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Peptic ulcers are open sores on the interior lining of the stomach and the upper region of the small intestine. Stomach discomfort is the most prevalent sign of a peptic ulcer.
Peptic ulcers include:
- Gastric ulcers: These are ulcers that form on the inside of the stomach.
- Duodenal ulcers: These are ulcers that form on the inner of the upper section of the small intestine (duodenum)
Infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, and others) and naproxen sodium are the most common causes of peptic ulcers (Aleve). Peptic ulcers are not caused by stress or spicy foods. They can, however, aggravate your symptoms.
WHAT ARE THE SYMPTOMS OF PEPTIC ULCER?
- Stomach pain that burns
- A sensation of fullness, bloating, or belching
- Intolerance to fatty meals
- Heartburn
- Nausea
Burning stomach pain is the most prevalent peptic ulcer symptom. Stomach acid aggravates the agony, as does an empty stomach. The discomfort is frequently eased by eating foods that buffer stomach acid or by taking an acid-reducing medicine, but it may return. The discomfort could be worse between meals and at night.
Many patients with peptic ulcers have no symptoms.
Ulcers can occasionally create severe indications or symptoms such as:
- Vomiting blood (which could be red or black)
- Stools with dark blood or stools that are black or tarry
- Breathing difficulties
- Feeling dizzy
- Vomiting or nausea
- Unknown cause of weight loss
- Changes in appetite
WHAT ARE THE CAUSES OF PEPTIC ULCER?
When acid in the digestive tract eats away at the inner surface of the stomach or small intestine, peptic ulcers form. The acid might cause an uncomfortable open sore that may bleed.
A mucous layer coats your digestive tract, which generally protects it from acid. However, if the amount of acid increases or the amount of mucus decreases, you may get an ulcer.
The following are common causes:
- A bacterium: Helicobacter pylori bacteria are frequently found in the mucous layer that covers and protects the tissues lining the stomach and small intestine. The H. pylori bacterium does not often cause issues, but it can induce inflammation of the stomach's inner layer, resulting in an ulcer.
It is unknown how H. pylori infection spreads. It can be passed from person to person through close contact, such as kissing. H. pylori can also be contracted by food and drink.
- Use of specific pain medications on a regular basis: Aspirin and other over-the-counter and prescription pain relievers known as nonsteroidal anti-inflammatory medicines (NSAIDs) might irritate or inflame the lining of your stomach and small intestine. Ibuprofen (Advil, Motrin IB, and others), naproxen sodium (Aleve, Anaprox DS, and others), ketoprofen, and others are among these drugs. They do not include acetaminophen (Tylenol, others).
- Other drugs: Other drugs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax), and risedronate (Actonel), can dramatically increase the risk of getting ulcers when combined with NSAIDs.
WHAT ARE THE RISK FACTORS FOR PEPTIC ULCER?
In addition to the dangers associated with NSAID use, you may be at increased risk of peptic ulcers if you:
- Smoke: Smoking may increase the risk of peptic ulcers in persons with H. pylori infection.
- Consume alcohol: Alcohol can irritate and dissolve your stomach's mucous lining, as well as increase the amount of stomach acid produced.
- Have an untreated stress problem.
- Consume spicy meals.
These variables do not create ulcers on their own, but they can make them worse and more difficult to heal.
WHAT ARE THE COMPLICATIONS OF PEPTIC ULCER?
Peptic ulcers, if left untreated, can lead to:
- Internal bleeding: Bleeding can be slow and cause anemia, or it can be severe and necessitate hospitalization or a blood transfusion. Severe blood loss might result in black or bloody vomit or feces.
- A perforation in the stomach wall: Peptic ulcers can eat a hole through the wall of your stomach or small intestine, placing you at risk of serious abdominal infection (peritonitis).
- Obstruction: Peptic ulcers can obstruct the flow of food through the digestive tract, leading you to feel full quickly, vomit, and lose weight due to swelling from inflammation or scarring.
- Gastric cancer: H. pylori infection has been linked to an increased risk of stomach cancer in studies.
HOW IS PEPTIC ULCER DIAGNOSED?
Your doctor may first conduct a medical history and perform a physical exam to discover an ulcer. You may then be required to undertake diagnostic tests such as:
- H. pylori laboratory tests: Your doctor may advise you to have tests done to see if you have the bacterium H. pylori. He or she may use a blood, stool, or breath test to look for H. pylori. The most accurate test is the breath test.
You drink or eat anything containing radioactive carbon for the breath test. In your stomach, H. pylori degrades the chemical. You then blow into a bag, which is subsequently sealed. If you have H. pylori, your breath will contain radioactive carbon in the form of carbon dioxide.
Please notify your doctor if you are using an antacid prior to H. pylori testing. Depending on the test, you may need to stop taking the drug for a while because antacids might create false-negative findings.
- Endoscopy: Your doctor may examine your upper digestive system with a scope (endoscopy). Endoscopy involves your doctor inserting a hollow tube with a lens (endoscope) down your neck and into your esophagus, stomach, and small intestine. Your doctor examines the endoscope for ulcers.
If your doctor discovers an ulcer, a small tissue sample (biopsy) may be taken for testing at a lab. A biopsy can also determine whether H. pylori is present in the stomach lining.
Endoscopy is more likely to be recommended if you are elderly, have indications of bleeding, have recently lost weight, or have difficulties eating and swallowing. If the endoscopy reveals an ulcer in your stomach, you should have a follow-up endoscopy following therapy to ensure that it has healed, even if your symptoms improve.
- Upper gastrointestinal series: This set of X-rays of the upper digestive system, also known as a barium swallow, produces images of your esophagus, stomach, and small intestine. You consume a white liquid (containing barium) during the X-ray, which coats your digestive tract and makes an ulcer more noticeable.
WHAT ARE THE TREATMENTS FOR PEPTIC ULCER?
The treatment for peptic ulcers is determined by the cause. Typically, treatment will include eradicating the H. pylori bacterium, removing or minimizing the usage of NSAIDs, and assisting your ulcer to heal using medicine.
Among the medications available are:
- Antibiotics used to kill H. pylori: If H. pylori is discovered in your digestive tract, your doctor may prescribe a cocktail of medications to eradicate the bacterium. Amoxicillin (Amoxil), clarithromycin (Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline, and levofloxacin are among examples.
The medications used will be determined by your location and the current rate of antibiotic resistance. Antibiotics will most certainly be required for two weeks, as well as extra medications to lower stomach acid, such as a proton pump inhibitor and maybe bismuth subsalicylate (Pepto-Bismol).
- Acid-blocking medications that aid healing: Proton pump inhibitors (PPIs) lower stomach acid by inhibiting the action of the sections of the cell that create acid. These medications include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), and pantoprazole (prescription and over-the-counter) (Protonix).
Proton pump inhibitors, especially at high doses, may raise the risk of hip, wrist, and spine fractures over time. Consult your doctor to see if a calcium supplement can help minimize this risk.
- Medications to lower acid production: Acid blockers, also known as histamine (H-2) blockers, decrease the amount of stomach acid discharged into your digestive tract, relieving ulcer discomfort and promoting healing.
Acid blockers, which are available by prescription or over the counter, include famotidine (Pepcid AC), cimetidine (Tagamet HB), and nizatidine (Axid AR).
- Acid-neutralizing antacids: Your doctor may prescribe an antacid as part of your medication prescription. Antacids neutralize stomach acid and might provide immediate pain relief. Depending on the major constituents, side effects may include constipation or diarrhea.
Antacids can relieve symptoms but are not often used to treat ulcers.
- Medications that protect the stomach and small intestine lining: In some situations, your doctor may prescribe cytoprotective drugs, which aid in the protection of the tissues that line your stomach and small intestine.
Sucralfate (Carafate) and misoprostol are two prescription drugs (Cytotec).
Aftercare after the initial treatment
Peptic ulcer treatment is frequently effective, resulting in ulcer healing. However, if your symptoms are severe or persist despite treatment, your doctor may consider an endoscopy to rule out other possible causes.
If an ulcer is discovered during endoscopy, your doctor may advise you to have another endoscope following your therapy to ensure that your ulcer has healed. Inquire with your doctor whether you should have any follow-up testing after your therapy.
Ulcers that do not heal
Refractory ulcers are peptic ulcers that do not cure despite treatment. There are numerous reasons why an ulcer may not heal, including:
- Failure to take drugs as prescribed
- The fact that some strains of H. pylori are antibiotic-resistant
- Tobacco consumption on a regular basis
- The use of pain medicines, such as NSAIDs, on a regular basis increases the risk of ulcers.
Less frequently, refractory ulcers can be caused by:
- Zollinger-Ellison syndrome is characterized by extreme overproduction of stomach acid.
- A different infection than H. pylori
- Cancer of the stomach
- Crohn's disease and other disorders that can create ulcer-like lesions in the stomach and small intestine
Treatment for refractory ulcers typically entails removing things that may impede healing as well as employing various antibiotics.
If you have a major ulcer complication, such as acute bleeding or a perforation, you may need surgery. However, due of the many excellent drugs now accessible, surgery is used significantly less frequently than in the past.
HOME REMEDIES FOR PEPTIC ULCER
If you do the following, you may find relief from the agony of a stomach ulcer:
- Consider changing your pain relievers: If you take pain medicines on a regular basis, ask your doctor if acetaminophen (Tylenol, for example) is a choice for you.
- Stress management: Stress can aggravate the symptoms of a peptic ulcer. Consider the origins of your stress and do everything you can to address them. Some stress is inescapable, but you can learn to manage with it by exercising, socializing, or writing in a journal.
- Avoid smoking: Smoking can disrupt the stomach's protective lining, leaving it more vulnerable to the development of an ulcer. Smoking also raises stomach acid levels.
- Limit or avoid alcohol consumption: Excessive alcohol consumption can irritate and erode the mucous lining of the stomach and intestines, resulting in inflammation and bleeding.