Can stomach ulcers cause fatigue. How do bloating, heartburn, nausea, and pain relate to peptic ulcers. What is the link between muscular fatigue and peptic ulcers in dogs. How does physical rest impact ulcer management.

The Relationship Between Stomach Ulcers and Fatigue

Stomach ulcers, also known as peptic ulcers, are open sores that develop on the lining of the stomach or small intestine. While the primary symptoms often include abdominal pain and discomfort, many individuals with ulcers also report experiencing fatigue. This connection between stomach ulcers and fatigue is not merely coincidental but can be attributed to several factors.

Chronic pain and discomfort associated with stomach ulcers can lead to sleep disturbances, which in turn result in daytime fatigue. Additionally, the body’s inflammatory response to the ulcer may contribute to feelings of tiredness and low energy. Furthermore, nutritional deficiencies that can occur due to changes in eating habits or malabsorption issues related to the ulcer may also play a role in causing fatigue.

How Ulcers Affect Energy Levels

Do ulcers directly cause a decrease in energy levels? While ulcers themselves do not directly deplete energy, they can indirectly lead to fatigue through various mechanisms:

• Anemia: Bleeding ulcers can cause iron-deficiency anemia, resulting in fatigue.
• Stress: The physical and emotional stress of dealing with ulcer symptoms can be exhausting.
• Malnutrition: Ulcers may interfere with proper nutrient absorption, leading to deficiencies that cause fatigue.
• Inflammation: The body’s inflammatory response to ulcers can contribute to feelings of tiredness.

Common Symptoms Associated with Stomach Ulcers

While fatigue is a notable symptom, stomach ulcers are often accompanied by a range of other symptoms. Understanding these can help in early detection and prompt treatment.

Bloating and Stomach Ulcers

Is bloating a common symptom of stomach ulcers? Indeed, many individuals with peptic ulcers experience bloating, which is a feeling of fullness or swelling in the abdominal area. This symptom can be particularly pronounced after eating and may be accompanied by discomfort or pain.

Heartburn: A Telltale Sign of Ulcers

Heartburn, characterized by a burning sensation in the chest or throat, is frequently reported by those with stomach ulcers. This occurs when stomach acid irritates the ulcer, causing the characteristic burning feeling. While not all cases of heartburn indicate an ulcer, persistent heartburn should be evaluated by a healthcare professional.

Nausea and Its Relation to Peptic Ulcers

Nausea is another common symptom associated with stomach ulcers. The presence of an ulcer can disrupt normal digestive processes, leading to feelings of queasiness or the urge to vomit. In some cases, nausea may be accompanied by vomiting, especially if the ulcer is severe or bleeding.

Pain: The Primary Indicator of Stomach Ulcers

Does pain always indicate the presence of a stomach ulcer? While pain is the most characteristic symptom of peptic ulcers, its presentation can vary. Some individuals experience a dull, gnawing pain, while others report sharp, burning sensations. The pain is typically localized to the upper abdomen and may worsen when the stomach is empty or at night.

The Impact of Muscular Fatigue on Peptic Ulcers: Insights from Animal Studies

Research conducted on dogs has provided intriguing insights into the relationship between muscular fatigue and peptic ulcers. A study by Lillehei and Wangensteen at the University of Minnesota explored this connection, yielding surprising results.

Experimental Findings on Muscular Fatigue and Ulcer Formation

The study compared two groups of dogs: one subjected to continuous muscular activity and histamine injections, and a control group not subjected to the activity. The results were striking:

• In the control group of 13 dogs, only 3 (23%) showed mild duodenal ulcers or erosions.
• Among the 15 fatigued dogs, 11 (73%) developed relatively severe gastric, duodenal, or jejunal ulcers or erosions.
• Six cases in the fatigued group showed multiple ulcers, with two cases resulting in perforation and one fatality.

These findings suggest a significant correlation between muscular fatigue and increased susceptibility to peptic ulcers, at least in the canine model studied.

The Role of Physical Rest in Ulcer Management

Historically, complete physical rest has been recommended by internists as a valuable component in managing peptic ulcers. This advice, primarily derived from clinical experiences, has long been a cornerstone of ulcer treatment strategies.

Evaluating the Efficacy of Rest in Ulcer Treatment

Is physical rest truly beneficial for ulcer healing? While the traditional recommendation for rest has been widely accepted, it’s important to note that this approach was not initially supported by extensive experimental evidence. The study on muscular fatigue in dogs provides some scientific backing to this clinical practice, suggesting that reduced physical exertion may indeed play a role in ulcer prevention and management.

However, modern ulcer treatment typically focuses on addressing the underlying causes, such as H. pylori infection or NSAID use, rather than relying solely on rest. Nonetheless, moderate rest may still be advised as part of a comprehensive treatment plan, especially during acute phases of the condition.

Advancements in Understanding Ulcer Etiology and Treatment

Our understanding of peptic ulcers has evolved significantly since the mid-20th century when the aforementioned dog study was conducted. Today, we recognize that the majority of peptic ulcers are caused by either Helicobacter pylori (H. pylori) bacterial infection or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Modern Approaches to Ulcer Treatment

How has ulcer treatment changed in recent years? Contemporary ulcer management typically involves:

1. Antibiotic therapy to eradicate H. pylori infection, if present
2. Proton pump inhibitors (PPIs) or H2 blockers to reduce stomach acid production
3. Discontinuation or reduction of NSAID use, if applicable
4. Lifestyle modifications, including stress reduction and dietary changes
5. Bismuth subsalicylate for additional protection of the stomach lining

While rest may still be recommended, especially during acute phases, it is no longer considered the primary treatment modality for peptic ulcers.

Preventing Ulcer-Related Fatigue: Lifestyle and Dietary Considerations

Given the potential link between stomach ulcers and fatigue, prevention and management of ulcers can play a crucial role in maintaining energy levels and overall well-being.

Dietary Strategies for Ulcer Prevention

Can certain foods help prevent or manage ulcers? While diet alone cannot cure ulcers, certain dietary choices may help reduce symptoms and support healing:

• Consume a diet rich in fruits, vegetables, and whole grains
• Limit intake of spicy, acidic, or fatty foods that may irritate the stomach
• Avoid alcohol and caffeine, which can increase stomach acid production
• Eat smaller, more frequent meals to reduce stomach acid buildup
• Consider probiotic-rich foods to support gut health

Stress Management and Ulcer Prevention

While stress itself doesn’t cause ulcers, it can exacerbate symptoms and potentially slow healing. Implementing stress-reduction techniques such as meditation, yoga, or regular exercise can be beneficial for overall health and may help manage ulcer symptoms.

When to Seek Medical Attention for Suspected Ulcers

Recognizing the signs of a potential ulcer and knowing when to seek medical attention is crucial for prompt diagnosis and treatment.

Red Flags: Symptoms Requiring Immediate Medical Care

Are there symptoms that indicate a medical emergency? Certain symptoms may indicate a serious complication of peptic ulcers and require immediate medical attention:

• Severe, sudden abdominal pain
• Vomiting blood or material that looks like coffee grounds
• Black, tarry stools
• Difficulty swallowing or persistent vomiting
• Unintended weight loss or loss of appetite

If you experience any of these symptoms, seek medical care promptly. Early intervention can prevent serious complications and promote faster healing.

Diagnostic Procedures for Suspected Ulcers

How are stomach ulcers diagnosed? If a peptic ulcer is suspected, your healthcare provider may recommend one or more of the following diagnostic procedures:

1. H. pylori testing: This can be done through blood, stool, or breath tests.
2. Upper endoscopy: A thin, flexible tube with a camera is used to visualize the stomach and small intestine.
3. Upper GI series: X-rays are taken after drinking a barium solution to highlight the digestive tract.
4. CT scan: This imaging technique can help detect complications such as perforation.

These diagnostic tools allow for accurate identification of ulcers and help guide appropriate treatment strategies.

MUSCULAR FATIGUE AND PEPTIC ULCER | JAMA

MUSCULAR FATIGUE AND PEPTIC ULCER | JAMA | JAMA Network










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Article

January 22, 1949

JAMA. 1949;139(4):232. doi:10.1001/jama.1949.02900210038013

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Abstract

Complete physical rest is often recommended by internists as a valuable adjunct in the management of peptic ulcer. This precept was derived primarily from clinical experiences, with little supporting experimental evidence. Lillehei and Wangensteen¹ of the Department of Surgery, University of Minnesota, studied the effects of moderate muscular fatigue on the incidence and severity of histamine-provoked peptic ulcer in dogs.

Fifteen dogs given continuous muscular activity and injections of histamine were compared with 13 not subjected to the activity. Among the 13 nonfatigued control dogs, 10 showed normal gastrointestinal tracts. Three (23 per cent) showed mild duodenal ulcers or erosions. Among the 15 fatigued dogs, only 4 showed normal gastrointestinal tracts. Eleven (73 per cent) showed relatively severe gastric, duodenal or jejunal ulcers or erosions. In 6 cases multiple ulcers were noted, two of which had perforated, causing the death of 1 dog. These results are in accord with

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Bleeding Ulcer: Symptoms, Treatment, and More

Treatment for a bleeding ulcer can depend on its location, cause, and severity. It may involve medical procedures or medications.

Peptic ulcers are open sores in your digestive tract. When they’re located inside your stomach, they’re also called gastric ulcers. When they are found in the upper part of your small intestine, they are called duodenal ulcers.

Some people aren’t even aware they have an ulcer. Others have symptoms like heartburn and abdominal pain. Ulcers can become very dangerous if they perforate the gut or bleed heavily (also known as a hemorrhage).

Keep reading to learn more about symptoms and treatment for ulcers, as well as to uncover a few ulcer myths.

Ulcers don’t always cause symptoms. In fact, only about one quarter of people with ulcers experience symptoms. Some of these symptoms include:

• abdominal pain
• bloating or a feeling of fullness
• belching
• heartburn
• nausea
• vomiting

Symptoms may be a little different for each person. In some cases, eating a meal can ease the pain. In others, eating only makes things worse.

An ulcer can bleed so slowly that you don’t notice it. The first signs of a slow-bleeding ulcer are symptoms of anemia, which include:

• pale skin color
• shortness of breath with physical activity
• lack of energy
• fatigue
• lightheadedness

An ulcer that is bleeding heavily may cause:

• stool that is black and sticky
• dark red or maroon colored blood in your stool
• bloody vomit with the consistency of coffee grounds

Rapid bleeding from an ulcer is a life-threatening event. If you have these symptoms, seek immediate medical attention.

There’s a layer of mucus in your digestive tract that helps protect the gut lining. When there’s too much acid or not enough mucus, the acid erodes the surface of your stomach or small intestine. The result is an open sore that can bleed.

Why this happens can’t always be determined. The two most common causes are Helicobacter pylori and nonsteroidal anti-inflammatory drugs.

Helicobacter pylori (H. pylori)

H. pylori is a bacterium that lives within the mucus in the digestive tract. It can sometimes cause inflammation in the stomach lining, which leads to an ulcer. The risk may be greater if you are infected with H. pylori and you also smoke.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These medications make it hard for your stomach and small intestine to protect themselves from stomach acids. NSAIDs also reduce the ability of your blood to clot, which can make a bleeding ulcer much more dangerous.

Drugs in this group include:

• aspirin (Bayer Aspirin, Bufferin)
• ibuprofen (Advil, Motrin)
• ketorolac (Acular, Acuvail)
• naproxen (Aleve)
• oxaprozin (Daypro)

Acetaminophen (Tylenol) is not an NSAID.

NSAIDS are also included in some combination medications used to treat stomach upset or colds. If you’re using multiple medications, there’s a good chance you’re taking more NSAIDs than you realize.

The risk of developing an ulcer caused by NSAIDs is greater if you:

• take a higher than normal dose
• take them too frequently
• drink alcohol
• are elderly
• use corticosteroids
• have had ulcers in the past

Additional risk factors

Zollinger-Ellison syndrome is another condition that can lead to ulcers. It causes gastrinomas, or tumors of the acid-producing cells in your stomach, which causes more acid.

Another rare type of ulcer is called Cameron’s ulcer. These ulcers occur when a person has a large hiatal hernia and often cause GI bleeding.

If you have ulcer symptoms, see your doctor. Prompt treatment can prevent excessive bleeding and other complications.

Ulcers are usually diagnosed after an upper GI endoscopy (EGD or esophagogastroduodenoscopy). An endoscope is a long flexible tube with a light and camera on the end. The tube is inserted into your throat, then to the esophagus, stomach, and upper part of the small intestine. Learn how to prepare for an endoscopy here.

Generally performed as an outpatient procedure, it allows the doctor to locate and identify problems in the stomach and upper intestine.

Bleeding ulcers must be addressed quickly, and treatment can start during the initial endoscopy. If bleeding from ulcers is found during the endoscopy, the doctor can:

• inject medication directly
• cauterize the ulcer to stop the bleeding
• clamp off the bleeding vessel

If you have an ulcer, you’ll be tested for H. pylori. This can be done using a tissue sample taken during the endoscopy. It can also be accomplished with noninvasive tests such as a stool sample or breath test.

If you have the infection, antibiotics and other drugs can help fight the bacteria and ease symptoms. To be certain you get rid of it, you must finish taking the medication as directed, even if your symptoms stop.

Ulcers are treated with acid-blocking drugs called proton pump inhibitors (PPIs) or h3 blockers. They can be taken orally, but if you have a bleeding ulcer, they can also be taken intravenously. Cameron ulcers are usually treated with PPIs, but sometimes surgery is needed to repair the hiatal hernia.

If your ulcers are the result of taking too many NSAIDs, work with your doctor to find another medication to treat pain.

Over-the-counter antacids sometimes relieve symptoms. Ask your doctor if it’s okay to take antacids.

You’ll have to take medication for at least a few weeks. You should also avoid taking NSAIDs going forward.

If you have severely bleeding ulcers, your doctor may want to perform another endoscopy at a later date to be certain that you’re fully healed and that you don’t have more ulcers.

An untreated ulcer that swells or scars can block your digestive tract. It can also perforate your stomach or small intestine, infecting your abdominal cavity. That causes a condition known as peritonitis.

A bleeding ulcer can lead to anemia, bloody vomit, or bloody stools. A bleeding ulcer usually results in a hospital stay. Severe internal bleeding is life-threatening. Perforation or serious bleeding may require surgical intervention.

Ulcers can be successfully treated, and most people heal well. When treated with antibiotics and other medications, the success rate is 80 to 90 percent.

Treatment will only be effective if you take all your medication as prescribed. Smoking and continued use of NSAIDs will impede healing. Also, some strains of H. pylori are antibiotic resistant, complicating your long-term outlook.

If you’re hospitalized due to a bleeding ulcer, the 30-day mortality rate is about 11 percent. Age, recurrent bleeding, and comorbidity are factors in this outcome. The main predictors for long-term mortality include:

• old age
• comorbidity
• severe anemia
• tobacco use
• being male

There’s a lot of misinformation about ulcers, including what causes them. For a long time, it was thought that ulcers were due to:

• stress
• worry
• anxiety
• a rich diet
• spicy or acidic foods

People with ulcers were advised to make lifestyle changes such as reducing stress and adopting a bland diet.

That changed when H. Pylori was discovered in 1982. Doctors now understand that while diet and lifestyle can irritate existing ulcers in some people, generally they do not cause ulcers. While stress can increase stomach acid that in turn irritates the gastric mucosa, stress is rarely the main cause of an ulcer. An exception is in individuals who are very ill, such as those in a critical care hospital unit.

Another longstanding myth is that drinking milk is good for ulcers. That may be because milk coats your stomach lining and relieves ulcer pain, at least for a short time. Unfortunately, milk encourages production of acid and digestive juices, which actually makes ulcers worse.

Peptic ulcer of the stomach or duodenum – symptoms, diagnosis, treatment in NCC №2 (CCH RAS)

Peptic ulcer of the stomach is a disease in which defects (ulcers) form in the stomach and (or) duodenum of a person. Most often suffer from peptic ulcer men from 20 to 50 years old, and every year their number is constantly growing.

The disease is characterized by a chronic course and cyclicity: the disease undermines the health of its owner for years, periods of exacerbation are replaced by deceptive calm. Usually the ulcer makes itself felt in spring and autumn.

Interestingly, duodenal ulcer occurs much more frequently than gastric ulcer.

Causes of stomach ulcers

The leading role in the development of the disease is played by the spiral microbe Helicobacter pylori, which damages the mucous membrane of the stomach and duodenum. However, this microorganism can be found in more than 80% of the inhabitants of Russia, but not everyone suffers from peptic ulcer.

The fact is, an ulcer does not develop without a number of additional factors:

• stress, anxiety, depression;
• bad heredity;
• malnutrition: eating rough and spicy food, alcohol abuse;
• smoking;
• uncontrolled intake of certain drugs (reserpine, corticosteroid hormones, aspirin).

What’s going on?

The Helicobacter pylori microbe is transmitted from person to person through close, prolonged contact, such as kissing, sharing dishes and towels, and poor hygiene in toilets.

Once in the stomach, Helicobacter begins to actively multiply and conduct subversive activities. It produces special enzymes (urease, proteases) that damage the protective layer of the mucous membrane (inner) of the stomach and duodenum, disrupt cell function, mucus production and metabolic processes, and cause ulcers.
On the other hand, constant stress can change the functioning of the nervous system, which leads to spasm of the muscles and blood vessels of the stomach. As a result, he remains without food and loses his invulnerability: the walls begin to be digested by caustic gastric juice. An ulcer forms.

How to recognize?

First of all, pain in the upper abdomen signals the occurrence and development of peptic ulcer. Night pains are disturbing, in which a person needs to eat something to “quench” the pain.

Often worried about heartburn 2-3 hours after eating. Nausea, vomiting, “sour” belching, frequent constipation – all this indicates that it is time for you to contact a gastroenterologist.
Keep in mind, in some cases, the ulcer may be asymptomatic!

What is dangerous?

If the disease is not treated, the ulcer extends deep into the wall of the stomach. This process can end with life-threatening complications: perforation (perforation), in which a through hole is formed in the wall of the stomach or intestine, and bleeding.

Diagnostics

Esophagogastroduodenoscopy (EGDS) is necessary to establish the diagnosis of peptic ulcer. Doctors often refer to this test simply as a gastroscopy. Gastroscopy is performed on an outpatient basis: an endoscope is inserted through the mouth into the stomach – a narrow flexible tube with an optical device at the end, with which the doctor examines the gastrointestinal tract from the inside, takes samples of gastric juice, etc. If the patient for some reason refuses gastroscopy, ultrasound and radiography of the stomach will help to make the correct diagnosis.

Treatment

After the discovery of the microbe that causes peptic ulcer disease, doctors first of all began to prescribe antibiotics to patients (several at a time) to treat ulcers.
Additionally, patients are prescribed drugs that neutralize the main component of gastric juice – hydrochloric acid (antacids), or reduce its amount, as well as drugs that form a protective film on the surface of the gastric mucosa.
All ulcers should follow the correct daily regimen, if possible not be nervous, give up smoking and alcoholic beverages for the duration of treatment and adhere to a special diet.

The active course of treatment takes an average of 2 weeks, after which it is necessary to continue maintenance treatment and follow a diet.

Surgical intervention is required only for long-term non-healing stomach ulcers, as well as for complications of peptic ulcer. During an operation for a peptic ulcer, the affected area of ​​​​the stomach or intestines is most often removed, and some nerve branches are also cut, which helps to reduce the acidity of gastric juice.

Prophylaxis

To prevent new attacks of the disease, doctors recommend:

• take anti-ulcer drugs in courses in spring and autumn, when the likelihood of the disease returning is high;
• keep a diet and diet, limit alcohol consumption, smoking;
• Visit a gastroenterologist 1-2 times a year.

Gastric ulcer: causes, symptoms and recommendations for the treatment of the disease. Dr. Peter

Gastric ulcers are treatable, defects can heal completely, but without proper therapy, serious complications, even life-threatening, are possible. A stomach ulcer caused by painkillers often goes unnoticed until it causes complications such as bleeding. In rare cases, stomach ulcers can cause the stomach to perforate.

Stomach ulcers: causes

The two most common causes of stomach ulcers are Helicobacter pylori infection or long-term use of non-steroidal anti-inflammatory drugs. Helicobacter pylori bacteria can multiply in the lining of the stomach and cause infection there. Bacterial activity damages the mucous membrane and increases acid production in the stomach. As a result, the gastric mucosa loses its ability to protect the body.

The most common NSAIDs that cause ulcers are:

These drugs inhibit the production of the hormone prostaglandin, which, among other things, regulates the neutralization of stomach acid. If prostaglandin is absent, the mucosa is more susceptible to damage by stomach acid and pathogens. In some cases, a stomach ulcer may develop due to a combination of both causes. Non-steroidal anti-inflammatory drugs taken with cortisone can exacerbate stomach acid damage.

Stomach ulcer: symptoms

Stomach ulcer or simply an ulcer is a deep wound in the wall of the stomach. Occurs when the mucous membrane is damaged, most often when infected with Helicobacter pylori bacteria. In addition, regular use of non-steroidal anti-inflammatory drugs can cause drug-induced ulcers. The chance of getting a stomach ulcer increases with age.

Most stomach ulcers cause no symptoms or only some mild symptoms. They are often detected only in the presence of complications, especially if they were caused by taking painkillers. Many of the symptoms that occur with an ulcer are highly non-specific. A stomach ulcer can cause the following symptoms:

• feeling of pressure and fullness,

• loss of appetite,

• nausea and vomiting,

• irregular stools and gas s,

• heartburn and sour eructations,

• and pain in upper abdomen, often unrelated to food, or more likely to occur after a meal than before a meal.

Why gastric ulcer is dangerous

If a stomach ulcer is not detected and treated for a long time, serious complications can occur. The most common is gastrointestinal bleeding. Therefore, it is important to consult a doctor in a timely manner if the following symptoms appear:

• black stools,

• vomiting of blood (red or black),

• signs of anemia such as abnormal fatigue, shortness of breath on exertion, or pallor.

Frequent vomiting after eating is also a warning sign to seek immediate medical attention – this symptom can be caused by scarring on the pylorus (the outlet between the stomach and large intestine) due to repeated ulcers in this area. Scarring can lead to narrowing of the pylorus. As a result, the contents of the stomach come back with vomiting because they can no longer be transported to the intestines.

In very rare cases, stomach ulcers can lead to perforation of the stomach wall. It causes sudden, very severe abdominal pain and is life-threatening.

Diagnosis of gastric ulcer

If a doctor suspects a stomach ulcer, he will begin by palpation of the stomach, i. e. palpation of the epigastric region. This is usually followed by a gastroscopy to look at the esophagus and stomach. A tissue sample (biopsy) is taken during FGS and checked for Helicobacter pylori bacteria, signs of infection, and changes in tissue similar to those seen in cancer. In addition, a gastro-panel is prescribed, a set of tests to assess the work of digestion.

How to treat stomach ulcers

Gastric ulcers sometimes heal on their own without treatment within 2-3 months. However, it often develops again after a while. Treatment depends on the results of the gastroscopy and biopsy.

If doctors don’t find Helicobacter bacteria or cancer, proton pump inhibitors (PPIs) such as omeprazole and pantoprazole are usually given to treat stomach ulcers. They reduce the buildup of stomach acid. The drug is taken over a period of 4 to 8 weeks.

If a non-steroidal anti-inflammatory drug (NSAID) is the cause of the stomach ulcer, it should no longer be taken or an alternative should be used instead. Also, people with stomach ulcers should not smoke or drink alcohol, or at least take a break for a while.

If the cause is Helicobacter pylori infection, two additional antibiotics with different active ingredients are given along with proton pump inhibitors (triple therapy).

Quadruple therapy with three antibiotics and a proton pump inhibitor may also be an option for treating gastric ulcers, for example in cases of antibiotic resistance. In both cases, the drugs are taken simultaneously for 1-2 weeks. If symptoms persist, treatment with proton pump inhibitors alone can be continued.

Approximately 4 weeks after the end of antibiotic treatment, the doctor checks whether the treatment was successful. Your doctor will usually do a special breath test (urea test) to see if there are still Helicobacter bacteria in your stomach. If the test is positive, treatment with other antibiotics and a proton pump inhibitor may be repeated.

For severe bleeding, the ulcer is treated with minimally invasive surgery (endoscopy), which involves a small incision in the abdominal wall.