Stomach ulcer (Peptic ulcer) : Symptoms, Causes, Diagnosis & Treatment

December 3, 2018

A peptic ulcer —peptic is defined as pertaining to, or associated with, digestion— is a break in the surface lining of the stomach or duodenum which is deep enough to produce a shallow crater (ulcer) in its wall.

Peptic ulcers are found approximately four times as often in the duodenum than in the stomach, and can also be found, albeit rarely, in the lower esophagus or beyond the duodenum in the small intestine. Duodenal ulcers are more common in men, whereas gastric ulcers affect men and women more or less equally Ulcers are found at all ages but are more common with increasing age. u6lcers may appear acutely or develop slowly and chronically. Close to 10% of all adults may suffer from peptic ulcer disease at some time in their lives

Peptic ulcers are difficult to self diagnose. Upper abdominal pain is a common symptom.

How does Peptic ulcer affect your body?

Peptic ulcers are any ulcers that affect both the stomach and small intestines. Stomach ulcers occur when the thick layer of mucus that protects your stomach from digestive juices is reduced. This allows the digestive acids to eat away at the tissues that line the stomach, causing an ulcer.

What are the Causes of Peptic ulcer?

Peptic ulcers normally occur because of:

Pylori bacteria – H. pylori bacteria are responsible for the majority of gastric and duodenal ulcers. H. pylori spread through food and water. They live in the mucus that coats the lining of the stomach and duodenum, and they produce urease, an enzyme that neutralizes stomach acid by making it less acidic. To compensate for this, the stomach produces more acid, and this irritates the stomach lining. The bacteria also weaken the defense system of the stomach and causes inflammation. Patients with peptic ulcers caused by H. pylori need treatment to get rid of the bacterium from the stomach, and to prevent them coming back.
Non-steroidal anti-inflammatory drugs (NSAIDs) – Non-steroidal anti-inflammatory drugs are medications for headaches, period pains, and other pains. Examples include aspirin and ibuprofen. Many NSAIDs are available without a prescription. They lower the stomach’s ability to make a protective layer of mucus. This makes it more susceptible to damage by stomach acid. NSAIDs can also affect the flow of blood to the stomach, reducing the body’s ability to repair cells.
Genetics – A significant number of individuals with peptic ulcers have close relatives with the same problem, suggesting that genetic factors may be involved.
Smoking – People who regularly smoke tobacco are more likely to develop peptic ulcers when compared with non-smokers.
Alcohol consumption – Regular heavy drinkers of alcohol have a higher risk of developing peptic ulcers.
Corticosteroid use – People on large or chronic doses of corticosteroids are also at greater risk.
Mental stress – This stress has not been linked to the development of new peptic ulcers, but symptoms appear to be more severe in people with ulcers who are experiencing ongoing mental stress.

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What are the Risk Factors of Peptic ulcer?

Common risk factors include :

Frequent use of over-the-counter painkillers such as aspirin, ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs).
A family history of ulcers – More than 20% of people with peptic ulcers also have a family history of the problem.
Increased age – Studies show that peptic ulcers occur more commonly in the elderly. This is true for both sexes and is most probably linked to the use of NSAIDs (e.g. for treating chronic pain and arthritis).

What are the symptoms of Peptic ulcer?

Common symptoms are:

Abdominal pain, usually located in the upper central abdomen
Pain which may also be felt in the back
Pain which may be worse when the stomach is empty; although not always the case, this pain can sometimes be relieved by eating
pain which wakes a patient from sleep
indigestion or heartburn,
Vomiting and anemia.

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How is Peptic ulcer diagnosed?

Endoscopy – Your doctor may use a scope to examine your upper digestive system (endoscopy). During endoscopy, your doctor passes a hollow tube equipped with a lens (endoscope) down your throat and into your esophagus, stomach and small intestine. Using the endoscope, your doctor looks for ulcers. If your doctor detects an ulcer, small tissue samples (biopsy) may be removed for examination in a lab. A biopsy can also identify whether H. pylori is in your stomach lining.
Upper gastrointestinal series/barium swallow – This series of X-rays of your upper digestive system creates images of your esophagus, stomach and small intestine. During the X-ray, you swallow a white liquid (containing barium) that coats your digestive tract and makes an ulcer more visible.
Laboratory tests for H. pylori – Your doctor may recommend tests to determine whether the bacterium H. pylori is present in your body. He or she may look for H. pylori using a blood, stool or breath test. The breath test is the most accurate. Blood tests are generally inaccurate and should not be routinely used.

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How to prevent & control Peptic ulcer?

Common preventive measures include :

Antibiotic therapy to eradicate helicobacter pylori in the population at risk.
Careful use of aspirin and other NSAIDs, as well as avoidance by people at high risk of complications.
Stopping smoking may also reduce the chances of developing and ulcer.

Treatment of Peptic ulcer Allopathic Treatment –

Antibiotic medications to kill H. pylori – If H. pylori is found in your digestive tract, your doctor may recommend a combination of antibiotics to kill the bacterium. These may include amoxicillin (Amoxil), clarithromycin (Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline (Tetracycline HCL) and levofloxacin (Levaquin).
Medications that block acid production and promote healing – Proton pump inhibitors — also called PPIs — reduce stomach acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium) and pantoprazole (Protonix).
Medications to reduce acid production – Acid blockers — also called histamine (H-2) blockers — reduce the amount of stomach acid released into your digestive tract, which relieves ulcer pain and encourages healing. Available by prescription or over-the-counter, acid blockers include the medications ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine (Axid AR).
Antacids that neutralize stomach acid – Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients. Antacids can provide symptom relief, but generally aren’t used to heal your ulcer.
Medications that protect the lining of your stomach and small intestine – In some cases, your doctor may prescribe medications called cytoprotective agents that help protect the tissues that line your stomach and small intestine. Options include the prescription medications sucralfate (Carafate) and misoprostol (Cytotec).

Treatment of Peptic ulcer Homeopathic Treatment –

Argentum Nitricum – For stomach ulcers with radiating pains
Nux Vomica – Highly effective among Homeopathic medicines for stomach ulcers where eating worsens pain
Kali Bichromicum – For ulcers in stomach
Lycopodium Clavatum – For stomach ulcers with bloated abdomen
Carbo Veg – One of the known Homeopathic medicines for stomach ulcers

Peptic ulcer – Lifestyle Tips

Stop smoking
Avoid excessive alcohol intake
Avoid aspirin and other NSAIDs, if possible

What are Recommended Exercises for Person with Peptic ulcer?

Exercise regulary. To reap the health benefits of exercise — including weight maintenance and prevention of disease — plan to exercise for at least 30 minutes a day, five days per week. Your exercise regimen may include Strength training, Cardio exercises or Yoga.

Peptic ulcer & Pregnancy – Things to know

Gastrointestinal (GI) disorders represent some of the most frequent complaints during pregnancy, possibly due in part to elevated levels of progesterone (eg, nausea/vomiting, gastroesophagel reflux disease [GERD]) and/or prostaglandins (diarrhea). [1] Some women have GI disorders that are unique to pregnancy. Other pregnant patients present with chronic GI disorders that require special consideration during their pregnancy. Understanding the presentation and prevalence of various GI disorders is necessary to optimize care for these patients.

Common Complications Related to Peptic ulcer

Bleeding – If you have a bleeding ulcer, you’ll have black, tar-like stools (called melaena) and you’re most likely to feel weak – so much so that you may feel as if you’re going to faint when standing. You may also vomit blood. The blood in the stomach is usually changed by gastric acid, giving it a grainy, black appearance (like coffee grains).
Gastric-outlet obstruction – If you have a gastric-outlet (pyloric) obstruction caused by an ulcer, you’re most likely to experience increasing abdominal pain and you may vomit undigested or partially digested food because it can’t pass into the rest of the digestive tract.
Perforation -In the case of a perforated ulcer, gastric contents will leak into your abdominal cavity. This causes acute peritonitis (inflammation of the abdominal cavity). You will have sudden and severe abdominal pain, which worsens whenever you move. The abdominal muscles become rigid and board-like, and surgery is usually urgently required.
Penetration – Sometimes an ulcer at the back of the bowel might break through the wall. You might experience pain radiating to the back, especially when you lie down. Because there’s no free perforation, you won’t be as sick as with a perforation, but a lot of fibrosis (thickening and scarring of the connective tissue) may occur in that region.

Other FAQs about Peptic ulcer

Q. How long does it take a stomach ulcer to heal?

A. Typically, you will take antibiotics along with acid-suppressing medicine for two weeks. Then you may take acid-suppressing medication for another four to eight weeks. Gastric ulcers tend to heal more slowly than duodenal ulcers. Uncomplicated gastric ulcers take up to two or three months to heal completely.

Q. Is Potato good for stomach ulcer?

A. Potato juice can help cure stomach ulcers. Scientists from Manchester University have discovered that a key molecule in potato can both cure and prevent the bacteria that lives in the stomach and causes stomach ulcers and heartburn.

Q. What does an ulcer pain feel like?

A. The main symptom of a stomach or duodenal ulcer is upper abdominal pain, which can be dull, sharp, or burning (a hunger-like feeling). Bloating and burping are not symptoms of peptic ulcer, and vomiting, poor appetite, and nausea are uncommon symptoms of peptic ulcer.