Stomach ulcer

What is it?           

A gastric ulcer, which is also known as peptic or stomach ulcer, is a sore in the mucous membrane that lines the stomach or duodenum, the first segment of the small intestine.  

The most common symptom is heartburn, which may happen after eating or during the night, this can last several hours.  

Prognosis

Withh treatment and dietary changes (having a balanced diet, not smoking, reducing alcohol consumption) symptoms normally improve over time.  

What are the symptoms?

The symptoms of a gastric ulcer vary from person to person, and in some people they are asymptomatic, this is especially true of small ulcers. Heartburn is considered to be the most common symptom of peptic ulcers, and it can last between a few minutes to several hours, and can affect the person intermittently for several days or weeks.  

Other common symptoms include:

  • Feeling full
  • Difficulties drinking a normal amount of liquid
  • Hunger and feeling empty after eating
  • Nausea
  • Stomach ache. 

A gastric ulcer can also cause other less common symptoms:

  • Swelling
  • Being gassy and burping
  • Lack of appetite
  • Felling fatigued
  • Vomiting
  • Chest pain
  • Weight loss
  • Dark stools.

Medical tests

The specialist will ask the patient about the symptoms being experienced, their medical history, and they will carry out a physical examination to check if there is swelling and pain the stomach. They will also use a stethoscope to check for any unusual sounds around the abdomen area.  

An ulcer is often treated with medications, and a test is carried out two weeks later to check that they have been effective.  

If the medication has not worked, the doctor may opt to carry out an upper endoscopy, where a thin tube with a camera on the end is inserted in the throat to examine the state of the stomach. A biopsy may also be carried out.      

What causes it?

The gastric ulcer sore is formed when the stomach is exposed and vulnerable to its own acidity. This can be caused by different things:

  • Genetics
  • Medications that affect the lining of the stomach
  • Infection caused by Helicobacter pylori
  • Excessive consumption of alcoholic drinks, which irritate the gastric mucosa
  • Stress

The patient’s lifestyle can also be the cause of an ulcer. Having an unbalanced diet rich in fat and sugar can worsen symptoms. Irritants such as caffeine, spices, and peppers can aggravate symptoms and cause the ulcer to worsen. This can cause other gastric issues to appear or progress, and example being gastroesophageal reflux disease (GERD).  

How can it be prevented?

A gastric ulcer is known to get worse with alcohol and tobacco use. In the past it was thought that it was caused by eating too much spicy food. Now we know that stress can be a contributing factor.   

A person can live with an ulcer, they normally heal between eight and ten weeks. By following a balanced diet, and dropping habits such as smoking, coffee, alcohol, and chocolate consumption, can prevent an ulcer forming. Not eating too late at night can also help.        

What is the treatment?

There are several medications that can be used to treat a gastric ulcer.

If H. Pylori is the cause of the ulcer, the treatment will be what is known as triple therapy. This is a combination of antibiotics with bismuth subsalicylate.    

Other medications that can neutralise heartburn and the stomach lining include:

  • Proton pump inhibitors
  • Histamine receptor blocker
  • Stomach protectors.

If anti-inflammatory medications have caused the ulcer and there is no sign of H. Pylori, then reducing the amount of medications taken is crucial, another option is to look into a different type of painkiller.       

What specialist should I see?

The specialist who treats gastric ulcers is a gastroenterologist.     

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