A peptic ulcer is a sore arising as digestive juices strip off digestive system lining. A peptic ulcer can occur in the stomach lining, duodenum or lower part of the esophagus. Symptoms may include discomfort such as indigestion, nausea and weight loss.
Overall , it is estimated that at least once in their lifetime up to 10 percent of adults are affected by peptic ulcers. Every year about 500,000 people in the United States develop a peptic ulcer.
If a peptic ulcer hits the stomach, it’s called a gastric ulcer, one in the duodenum is called a duodenal ulcer, and an ulcer in the esophagus is an ulcer.
The most common causes are bacteria from Helicobacter pylori ( H. pylori), and the use of non-steroidal anti-inflammatory drugs.
Important facts about peptic ulcers:
- Peptic ulcers can affect anywhere in the digestive system.
- Symptoms include stomach pain, sometimes feeling like indigestion, and nausea.
- Causes include bacteria and certain types of medication.
- Treatments include proton pump inhibitors (PPIs) and antibiotics.
Symptoms
Catching a peptic ulcer with no signs at all is not uncommon among people. But the indigestion-like pain is one of the most common signs of peptic ulcers.
The pain from the belly button to the breastbone can happen anywhere. It can be short, or hours-long. It is more serious when the stomach is empty or directly after eating (depending on where it is located); often during sleep, it is worse. It can be relieved by eating some foods and some foods may make it worse.
Other symptoms include:
- difficulty swallowing food
- food that is eaten comes back up
- feeling unwell after eating
- weight loss
- loss of appetite
Over-the-counter medications can often provide relief for these symptoms. Rarely, ulcers can cause severe signs and symptoms, such as:
- vomiting blood
- black and tarry stools, or stools with dark red blood
- nausea and vomiting that is especially persistent and severe
These symptoms indicate a medical emergency. The patient should see a doctor immediately.
Complications
The risk of complications increases if the ulcer is left untreated, or if treatment is not completed. Complications can include:
- internal bleeding
- hemodynamic instability, a result of internal bleeding which can affect multiple organs and be a serious complication
- peritonitis, in which the ulcer bores a hole through the wall of the stomach or small intestine
- scar tissue
- pyloric stenosis, a chronic inflammation in the lining of the stomach or duodenum
Peptic ulcers can recur. Having a first ulcer increases the risk of developing another one later.
Treatment
The type of treatment usually depends on what caused the peptic ulcer. Treatment would either reduce the levels of stomach acid so that the ulcer will heal, or remove the H. Pylori. Pylori.
Proton pump inhibitors (PPIs)
PPIs minimize the amount of stomach acid that it creates. Patients that test negative for H are recommended for these. Pylori. Pylori. Treatment typically lasts 1-2 months but treatment can last longer if the ulcer is severe.
H. pylori infection treatment
Patients infected with H. Pylori’s typically require antibiotics and PPIs. This procedure is successful in most cases, and within days, the ulcer will begin to disappear. The person will need to be checked again after care is finished to ensure the H. Pylori went. They will undergo another course of various antibiotics, if needed.
Non-steroidal anti-inflammatory drugs
If the ulcer comes from NSAIDs the patient must avoid taking it. Options include acetaminophen. If the person can not stop taking NSAIDs, the physician can reduce the dosage and later evaluate the patient’s need for it. Long-term treatment of another drug, alongside the NSAID.
Follow-up treatment
The patient may still have indigestion even after the ulcer has healed and treatment is complete. In such cases , the doctor can suggest some changes in diet and lifestyle. If symptoms continue, antagonists may be treated with low-dose PPI or H2-receptor. An endoscopy can be necessary in serious cases of bleeding to stop the bleeding at the ulcer site.
Diet
Changes in diet may be important in treating and preventing peptic ulcers.
Avoiding foods and flavorings that cause the stomach to produce acids such as chili powder, garlic, black pepper and caffeine is essential. Alcohol has the same stomach effect and should be avoided, too.
The diet should contain plenty of foods which provide plenty of easily dissolving vitamin A and fibre. Might include:
Sources of soluble fiber
- oats
- apples
- oranges
- carrots
- psyllium husk
- legumes
- flax seeds
- nuts
- barley
Sources of vitamin A
- liver
- broccoli
- kale
- spinach
- sweet potatoes
- collard greens
It is advised to eat foods rich in antioxidants, such as a variety of berries and snap peas. Green tea has also demonstrated a restrictive effect on the growth of H. pyloriunder laboratory conditions. It’s unclear if it will have the same effect inside the human body, though.
For a peptic ulcer, a healthy diet filled for fruits and vegetables and low in intense spices and spices can help.
Causes
Peptic ulcers normally occur because of:
- H. pylori bacteria
- non-steroidal anti-inflammatory drugs (NSAIDs)
H. pylori bacteria are responsible for the majority of gastric and duodenal ulcers. A less probable source is the NSAIDs.
How does H. pylori cause ulcers?
Although many people naturally carry H. Pylori, the explanation why the bacteria cause only ulcers in some people is not clear. H. Pylori disseminated food and water. They live in the mucus that forms the lining of the stomach and duodenum and they create urease, an enzyme that by making it less acidic, neutralizes stomach acid.
To make up for this the stomach produces more acid, which irritates the lining of the intestine. The bacteria also disrupt the stomach defense system and cause it to become inflamed. Patients with peptic ulcers caused by H. Pylori requires medication to get rid of the stomach bacteria and to keep them from returning.
How do anti-inflammatory drugs which are not steroidal cause ulcers?
Non-steroidal anti-inflammatory drugs (NSAIDS) are headache, period pain and other pain medications. Take aspirin and ibuprofen for example. Many nonprescription NSAIDs are available.
They lower the capacity of the stomach to form a protective mucus layer. This renders it more susceptible to stomach acid injury. NSAIDs can also influence blood flow to the stomach, thus decreasing the capacity of the body to repair cells.
Other causes of peptic ulcers
- 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.
Diagnosis
A patient ‘s description of symptoms will normally cause a doctor to suspect a peptic ulcer.
Tests which may validate a diagnosis include:
- a blood test to check for H. pylori, though a positive test does not always mean there is an active infection
- a breath test, using a radioactive carbon atom to detect H. pylori
- a stool antigen test to detect H. pylori in the feces
- an upper gastrointestinal (GI) X-ray to identify ulcers
An endoscopy may also be used. This requires a long, narrow tube which is threaded down the throat of the patient and into the stomach and duodenum with a camera attached at the end. This is the most effective diagnostic test.
If an ulcer is found, the physician may take a biopsy (a small tissue sample) under a microscope for analysis. Can a biopsy test for H. pylori and look for evidence of cancer. Some months later, endoscopy can be performed to assess whether the ulcer is healing.
Outlook
Generally the outlook is excellent for a person with a peptic ulcer.
They can be painful and debilitating but in nearly all cases, a peptic ulcer can be treated effectively and prevented from returning.
Treat H. pylori infection and avoiding NSAIDs can ensure that the problem does not recur.
