¬†Stomach ulcers, sometimes referred to as peptic ulcer disease, are lesions that form on the stomach’s lining. Most of the time, people feel this pain as a pain around their chests or abdomen, and it usually refers to their upper back as well. The site of the ulcer gives clue where this ulcer may be located within the gastrointestinal tract.

Duodenal ulcers are ulcers that may develop in the area of the intestine that is immediately after the stomach.

The symptoms of duodenal ulcers, also known as peptic ulcers, are the same as those of stomach ulcers, and their treatments are also the same.

Symptoms and signs

A central stomach discomfort that is burning or gnawing is the most typical sign of a stomach ulcer (abdomen).

However, not everyone who has a stomach ulcer feels pain; some may also have other symptoms, including indigestion, heartburn, acid reflux, and feeling ill.

Additional symptoms

Less frequent symptoms of a stomach ulcer may be:

  • indigestion
  • heartburn
  • reduced appetite
  • Having a sick feeling
  • weight loss

Some individuals discover that after consuming fatty meals, they burp or feel bloated.

Causes of Stomach Ulcers

The layer that shields the stomach lining from stomach acids is damaged when a stomach ulcer develops.

Usually as a consequence of:

  1. An infection with the bacterium Helicobacter pylori (H. pylori)
  2. Consuming nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin, especially if you take them often or in large quantities

There was formerly a belief that stress or certain meals might result in stomach ulcers, although there is little evidence to support this.

Although stomach ulcers may affect anybody, they are more prevalent in those aged 60 and older. Women are less affected than men.

Possible Complications of Stomach Ulcer

Although stomach ulcer complications are generally rare, they may be very severe and even fatal.

The following are the primary issues:

  • Bleeding at the ulcer’s location
  • Breaking open of the stomach lining where the ulcer is located (perforation).
  • The ulcer prevents food from passing through the digestive system (gastric obstruction).
  • Having a burning or biting ache in your belly is the most typical sign of a stomach ulcer (tummy).
  • Not every gut ulcer causes discomfort. Some stomach ulcer complications, such as bleeding from the ulcer, may not cause symptoms at all.
  • stomach discomfort

A stomach ulcer may hurt so bad that it often seems like your stomach is on fire.

It often begins within a few hours after eating and may continue anywhere from a few minutes to a few hours. You can get nighttime soreness and wake up.

If the ulcer is not treated, using antacids (indigestion medications) may only briefly reduce the discomfort.

The H. pylori bacterium

 H. pylori infection normally produces no symptoms but occasionally gastritis or stomach or small intestine ulcers. The infection also causes cancer.

H. pylori bacteria

In 2015, approximately 50% of the world’s population had H. pylori in their upper GI tracts[6], with poorer nations being disproportionately affected.

Up to 90% of H. pylori-infected persons never develop symptoms. 

H. pylori infection increases the risk of peptic ulcers by 10% to 20%.

Symptoms include stomach discomfort, nausea, bloating, belching, and vomiting.

Pain typically occurs when the stomach is empty, between meals, and in the early morning hours, but it can also occur at other times.

Less common ulcer symptoms include nausea, vomiting, and loss of appetite.

It’s unclear why some individuals experience greater damage than others.

Non Steroidal Anti-inflammatory Drugs (NSAIDs) – Pain Killers

NSAIDs are medications that are often used to manage pain, inflammation, and a high body temperature (fever) (swelling).

Ibuprofen, aspirin, naproxen, and diclofenac are examples of commonly used NSAIDs.

NSAIDs are often used without any negative side effects. However, there is always a chance that the drug might lead to issues, including stomach ulcers, especially if used often or in excessive amounts.

If you presently have or have ever had a stomach ulcer, it may be suggested that you avoid using NSAIDs.

A popular alternative to painkillers is paracetamol.

How Lifestyle Contributes To This Condition

There isn’t much proof that some lifestyle variables, such as spicy meals, stress, and alcohol, may lead to stomach ulcers. However, they could exacerbate your symptoms.

Smoking is believed to increase your chance of getting stomach ulcers and may reduce the effectiveness of therapy.

When to See a Doctor

If you believe you could have a stomach ulcer, you should see your doctor.

If you experience any of the following:

You keep passing tar-like, tarry, black stools.

Your stomach hurts suddenly and sharply, and it keeps getting worse.

you’re passing blood, Blood may seem brilliant red or dark brown and gritty, like coffee grounds.

These could indicate a significant problem, including internal hemorrhage.

Diagnosing Stomach Ulcer

  • You could get an H. pylori infection checked for if your doctor suspects you have a stomach ulcer.
  • A gastroscopy, a technique that allows medical professionals to see into your stomach, may be recommended for you.

How H. pylori Infection Test Are Performed

One of the following tests may be advised by the doctor:

  1. A urea breath test involves giving you a drink that contains urea, a substance that H. pylori breaks down, and checking your breath thereafter.
  2. A stool antigen test, which examines the germs in a tiny sample of faeces.
  3. A blood test, which involves testing a sample of your blood for antibodies to the H. pylori bacteria (antibodies are proteins produced naturally in your blood that aid in the fight against infection); the stool antigen test has now largely taken the role of this procedure.

If you have H. pylori, you will need to have therapy to get rid of it so that the ulcer may be healed and won’t come again.

Gastroscopy

This technique allows a direct view into the stomach to determine if an ulcer is present.

It entails inserting an endoscope, a thin, flexible tube with a camera inside, into your stomach and the first segment of your small intestine (duodenum).

To make the passing of the endoscope more pleasant, you could get a light sedative injection before to the operation and have a local anesthetic sprayed down your throat.

Typically, the camera’s photos will either confirm or disprove the presence of an ulcer. Additionally, a little tissue sample from your stomach or duodenum may be obtained in order to conduct an H. pylori bacteria test.

You won’t need to spend the night in the hospital since a gastroscopy is performed at a hospital and often on the same day.

Treatment For Stomach Ulcers Disease 

Your stomach ulcer’s course of treatment will depend on what gave rise to it. Most ulcers heal in a few months with therapy.

  • A course of antibiotics plus a drug called a proton pump inhibitor (PPI) are advised if a bacterial infection called Helicobacter pylori (H. pylori) is the root cause of your stomach ulcer.
  • This is also suggested if it’s suspected that using non-inflammatory medications plus having an H. pylori infection are what’s causing your stomach ulcer (NSAIDs).
  • A course of PPI medication is advised if consuming NSAIDs alone is the only thing that caused your stomach ulcer.
  • Sometimes H2-receptor antagonists, a different class of drug, are used instead of PPIs.
  • An extra drug known as an antacid may sometimes be prescribed to you in order to temporarily ease your symptoms.
  • After 4 to 6 weeks, you could have a second gastroscopy to be sure the ulcer has healed.
  • While receiving therapy, there are no specific lifestyle modifications you need to make, although cutting less on stress, alcohol, spicy foods, and smoking may help you feel better while your ulcer heals.

Antibiotics

The typical treatment for an H. pylori infection is a course of two antibiotics, each of which must be taken twice daily for a week.

The most often used antibiotics are metronidazole, clarithromycin, and amoxicillin.

These antibiotics may have modest side effects, which might include:

experiencing nausea and vomiting, diarrhoea, and a metallic aftertaste

A test will be performed on you at least 4 weeks following the end of your antibiotic treatment to determine if you still have H. pylori bacteria in your stomach. If there are, you could need a variety of antibiotics.

Proton pump blockers (PPIs)

PPIs prevent additional harm to the ulcer while it heals naturally by lowering the amount of acid your stomach generates. Typically, they are recommended for 4 to 8 weeks.

The PPIs that are most often used to treat stomach ulcers include omeprazole, pantoprazole, and lansoprazole.

Although they often have minor side effects, they might include:

  • Headaches, constipation or diarrhea, nausea, headache, dizziness, and rashes

Once the course of therapy is through, they should disappear.

H2-receptor blockers

H2-receptor antagonists, like PPIs, function by decreasing the quantity of acid your stomach generates.

The most used H2-receptor antagonist for treating stomach ulcers is ranitidine.

Although they are rare, side effects might include:

  • Diarrhoea\headaches\dizziness\rashes\tiredness

Antacids

Since treatments might take several hours to take effect, your doctor could advise taking extra antacid medicine to swiftly neutralize your stomach acid and short-term discomfort.

Some antacids also include an ingredient called alginate, which coats the lining of your stomach with a protective layer.

In pharmacies, some drugs may be purchased without a prescription. On which is most appropriate for you, your pharmacist may provide you advice.

Take antacids after a meal or before sleep if you are experiencing symptoms or anticipating them.

It is better to take antacids with alginates after meals.

The following minimal side effects of both drugs are possible:

  • Either constipation or diarrhea\Farting (flatulence)\Stomach pain that makes you feel ill

Your doctor will want to assess your usage of NSAIDs if you believe they contributed to the development of your stomach ulcer.

You could be told to take an alternate analgesic like paracetamol that isn’t linked to stomach ulcers.

A COX-2 inhibitor, a different kind of NSAID that is less prone to induce stomach ulcers, may sometimes be advised.

Your doctor will determine if you need to continue taking low-dose aspirin (an NSAID) if you are doing so to lower your risk of blood clots or emboli.

Aspirin may be recommended combined with long-term therapy with a PPI or H2-receptor antagonist to attempt to prevent additional ulcers if you do need to continue taking it.

It’s critical to comprehend the possible dangers of continuous NSAID usage.

You’re more prone to endure internal bleeding and another stomach ulcer, both of which are dangerous complications.

Complications of a stomach ulcer

Although stomach ulcer complications are generally rare, they may be quite dangerous if they do occur, like –

Bleeding internally

The most frequent consequence of stomach ulcers is internal bleeding. It could take place if an ulcer grows near a blood vessel.

There are two types of bleeding that may occur: slow, chronic bleeding that results in anemia and causes weariness, breathlessness, pale complexion, and palpitations (noticeable heartbeats)

fast and severe bleeding, which causes you to produce bloody or tar-like stools or vomit blood

If your anemia symptoms are chronic, you should see your doctor. They could suggest that you see a gastroenterologist for a checkup and treatment if they suspect that you might have a stomach ulcer.

If you have signs of more serious bleeding, speak with your doctor right away or go to the closest accident and emergency (A&E) hospital.

Internal bleeding treatment

A gastroscopy will be done to determine the source of the bleeding, and it is often possible to provide therapy to halt the bleeding at this time.

It is sometimes possible to halt bleeding ulcers using specialized methods performed under X-ray supervision, although surgery may sometimes be necessary to fix the broken blood artery.

You can also need blood transfusions to replenish the blood you lost.

Perforation

Perforation, or the breaking open of the stomach lining, is a less common side effect of stomach ulcers.

Because it allows the germs that dwell in your stomach to escape and infect the lining of your abdomen, this might be quite harmful (peritoneum). Peritonitis is the term for this.

A peritonitis infection has the potential to quickly enter the bloodstream (sepsis) before moving on to other organs. If left untreated, this has the potential to cause multiple organ failure and be deadly.

The most typical sign of peritonitis is abrupt, progressive abdominal discomfort.

Call your doctor right away if you are experiencing this kind of discomfort.

The medical urgency of peritonitis necessitates hospital hospitalization. Occasionally, surgery may be required.

Gastric Outflow Blockade

In certain situations, a stomach ulcer that is infected (swollen) or scarred might prevent food from passing through your digestive tract. Gastric outlet blockage is what it is.

Some symptoms of blocked gastric outflow include:

Recurring vomiting bouts with significant volumes of food-containing poop

accidental weight loss a continuous sense of bloating or fullness feeling very satisfied after eating less than normal

The blockage may be verified with a gastroscopy. Proton pump inhibitors (PPIs) or H2-receptor antagonists may be used to lower stomach acid levels until the swelling subsides if the blockage is the result of inflammation.

Although it may sometimes be addressed by inserting a tiny balloon using an endoscope and inflating it to broaden the blockage site, surgery may be required if the obstruction is brought on by scar tissue.

 Stomach Ulcer Prevention

Regularly wash your hands with soap and water to stop the transmission of germs that might lead to a stomach ulcer. Additionally, be sure to carefully clean all of your food and prepare it as necessary.

Stop taking these drugs (if it’s feasible) or take them less often to avoid ulcers brought on by NSAIDs. If you must take NSAIDs, be careful to take them as directed and refrain from drinking alcohol while doing so. And always consume meals and enough beverages while using these meds. 

References

https://en.wikipedia.org/wiki/Helicobacter_pylori

https://www.nhs.uk/conditions/stomach-ulcer/complications/

https://www.healthline.com/health/stomach-ulcer#home-remedies