What is a stomach ulcer?
Stomach ulcers are painful sores that can be found in the stomach lining or small intestine. Stomach ulcers are the most visible sign of peptic ulcer disease. They occur when the thick layer of mucus that protects your stomach from digestive juices is reduced, thus enabling the digestive acids to eat away at the lining tissues of the stomach.
Stomach ulcers are easily cured, but they can become severe without proper treatment.
What causes stomach ulcers?
Stomach ulcers aren’t necessarily caused by one single factor. The decrease in the stomach’s mucus lining that leads to an ulcer is usually caused by one of the following:
- An infection with the bacterium Helicobacter pylori (H. pylori)
- Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen
- Excess acid (hyperacidity) in the stomach, which may be related to genetics, lifestyle (stress, smoking), and certain foods
- Zollinger-Ellison syndrome, a rare disease that makes the body produce excess stomach acid
Certain factors and behaviours can put you at higher risk for developing stomach ulcers:
- Frequent use of steroids (such as those for treating asthma)
- Hypercalcemia (overproduction of calcium)
- Family history of stomach ulcers
- Being over 50 years old
- Excessive consumption of alcohol
Symptoms of stomach ulcers
A number of symptoms are associated with stomach ulcers. The severity of the symptoms depends on the severity of the ulcer.
The most common symptom is a burning sensation or pain in the area between your chest and belly button. Normally, the pain will be more intense when your stomach is empty and it can last for a few minutes or several hours.
Other common symptoms include:
- Dull pain in the stomach
- Weight loss
- Not wanting to eat because of pain
- Nausea or vomiting
- Burping or acid reflux
- Heartburn (burning sensation in the chest)
- Pain improves when you eat, drink, or take antacids
- Talk to your doctor if you experience symptoms of a stomach ulcer. Even though discomfort may be mild, ulcers can worsen if they aren’t treated.
How are stomach ulcers diagnosed?
Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications you’re taking.
To rule out H. pylori infection, a blood, stool, or breath test may be ordered. In a breath test, you’ll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori are present, the breath sample will contain higher-than-normal levels of carbon dioxide.
Other tests and procedures used to diagnose stomach ulcers include:
- Barium enema: a thick white liquid (barium) that you drink helps the stomach and small intestine show up on X-rays
- Endoscopy: a thin, lighted tube is inserted through the mouth and into the stomach to look for the presence of an ulcer
- Endoscopic biopsy: a piece of stomach tissue is removed so it can be analysed
Treating stomach ulcers
Treatment will vary depending on the cause of your ulcer. Most ulcers can be treated with a prescription from your doctor, but in rare cases, surgery may be required.
It’s important to promptly treat an ulcer. Talk to your doctor to discuss a treatment plan. If you have an actively bleeding ulcer, you’ll likely be hospitalized for intensive treatment with IV ulcer medications, and you may also require blood transfusion.
If your stomach ulcer is the result of H. pylori, you’ll need antibiotics. For mild to moderate stomach ulcers, your doctor will usually prescribe the following medications:
- H2 blockers: to prevent your stomach from making too much acid
- Proton pump inhibitors: blocks the cells that produce acid
- Over-the-counter antacids: to help neutralize stomach acid
- Cytoprotective agents: to protect the lining of the stomach and small intestine, such as Pepto-Bismol
Symptoms of an ulcer may subside quickly with treatment. Even if your symptoms disappear, you should continue to take medicine prescribed by your doctor. This is especially important of H. pylori infections to ensure that all bacteria are destroyed. Doctors will also suggest that you avoid smoking, alcohol, and any medications or foods that can trigger symptoms.
Certain side effects associated with stomach ulcer treatment include:
These side effects are temporary. Talk to your doctor about changing your medication if you experience extreme discomfort as a result of these side effects.
- In very rare cases, a complicated stomach ulcer will require surgery. These include ulcers that:
- Continue to return
- Don’t heal
- Tear the stomach or small intestine
- Keep food from flowing out of the stomach into the small intestine
Surgery may include:
- Removal of the entire ulcer
- Taking tissue from another part of the intestines and sewing it over the ulcer site
- Tying off a bleeding artery
- Cutting off nerve supply to the stomach to reduce the production of stomach acid
Complications associated with stomach ulcers
Seek treatment as soon as you believe that you might have a stomach ulcer. The longer an ulcer remains untreated, the more likely you are to develop complications. You should seek medical treatment if you experience any of the following symptoms:
- Sudden, sharp pain that doesn’t stop
- Black or bloody stools
- Bloody vomitus
- Vomit that looks like coffee grounds
These could be signs that the ulcer has eroded through the stomach, or broken a blood vessel. Scar tissue development is another possible complication. The tissue can prevent food from
moving from the stomach into the small intestine. All of these scenarios require intensive therapy, usually in a hospital setting.
Prevention of stomach ulcers
To prevent the spread of bacteria and reduce risk of bacterial infection, wash your hands with soap and water on a regular basis. Make sure all food is properly cleaned and cooked thoroughly.
To prevent ulcers caused by NSAIDs, stop using these medications (if possible) or limit their use. If you need to take NSAIDs, be sure to follow the recommended dosage and avoid alcohol while taking these medications.
Certain lifestyle changes can also help prevent ulcers from forming. Limiting alcohol consumption, avoiding tobacco products, and properly managing stress can all contribute to a healthy stomach lining.