

• Abdominal Pain:

  • A burning or gnawing sensation in the upper abdomen, often between meals or at night.

• Bloating and Belching:

  • Feeling full or bloated after eating a small meal and increased burping.

• Nausea and Vomiting:

  • Vomiting may occur, and in severe cases, it can contain blood.

• Loss of Appetite and Weight Loss:

  • Discomfort after eating can lead to reduced food intake and unintended weight loss.

• Dark or Tarry Stools:

  • Indicates bleeding in the stomach, as digested blood turns the stool black.

• Anemia Symptoms:

  • Fatigue, weakness, and shortness of breath due to chronic blood loss.

Diagnosis

If a stomach ulcer is suspected, a healthcare provider may use several diagnostic methods:

1. Medical History and Physical Exam:

   • Discussing symptoms, medical history, and risk factors.

2. Endoscopy:

   • A flexible tube with a camera is inserted through the throat to view the stomach lining and possibly take a biopsy.

3. Barium Swallow (Upper GI Series):

   • X-rays taken after swallowing a barium solution to highlight the stomach and ulcers.

4. Tests for H. pylori:

   • Blood Test: Detects antibodies to H. pylori.
   • Stool Test: Identifies H. pylori antigens.
   • Breath Test: Measures carbon dioxide in the breath after ingesting a substance that H. pylori can metabolize.

Treatment

Treatment aims to heal the ulcer, relieve symptoms, and prevent complications. Common approaches include:

1. Medications:

   • Proton Pump Inhibitors (PPIs): Reduce stomach acid production (e.g., omeprazole, lansoprazole).
   • H2-Receptor Antagonists: Also decrease acid production (e.g., ranitidine, famotidine).
   • Antacids: Neutralize existing stomach acid for quick symptom relief.
   • Protective Medications: Sucralfate can protect the ulcer site.
   • Antibiotics: Prescribed if H. pylori infection is present (e.g., clarithromycin, amoxicillin, metronidazole).

2. Lifestyle Modifications:

   • Avoid NSAIDs: Use alternative pain relievers if necessary.
   • Quit Smoking: Promotes healing and reduces recurrence.
   • Limit Alcohol Intake: Protects the stomach lining.
   • Healthy Diet: Avoid foods that trigger or worsen symptoms.

3. Surgery:

   • Rarely needed today due to effective medications.
   • Considered if complications like perforation, bleeding, or obstruction occur.

Prevention

Preventing stomach ulcers involves addressing risk factors and maintaining a healthy lifestyle:

• Manage H. pylori Infections:

  • Seek treatment if diagnosed with an H. pylori infection.

• Use NSAIDs Cautiously:

  • Limit use and take with food or protective medications if necessary.

• Healthy Lifestyle Choices:

  • Avoid smoking and limit alcohol consumption.
  • Maintain a balanced diet rich in fruits, vegetables, and fiber.

• Stress Management:

  • While stress isn't a direct cause, managing it can help reduce symptom severity.

Complications

If left untreated, stomach ulcers can lead to serious health issues:

1. Internal Bleeding:

   • Can cause vomiting blood or passing black stools.
   • May lead to anemia and require blood transfusions.

2. Perforation:

   • The ulcer creates a hole through the stomach wall, leading to peritonitis, a life-threatening infection of the abdominal cavity.

3. Gastric Outlet Obstruction:

   • Swelling or scarring blocks the passage of food through the digestive tract, causing vomiting and weight loss.

4. Increased Risk of Stomach Cancer:

   • Chronic H. pylori infection and ulcers may elevate cancer risk.

When to See a Doctor

Seek medical attention if you experience:

• Persistent or severe abdominal pain.
• Vomiting blood or material that looks like coffee grounds.
• Black or tarry stools.
• Unexplained weight loss.
• Signs of anemia, such as fatigue or dizziness.
• Difficulty swallowing.

Early diagnosis and treatment can prevent complications and promote healing.

Conclusion

Stomach ulcers are common but manageable conditions that require medical attention to alleviate symptoms and prevent complications. Understanding the causes, recognizing the symptoms, and adhering to treatment plans are crucial steps toward recovery. If you suspect you have a stomach ulcer, consult a healthcare professional for proper evaluation and management.