Stomach and Duodenal Ulcers (Peptic Ulcers)

What is a peptic ulcer?

A peptic ulcer is a sore on the lining of your stomach or the first part of your small intestine (duodenum). If the ulcer is in your stomach, it is called a gastric ulcer. If the ulcer is in your duodenum, it is called a duodenal ulcer.

Ulcers are fairly common.

What causes peptic ulcers?

In the past, experts thought lifestyle factors such as stress and diet caused ulcers. Today we know that stomach acids and other digestive juices help create ulcers. These fluids burn the linings of your organs.

Causes of peptic ulcers include:

• H. pylori bacteria (Helicobacter pylori). Most ulcers are caused by an infection from a bacteria or germ called H. pylori. This bacteria hurts the mucus that protects the lining of your stomach and the first part of your small intestine (the duodenum). Stomach acid then gets through to the lining.
• NSAIDs (nonsteroidal anti-inflammatory drugs). These are over-the-counter pain and fever medicines such as aspirin, ibuprofen, and naproxen. Over time they can damage the mucus that protects the lining of your stomach.

What are the symptoms of peptic ulcers?

Each person’s symptoms may vary. In some cases ulcers don’t cause any symptoms.

The most common ulcer symptom is a dull or burning pain in your belly between your breastbone and your belly button (navel). This pain often occurs around meal times and may wake you up at night. It can last from a few minutes to a few hours.

Less common ulcer symptoms may include:

• Feeling full after eating a small amount of food
• Burping
• Nausea
• Vomiting
• Not feeling hungry
• Losing weight without trying
• Bloody or black stool
• Vomiting blood

Peptic ulcer symptoms may look like other health problems. Always see your healthcare provider to be sure.

How are peptic ulcers diagnosed?

Your healthcare provider will look at your past health and give you a physical exam. You may also have some tests.

Imaging tests used to diagnose ulcers include:

• Upper GI (gastrointestinal) series or barium swallow. This test looks at the organs of the top part of your digestive system. It checks your food pipe (esophagus), stomach, and the first part of the small intestine (the duodenum). You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on an X-ray. 
• Upper endoscopy or EGD (esophagogastroduodenoscopy). This test looks at the lining of your esophagus, stomach, and duodenum. It uses a thin lighted tube called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your health care provider can see the inside of these organs. A small tissue sample (biopsy) can be taken. This can be checked for H. pylori.

You may also have the following lab tests to see if you have an H. pylori infection:

• Blood tests. These check for infection-fighting cells (antibodies) that mean you have H. pylori.
• Stool culture. A small sample of your stool is collected and sent to a lab. In 2 or 3 days, the test will show if you have H. pylori.
• Urea breath test. This checks to see how much carbon dioxide is in your breath when you exhale. You will swallow a urea pill that has carbon molecules. If you have H. pylori, the urea will break down and become carbon dioxide. You will have a sample taken of your breath by breathing into a bag. It will be sent to a lab. If your sample shows higher than normal amounts of carbon dioxide, you have H. pylori.

How are peptic ulcers treated?

Treatment will depend on the type of ulcer you have. Your healthcare provider will create a care plan for you based on what is causing your ulcer.

Treatment can include making lifestyle changes, taking medicines, or in some cases having surgery.

Lifestyle changes may include:

• Not eating certain foods. Avoid any foods that make your symptoms worse.
• Quitting smoking. Smoking can keep your ulcer from healing. It is also linked to ulcers coming back after treatment.
• Limiting alcohol and caffeine. They can make your symptoms worse.
• Not using NSAIDs (non-steroidal anti-inflammatory medicines). These include aspirin and ibuprofen.

Medicines to treat ulcers may include:

• Antibiotics. These bacteria-fighting medicines are used to kill the H. pylori bacteria. Often a mix of antibiotics and other medicines is used to cure the ulcer and get rid of the infection.
• h3-blockers (histamine receptor blockers).  These reduce the amount of acid your stomach makes by blocking the hormone histamine. Histamine helps to make acid.
• Proton pump inhibitors or PPIs. These lower stomach acid levels and protect the lining of your stomach and duodenum.
• Mucosal protective agents. These medicines protect the stomach’s mucus lining from acid damage so that it can heal.
• Antacids. These quickly weaken or neutralize stomach acid to ease your symptoms.

In most cases, medicines can heal ulcers quickly. Once the H. pylori bacteria is removed, most ulcers do not come back.

In rare cases, surgery may be needed if medicines don’t help. You may also need surgery if your ulcer causes other medical problems.

What are the complications of peptic ulcers?

Ulcers can cause serious problems if you don’t get treatment.

The most common problems include:

• Bleeding. As an ulcer wears away the muscles of the stomach or duodenal wall, blood vessels may be hurt. This causes bleeding.
• Hole (perforation). Sometimes an ulcer makes a hole in the wall of your stomach or duodenum. When this happens, bacteria and partly digested food can get in. This causes infection and redness or swelling (inflammation).
• Narrowing and blockage (obstruction). Ulcers that are found where the duodenum joins the stomach can cause swelling and scarring. This can narrow or even block the opening to the duodenum. Food can’t leave your stomach and go into your small intestine. This causes vomiting. You can’t eat properly.

When should I call my healthcare provider?

See your healthcare provider right away if you have any of these symptoms:

• Vomiting blood or dark material that looks like coffee grounds
• Extreme weakness or dizziness
• Blood in your stools (your stools may look black or like tar)
• Nausea or vomiting that doesn’t get better, or gets worse
• A sudden, severe pain that may spread to your back
• Losing weight without even trying

Untreated peptic ulcers may cause other health problems. Sometimes they bleed. If they become too deep, they can break through your stomach.

Ulcers can also keep food from going through your stomach.

Key points

• These ulcers are sores on the lining of your stomach or the first part of your small intestine (the duodenum).
• Stomach acids and other digestive juices help to make ulcers by burning the linings of these organs.
• Most ulcers are caused by infection from a bacteria or germ called H. pylori (Helicobacter pylori) or from using pain killers called NSAIDs.
• The most common symptom is a dull or burning pain in the belly between the breastbone and the belly button.
• Ulcers can be treated with a mix of lifestyle changes and medicines. In rare cases, surgery is needed.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Peptic ulcers: what are the symptoms?

The symptoms of peptic ulcers, which comprise gastric (or stomach) ulcers and duodenal ulcers, can vary from person to person and with the location of the ulcer. You may have an ulcer without experiencing any symptoms, have obvious symptoms, or experience a complication, such as bleeding or perforation.

Common symptoms of peptic ulcers

The following symptoms are commonly associated with peptic ulcers. However, bear in mind that peptic ulcers often cause no symptoms, especially in older people.

Burning or gnawing abdominal pain

Abdominal pain or discomfort is a typical symptom of peptic ulcers (both gastric and duodenal). The pain tends to come and go, and is often worse at night.

You may feel the pain anywhere in the area between your navel and your breastbone. It often occurs when the stomach is empty.

The pain may last from between a few minutes to several hours, and may be relieved by eating, drinking milk or taking antacid medicines. However, sometimes eating can make symptoms worse. In addition, drinking milk may be just a temporary fix. While it can improve symptoms quickly, it may increase acid production later on, making symptoms worse.

The pain or discomfort associated with peptic ulcers is sometimes referred to as ‘dyspepsia’.

Nausea and vomiting

Sometimes you might experience nausea or vomiting. These symptoms are not as common as abdominal pain.

Nausea associated with a peptic ulcer may be relieved by eating.

Loss of appetite and weight

Again these symptoms are less common than abdominal pain, but people with peptic ulcers may suffer from loss of appetite and so lose weight.

More serious symptoms

Sometimes people are not aware they have an ulcer until they experience a serious complication, and some of these may include the following.

Haemorrhage

As an ulcer corrodes the lining of the stomach or duodenum, it may extend into the stomach or duodenal wall. In these cases, blood vessels can also be damaged, which can cause bleeding.

If these blood vessels are small, the blood may slowly seep into the digestive tract, leading to the development of anaemia over time. This may make you feel weak, dizzy or tired.

If larger blood vessels are involved, the bleeding will occur much more rapidly. This is a more dangerous situation. You may feel weak when you stand up, or you may faint or vomit blood. Your stools may be a black or dark red colour (from the blood) and ‘tar-like’ in consistency.

If you have any of these symptoms you should seek medical attention immediately, as you may need treatment to stop the bleeding.

Perforation and penetration

Although rare, ulcers can develop to such an extent that they completely perforate through the stomach or duodenal wall. This can cause the gastric contents, including partially digested food, to leak through this opening into the abdominal cavity, resulting in peritonitis (inflammation of the membrane that lines the abdominal cavity). This can cause sudden, severe abdominal pain that is worsened by any kind of movement.

Sometimes an ulcer may penetrate through the wall of the stomach or duodenum into another abdominal organ, such as the pancreas.

Perforation and penetration of ulcers is a medical emergency that needs immediate treatment in hospital.

Narrowing and obstruction

If your ulcer is located at the end of the stomach where it attaches to the duodenum, the scarring it causes may eventually narrow the opening to the duodenum. This will prevent food from leaving your stomach and moving into the small intestine.

If this happens you may experience nausea and vomiting, as well as worsening abdominal pain and bloating. You may also feel full after eating a small amount of food.

See your doctor about ulcer symptoms

If you are experiencing upper abdominal pain (tummy pain) or any of the other symptoms mentioned above, you should see your doctor. If your doctor suspects you may have a peptic ulcer they will want to confirm the cause and diagnosis and start treatment.

1. BMJ Best Practice. Peptic ulcer disease (updated Jan 2018; reviewed Sep 2018). https://bestpractice.bmj.com/topics/en-gb/80 (accessed Oct 2018).
2. Gastric disorders (published March 2016). In: eTG complete. Melbourne: Therapeutic Guidelines Limited; 2018 Jul. https://tgldcdp.tg.org.au/ (accessed Oct 2018).
3. Mitchell H, Katerlaris P. Epidemiology, clinical impacts and current clinical management of Helicobacter pylori infection. Med J Aust 2016; 204 (10): 376-380. || doi: 10.5694/mja16.00104. https://www.mja.com.au/journal/2016/204/10/epidemiology-clinical-impacts-and-current-clinical-management-helicobacter (accessed Oct 2018).

Stomach ulcer (Gastric ulcer) | NHS inform

If you have a stomach ulcer, your treatment will depend on what caused it.

With treatment, most ulcers heal in a month or two.

Treating Helicobacter pylori (H. pylori) infection

If your stomach ulcer’s caused by a Helicobacter pylori (H. pylori) bacterial infection, you’ll be given:

• a course of antibiotics
• a medication called a proton pump inhibitor (PPI)

This is also recommended if it’s thought your stomach ulcer’s caused by a combination of an H. pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs).

Antibiotics

If you have an H. pylori infection, you’ll usually be prescribed a course of 2 or 3 antibiotics.

The most commonly used antibiotics are:

• amoxicillin
• clarithromycin
• metronidazole

You should take these twice a day for a week.

Side effects

The side effects of these are usually mild, but can include:

• feeling and being sick
• diarrhoea
• a metallic taste in your mouth

Further testing

You’ll be re-tested at least 4 weeks after finishing your antibiotic course to see if there are any H. pylori bacteria left in your stomach. If there are, a further course of eradication therapy using different antibiotics may be given.

Ulcers caused by NSAIDs

If your stomach ulcer’s caused by taking NSAIDs:

• you’ll be given a course of PPI medication
• your use of NSAIDs will be reviewed, and you may be advised to use an alternative painkiller

Alternative painkillers

You may be advised to use an alternative painkiller not associated with stomach ulcers, such as paracetamol.

COX-2 inhibitors are sometimes recommended. These are an alternative type of NSAID that’s less likely to cause stomach ulcers.

Low-dose aspirin

If you’re taking low-dose aspirin to reduce your risk of blood clots, your GP will tell you whether you need to keep taking it.

If you do, you may also be prescribed long-term treatment with a PPI or h3-receptor antagonist to prevent further ulcers.

Complications

It’s important to understand the potential risks associated with continued NSAID use.

You’re more likely to develop another stomach ulcer and could experience a serious complication, such as internal bleeding.

Read more about the complications of stomach ulcers

Proton pump inhibitors (PPIs)

PPIs work by reducing the amount of acid your stomach produces. This prevents further damage to the ulcer as it heals naturally.

The most commonly used PPIs are:

• omeprazole
• pantoprazole
• lansoprazole

They’re usually prescribed for 4 to 8 weeks.

Side effects

Side effects of these are usually mild, but can include:

These should pass once treatment has been completed.

h3-receptor antagonists

Sometimes a type of medication called h3-receptor antagonists are used instead of PPIs.

These also reduce the amount of acid your stomach produces.

Ranitidine is the most widely used h3-receptor antagonist for treating stomach ulcers.

Side effects

Side effects are uncommon, but can include:

• diarrhoea
• headaches
• dizziness
• rashes
• tiredness

Antacids and alginates

As these treatments can take several hours before they start to work, your GP may recommend taking additional antacid medication.

Antacids:

• neutralise your stomach acid
• provide immediate, but short-term, symptom relief
• should be taken when you experience symptoms or when you expect them, such as after meals or at bedtime

Some antacids also contain a medicine called an alginate, which produces a protective coating on the lining of your stomach. Antacids containing alginates are best taken after meals.

You can buy these medications at pharmacies. Your pharmacist can tell you which is most suitable for you.

Side effects

Side effects of both medications are usually mild, but can include:

Lifestyle changes

There aren’t any special lifestyle measures you need to take during treatment.

However, avoiding stress, alcohol, spicy foods and smoking may reduce your symptoms while your ulcer heals.

Stomach Ulcer (Gastric Ulcer) | Symptoms and Treatment

What are stomach ulcers?

Dr Sarah Jarvis MBE

How common are stomach ulcers?

It’s not known exactly how common stomach ulcers are. They have become much less common since the 1980s because of much more effective treatments. So people with stomach ulcers now usually get better much more quickly.

The term ‘peptic ulcer’ is used to describe ulcers that are caused by too much acid in the stomach. This includes stomach ulcers and also ulcers in the first part of the gut (small intestine) known as the duodenum. Stomach ulcers are less common than duodenal ulcers.

Stomach ulcer symptoms

The main symptom caused by a stomach ulcer is having a pain in the upper tummy (abdomen). Other symptoms may include:

• Bloating. This means your tummy swells because your stomach is full of gas or air.
• Retching. Also known as ‘heaving’. This means sounding and looking as though you’re about to be sick (vomit) but not actually vomiting.
• Feeling sick (nausea).
• Vomiting.
• Feeling very ‘full’ after a meal.

What are the symptoms of any complications?

Stomach ulcers can cause various complications but these are much less common now because of more effective treatments. However, complications can be very serious and include:

Bleeding from the ulcer

• This can range from a ‘trickle’ to a life-threatening bleed.
• If there is sudden heavy bleeding then this will cause you to vomit blood (this is called a haematemesis) and make you feel very faint.
• Less sudden bleeding may cause you to vomit and the vomit looks coffee-coloured because the stomach acid has partly broken down the blood.
• A more gradual trickle of blood will pass through your gut (bowel) and cause your stools (faeces) to look very dark in colour or even black (this is called melaena).

Perforation
This is the term used to describe the ulcer having gone all the way through (perforated) the wall of the stomach. Food and acid in the stomach then leak out of the stomach. This usually causes severe pain and makes you very unwell. Stomach perforation is a medical emergency and needs hospital treatment as soon as possible.

Stomach blockage
This is now rare. An ulcer at the end of the stomach can cause the outlet of the stomach (the part of the stomach that goes into the duodenum) to narrow and cause an obstruction. This can cause frequent severe vomiting.

Stomach ulcer treatment

General advice

Lifestyle measures can improve symptoms, such as:

Acid-suppressing medication

A 4- to 8-week course of a medicine that greatly reduces the amount of acid that your stomach makes is usually advised. See the separate leaflet called Indigestion Medication for more information.

If your ulcer was caused by Helicobacter pylori (H. pylori)

Most stomach ulcers are caused by infection with H. pylori. Therefore, a main part of the treatment is to clear this infection. If this infection is not cleared, the ulcer is likely to return once you stop taking acid-suppressing medication. For more information, see the separate leaflet called Helicobacter Pylori.

If your ulcer was caused by an anti-inflammatory medicine

If possible, you should stop taking the anti-inflammatory medicine. This allows the ulcer to heal. You will also normally be prescribed an acid-suppressing medicine for several weeks. This stops the stomach from making acid and allows the ulcer to heal. However, in many cases, the anti-inflammatory medicine is needed to ease symptoms of arthritis or other painful conditions, or aspirin is needed to protect against blood clots. In these situations, one option is to take an acid-suppressing medicine each day indefinitely. This reduces the amount of acid made by the stomach and greatly reduces the chance of an ulcer forming again.

What about surgery?

In the past, surgery was commonly needed to treat a stomach ulcer. This was before it was discovered that H. pylori infection was the cause of most stomach ulcers, and before modern acid-suppressing medicines became available. Surgery is now usually only needed if a complication of a stomach ulcer develops, such as severe bleeding or a hole (perforation).

What happens after treatment?

A repeat gastroscopy (endoscopy) is usually advised a few weeks after treatment has finished. This is mainly to check that the ulcer has healed. It is also to be doubly certain that the ‘ulcer’ was not due to stomach cancer. If your ulcer was caused by H. pylori then a test is advised to check that the H. pylori infection has gone. This is done at least four weeks after the course of combination therapy has finished.

What causes stomach ulcers?

Your stomach normally produces acid to help with the digestion of food and to kill germs (bacteria). This acid is corrosive, so some cells on the inside lining of the stomach and the first part of the gut (small intestine) known as the duodenum produce a natural mucous barrier. This protects the lining of the stomach and duodenum.

There is normally a balance between the amount of acid that you make and the mucous defence barrier. An ulcer may develop if there is an alteration in this balance, allowing the acid to damage the lining of the stomach or duodenum. Causes of this include the following:

Infection with H. pylori

Infection with H. pylori is the cause in about 8 in 10 cases of stomach ulcer. See the separate leaflet called Helicobacter Pylori for more information.

Anti-inflammatory medicines – including aspirin

Anti-inflammatory medicines are sometimes called non-steroidal anti-inflammatory drugs (NSAIDs). Certain indigestion medications are sometimes used at the same time as an NSAID to prevent an ulcer.

Other causes and factors

Other causes are rare. For example, some viral infections can cause a stomach ulcer. Crohn’s disease may cause a stomach ulcer in addition to other problems of the gut.

Stomach cancer may at first look similar to an ulcer. Stomach cancer is uncommon but may need to be ‘ruled out’ if you are found to have a stomach ulcer.

What tests are there for a stomach ulcer?

If your doctor thinks you may have a stomach ulcer, the initial tests will include some blood tests. These tests will help to check whether you have become anaemic because of any bleeding from the ulcer. The blood test will also check to see that your liver and pancreas are working properly.

The main tests that are then used to diagnose a stomach ulcer are as follows:

• A test to detect the H. pylori germ (bacterium) is usually done if you have a stomach ulcer. The H. pylori bacterium can be detected in a sample of stool (faeces), or in a ‘breath test’, or from a blood test, or from a biopsy sample taken during a gastroscopy. See the separate leaflet called Helicobacter Pylori for more details.
• Gastroscopy (endoscopy) is the test that can confirm a stomach ulcer. Gastroscopy is usually done as an outpatient ‘day case’. You may be given a sedative to help you to relax. In this test, a doctor looks inside your stomach by passing a thin, flexible telescope down your gullet (oesophagus). The doctor will then be able to see any inflammation or ulcers in your stomach.
• Small samples (biopsies) are usually taken of the tissue in and around the ulcer during gastroscopy. These are sent to the laboratory to be looked at under the microscope. This is important because some ulcers are caused by stomach cancer. However, most stomach ulcers are not caused by cancer.

Stomach ulcer – Better Health Channel

A stomach or gastric ulcer is a break in the tissue lining the stomach. The term ‘peptic ulcer’ refers to those that occur in either the stomach or the first part of the small intestine that leads out of the stomach, called the duodenum.

It was once commonly thought that stress, smoking and diet were the principal causes of stomach ulcers. However, the Helicobacter pylori (H. pylori) bacterium is now known to be responsible for most duodenal ulcers and 60 per cent of stomach ulcers. The H. pylori bacterium also prompts many symptoms of dyspepsia, or indigestion.

Treatment for stomach ulcers includes the use of antibiotics to kill the infection, and acid-suppressing drugs.

Symptoms of stomach ulcers

Some stomach ulcers don’t produce any symptoms. If present, they can include:

• abdominal pain just below the ribcage
• indigestion
• nausea
• loss of appetite
• vomiting
• weight loss
• bright or altered blood present in vomit or bowel motions
• symptoms of anaemia, such as light-headedness
• shock due to blood loss – a medical emergency.

The stomach

The stomach is an organ of the digestive system, located in the abdomen just below the ribs and on the left. Swallowed food is squeezed down the oesophagus and pushed through a sphincter (small muscle ring) into the stomach, where it is mixed with powerful gastric juices containing enzymes and hydrochloric acid. The stomach is a muscular bag, so it can churn the food and break it down mechanically as well as chemically.

Once the food is the consistency of smooth paste, it is squeezed through a second sphincter into the first part of the small intestine (duodenum). The lining of the stomach – the mucosa or gastric epithelium – is layered with multiple folds. Ulcers occur in this lining.

Causes of stomach ulcers

A stomach ulcer can be caused by a variety of factors, including:

• Helicobacter pylori – bacteria is thought to be responsible for around 60 per cent of stomach ulcers and at least 90 per cent of duodenal ulcers.
• Certain medications – which include aspirin or clopidogrel, taken regularly to help prevent heart attack or stroke, and drugs for arthritis. Anti-inflammatory medications (NSAIDS) are thought to cause around two fifths of stomach ulcers.
• Cancer – stomach cancer can present as an ulcer, particularly in older people.

Helicobacter pylori

The Helicobacter pylori bacterium (H. pylori) is the main cause of peptic ulcers. The discovery of this micro-organism in 1983 revolutionised many aspects of gastroenterology, including the treatment of stomach ulcers.

It is thought that about one in three people over the age of 40 years is infected with this strain of bacteria in Australia. The germs live in the lining of the stomach and the chemicals they produce cause irritation and inflammation. H. pylori directly causes one third of stomach ulcers and is a contributing factor in around three fifths of cases. Other disorders caused by this infection include inflammation of the stomach (gastritis) and dyspepsia (indigestion).

Researchers believe the germ could also play a contributing role in the development of stomach cancers. The infection is more common among poor or institutionalised people. The mode of transmission is so far unknown, but is thought to include sharing food or utensils, coming into contact with infected vomit, and sharing of water (such as well water) in undeveloped populations.

Ulcer bleeding

This is a serious complication of ulcer disease and is particularly deadly in the elderly or those with multiple medical problems. Bleeding from stomach ulcers is more common in people treated with blood thinning agents, such as warfarin, aspirin or clopidogrel (Plavix) and those people should also consider using regular anti-ulcer medication to prevent this complication.

Perforated ulcer

A severe, untreated ulcer can sometimes burn through the wall of the stomach, allowing digestive juices and food to leak into the abdominal cavity. This medical emergency is known as a perforated ulcer. Treatment generally requires immediate surgery.

Diagnosis of a stomach ulcer

Diagnosing a stomach ulcer is done using a range of methods, including:

• Endoscopy – a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia. The endoscope is fitted with a small camera so the physician can see if there is an ulcer.
• Barium meal – a chalky liquid is drunk and an x-ray is performed, showing the stomach lining. These tests are less common nowadays, but may be useful where endoscopy is unavailable.
• Biopsy – a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found.
• C14 breath test – this checks for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon (C14) and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.

Treatment for a stomach ulcer

Special diets are now known to have very little impact on the prevention or treatment of stomach ulcers. Treatment options can include:

• medication – including antibiotics, to destroy the H. pylori colony, and drugs to help speed the healing process. Different drugs need to be used in combination; some of the side effects can include diarrhoea and rashes. Resistance to some of these antibiotics is becoming more common
• subsequent breath tests – used to make sure the H. pylori infection has been treated successfully
• changes to existing medication – the doses of arthritis medication, aspirin or other anti-inflammatory medication can be altered slightly to reduce their contributing effects on the stomach ulcer.
• reducing acid – tablets are available to reduce the acid content in the gastric juices
• lifestyle modifications – including quitting cigarettes, since smoking reduces the natural defences in the stomach and impairs the healing process.

Where to get help

• Your doctor
• NURSE-ON-CALL Tel. 1300 60 60 24 – for expert health information and advice (24 hours, 7 days)
• Gastroenterologist

Things to remember

• A stomach or gastric ulcer is a break in the tissue lining of the stomach.
• Most stomach ulcers are caused by infection with the Helicobacter pylori bacterium or anti-inflammatory medication, not stress or poor diet as once thought.
• Treatment options include antibiotics and acid-suppressing medications.

Peptic ulcer – Healthily

If you have a stomach ulcer, your treatment will depend on whether the cause is an H. pylori infection, non-steroidal anti-inflammatory drugs (NSAIDs) or both.

If your stomach ulcer is caused by an H. pylori infection, a course of antibiotics is recommended. This is known as eradication therapy because it will kill the bacteria.

If your stomach ulcer is caused by NSAIDs and you don’t have a H. pylori infection, a one-to two-month course of proton pump inhibitors (PPIs) are recommended. Your use of NSAIDs will also need to be reviewed and an alternative painkiller, such as paracetamol, may be recommended.

If it is thought that your stomach ulcer is caused by a combination of NSAID use and an H. pylori infection, you will be given a two-month course of PPIs and a course of eradication therapy.

An alternative type of medication, known as h3-receptor antagonists, are sometimes used instead of PPIs.

Eradication therapy

Eradication therapy involves taking a combination of two or three different antibiotics and a proton pump inhibitor (PPI), all at the same time. Taking one antibiotic alone is insufficient to kill the germ. You will usually be asked to take each antibiotic twice a day for 7-14 days. The antibiotics most commonly used in eradication therapy are:

• amoxicillin
• clarithromycin
• metronidazole

The side effects are usually mild and include:

• feeling sick
• diarrhoea
• a metallic taste in your mouth
• grey colouring of saliva or your stools

Try to persist with treatment if you only have mild side effects. Stop if you have severe watery diarrhoea or an obvious allergic reaction.

You will be re-tested at least four weeks after eradication therapy has been completed to see whether there are any H. pylori bacteria left in your stomach. If there is, you will be given a further course of eradication therapy using different antibiotics in combination with PPIs.

Proton pump inhibitors (PPIs)

Proton pump inhibitors (PPIs) work by blocking the actions of proteins called proton pumps, which are partially responsible for producing stomach acid. Reducing the amount of stomach acid prevents any further damage to your stomach ulcer, allowing it to heal naturally.

Lansoprazole and omeprazole are the two PPIs most commonly used to treat stomach ulcers. Side effects of these are usually mild but include:

These should pass once treatment has been completed.

h3-receptor antagonists

h3-receptor antagonists work by blocking the actions of a protein called histamine, which is also responsible for stimulating the production of acid.

Ranitidine is the most widely used h3-receptor antagonist for treating stomach ulcers.

Side effects are uncommon but may include:

• diarrhoea
• headaches
• dizziness
• skin rashes
• tiredness

Antacids and alginates

All of the treatments discussed above can take several hours before they start to work, so it is likely that your doctor will recommend some additional medication to help provide short-term symptom relief. .

Two types of medication that can be used are:

• antacids – to help neutralise stomach acid on a short-term basis
• alginates – which produce a protective coating on the lining of your stomach

Both antacids and alginates are available to buy over the counter at pharmacies. Your pharmacist will be able to advise you about the types of antacid and alginate most suitable for you.

Antacids are best taken when you experience symptoms or when you expect them, such as after meals or at bedtime. Alginates are best taken after meals.

Don’t take these medications within an hour of taking proton pump inhibitors or ranitidine as they may block the effects.

Side effects for both medications are uncommon but include:

Bananas are also thought to provide a protective effect against stomach acid, so you may want to consider eating these as an alternative way to relieve your symptoms, if you don’t want to take antacids or alginates.

Reviewing NSAID use

If your stomach ulcer has been caused by taking NSAIDs, your doctor will want to review your use of them.

You will usually be advised to use an alternative painkiller that is not linked to stomach ulcers, such as paracetamol or a low-dose opiate-based painkiller.

If you are taking low-dose aspirin to reduce your risk of getting blood clots, your doctor will help you decide whether you need to continue taking it. In most cases it is continued or only stopped for a few days.

In these cases a PPI is given as well as the aspirin to try to prevent further ulceration, and this is usually very effective. If you or your doctor feel that the continued used of NSAIDs is absolutely necessary, you will be prescribed a long-term course of a PPI or h3-receptor antagonist.

It is important that you understand the potential drawbacks and risks associated with continued NSAID use. You are more likely to develop another stomach ulcer and the risks of experiencing serious complications, such as internal bleeding, are higher.

Read more about the complications of stomach ulcers

An allergen is a substance that reacts with the body’s immune system and causes an allergic reaction.

Antibiotics are medicines that can be used to treat infections caused by micro-organisms, usually bacteria or fungi. For example amoxicillin, streptomycin and erythromycin.

Anti-inflammatory medicines reduce swelling and inflammation.

Bacteria are tiny, single-celled organisms that live in the body. Some can cause illness and disease and some others are good for you.

Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.

A blood transfusion involves transferring blood into a person using a tube that goes directly into a vein in the arm.

Blood vessels are the tubes in which blood travels to and from parts of the body. The three main types of blood vessels are veins, arteries and capillaries.

The brain controls thought, memory and emotion. It sends messages to the body controlling movement, speech and senses.

Dose is a measured quantity of a medicine to be taken at any one time, such as a specified amount of medication.

The sac-like organ of the digestive system. It helps digest food by churning it and mixing it with acids to break it down into smaller pieces.

An ulcer is a sore break in the skin, or on the inside lining of the body.

Abdominal pain | UF Health, University of Florida Health

Definition

Abdominal pain is pain that you feel anywhere between your chest and groin. This is often referred to as the stomach region or belly.

Video: Abdominal pain

Alternative Names

Stomach pain; Pain – abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache

Considerations

Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious.

Abdominal organs

How bad your pain is does not always reflect the seriousness of the condition causing the pain.

For example, you might have very bad abdominal pain if you have gas or stomach cramps due to viral gastroenteritis.

However, fatal conditions, such as colon cancer or early appendicitis, may only cause mild pain or no pain.

Other ways to describe pain in your abdomen include:

• Generalized pain — This means that you feel it in more than half of your belly. This type of pain is more typical for a stomach virus, indigestion, or gas. If the pain becomes more severe, it may be caused by a blockage of the intestines.
• Localized pain — This is pain found in only one area of your belly. It is more likely to be a sign of a problem in an organ, such as the appendix, gallbladder, or stomach.
• Cramp-like pain — This type of pain is not serious most of the time. It is likely to be due to gas and bloating, and is often followed by diarrhea. More worrisome signs include pain that occurs more often, lasts more than 24 hours, or occurs with a fever.
• Colicky pain — This type of pain comes in waves. It very often starts and ends suddenly, and is often severe. Kidney stones and gallstones are common causes of this type of belly pain.

Causes

Many different conditions can cause abdominal pain. The key is to know when you need to get medical care right away. Sometimes, you may only need to call a health care provider if your symptoms continue.

Less serious causes of abdominal pain include:

Other possible causes include:

Appendicitis

Sometimes, abdominal pain may occur due to a problem somewhere else in your body, such as your chest or pelvic area. For example, you may have abdominal pain if you have:

Home Care

You can try the following home care steps to ease mild abdominal pain:

• Sip water or other clear fluids. You may have sports drinks in small amounts. People with diabetes must check their blood sugar often and adjust their medicines as needed.
• Avoid solid food for the first few hours.
• If you have been vomiting, wait 6 hours, and then eat small amounts of mild foods such as rice, applesauce, or crackers. Avoid dairy products.
• If the pain is high up in your abdomen and occurs after meals, antacids may help, especially if you feel heartburn or indigestion. Avoid citrus, high-fat foods, fried or greasy foods, tomato products, caffeine, alcohol, and carbonated beverages.
• DO NOT take any medicine without talking to your provider.

These additional steps may help prevent some types of abdominal pain:

• Drink plenty of water each day.
• Eat small meals more frequently.
• Exercise regularly.
• Limit foods that produce gas.
• Make sure that your meals are well-balanced and high in fiber. Eat plenty of fruits and vegetables.

When to Contact a Medical Professional

Get medical help right away or call your local emergency number (such as 911) if you:

• Are currently being treated for cancer
• Are unable to pass stool, especially if you are also vomiting
• Are vomiting blood or have blood in your stool (especially if bright red, maroon or dark, tarry black)
• Have chest, neck, or shoulder pain
• Have sudden, sharp abdominal pain
• Have pain in, or between, your shoulder blades with nausea
• Have tenderness in your belly, or your belly is rigid and hard to the touch
• Are pregnant or could be pregnant
• Had a recent injury to your abdomen
• Have difficulty breathing

Call your provider if you have:

• Abdominal discomfort that lasts 1 week or longer
• Abdominal pain that does not improve in 24 to 48 hours, or becomes more severe and frequent and occurs with nausea and vomiting
• Bloating that persists for more than 2 days
• Burning sensation when you urinate or frequent urination
• Diarrhea for more than 5 days
• Fever, over 100°F (37. 7°C) for adults or 100.4°F (38°C) for children, with pain
• Prolonged poor appetite
• Prolonged vaginal bleeding
• Unexplained weight loss

What to Expect at Your Office Visit

Your provider will perform a physical exam and ask about your symptoms and medical history. Your specific symptoms, the location of pain and when it occurs will help your provider detect the cause.

LOCATION OF YOUR PAIN

• Where do you feel the pain?
• Is it all over or in one spot?
• Does the pain move into your back, groin, or down your legs?

TYPE AND INTENSITY OF YOUR PAIN

• Is the pain severe, sharp, or cramping?
• Do you have it all the time, or does it come and go?
• Does the pain wake you up at night?

HISTORY OF YOUR PAIN

• Have you had similar pain in the past? How long has each episode lasted?
• When does the pain occur? For example, after meals or during menstruation?
• What makes the pain worse? For example, eating, stress, or lying down?
• What makes the pain better? For example, drinking milk, having a bowel movement, or taking an antacid?
• What medications are you taking?

OTHER MEDICAL HISTORY

• Have you had a recent injury?
• Are you pregnant?
• What other symptoms do you have?

Tests that may be done include:

Images

References

MacGilchrist A, Iredale J, Parks R. The gastrointestinal system. In: Douglas G, Nicol F, Robertson C, eds. Macleod’s Clinical Examination. 13th ed. Philadelphia, PA: Elsevier; 2013:chap 8.

McQuaid KR. Approach to the patient with gastrointestinal disease. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 132.

Millham FH. Acute abdominal pain. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran’s Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 11.

Smith KA. Abdominal pain. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen’s Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 24.

Squires R, Carter SN, Postier RG. Acute abdomen. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 45.

Swartz MH. The abdomen. In: Swartz MH, ed. Textbook of Physical Diagnosis. 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 14.

90,000 types of pain, causes and their treatment

Stomach pain is one of the symptoms of many diseases. Moreover, often it is not directly related to this digestive organ and indicates problems with others. What can stomach pain speak about, how to find out its cause, and what makes sense to take to relieve pain?

Causes of stomach pain

The first question your doctor will ask you is about the nature of your stomach pain. It is the answer that can say a lot about the disease that caused the pain.

• Acute stomach pain that comes on suddenly, often indicates pancreatitis, cholecystitis, and duodenal ulcer.
• Sharp, sudden pain can be caused by chemical burns of mucous membranes or poisoning.
• Very severe sharp pain, which patients describe with the words “like a knife stuck in”, is often the result of perforation of the ulcer.
• A burning sensation is characteristic of an ulcer or gastritis, and a dull aching pain in the stomach is a symptom of the same diseases in a chronic or initial form.With gastritis, there is a clear connection with food intake: pain appears either immediately after eating, or when a person is pretty hungry.
• Spasmodic, cramping pain is often a sign of an ulcer or inflammation of the duodenum. Such pain often bothers at night or a few hours after the last meal.
• Acute, but short-term (several seconds) “shooting” pain, which occurs when inhaling or a sudden change in body position, is typical of spasms of the diaphragm, arising from inflammation or circulatory disorders.
• Constant weak aching pain in the stomach often accompanies malignant neoplasms, as well as stomach polyps. As the cancer spreads to the pancreas, the pain becomes girdle.
• Severe cramping pain is most common with gastrointestinal infections.
• Intense pain in the upper abdomen, which subsides after a couple of days, but remains constant – a fairly characteristic symptom of pathologies of the large intestine, in particular, colitis.
• Severe pain in the navel that travels to the right upper abdomen for several hours may indicate appendicitis.

These are not all causes of stomach pain. Sometimes this symptom accompanies other diseases – irritable bowel syndrome, bowel thrombosis, dissection of the abdominal aorta, intestinal obstruction, stomach trauma, ischemic heart disease, some nervous diseases, allergic reactions, etc.

Most diseases associated with this symptom are very serious and require immediate medical attention. Moreover, in some cases, the word “immediate” has a literal meaning – with appendicitis, perforation of an ulcer and severe poisoning, it can take hours, and even a slight delay can become fatal.

What to do in case of pain in the stomach area

Whatever the cause of the pain in the stomach, you cannot treat it yourself. Even an experienced doctor with many years of practice cannot make a diagnosis with complete certainty based on external signs alone. And a person without a medical education is even more unable to do this.

The number of first aid measures that can be provided for stomach pain is very small. The most you can do before the doctor arrives is to take an antispasmodic or analgesic.For heartburn, take antacids – drugs that reduce acidity, or antisecretory drugs that inhibit the production of acid. However, heartburn is not always associated with high acidity, so taking such funds may not only be useless, but also worsen the condition.

Special care should be taken with drugs in general: exposure to drugs can distort symptoms and create difficulties in diagnosis. It is also important to understand that modern pain relievers are very effective and can completely eliminate stomach pain for a fairly long time.This creates a false impression of recovery. However, the disease does not disappear anywhere. Removing pain in the stomach with pills, you only waste precious time: treat the effect, forgetting about the cause.

Important!
Under no circumstances should a heating pad be used to relieve stomach pain. In some conditions, heat can actually help and relieve pain, but in others (in particular, with purulent inflammation and bleeding), it significantly accelerates the development of the disease and worsens the condition.

You can help the doctor with the diagnosis. To do this, you will need to provide him with as complete information as possible about your condition. Therefore, before admission to the clinic, try to remember and formulate in as much detail as possible:

• the circumstances of the onset of pain (before, after or during meals, day or night) and its nature (sudden or gradually increasing, acute, aching, sharp, burning, cramping) … Try to remember if the source of the pain moved, and if so, how.
• ration in the last days before the onset of pain: what, when and how much did you eat (food and drinks).
• List of medicines you are taking (including dietary supplements and vitamin complexes).
• any additional symptoms. It is important for the doctor to know if you have experienced nausea and vomiting, bitter taste in the mouth, diarrhea or constipation, belching and bloating, blood or mucus in your stools, rash, fever, shortness of breath, rapid heartbeat and dizziness, any other pain ( head, muscle, articular).
• Recent changes in health status. These include both natural (pregnancy, childbirth, lactation, menopause) and pathological. Remember all the illnesses, nervous shocks, episodes of severe fatigue that have been suffered in recent times. Factors such as sudden weight gain or unreasonable weight loss, the development of anxiety and depression, and changes in lifestyle may be significant.

Organizing this information is the best help you can give yourself.But the diagnosis and treatment should be carried out by a qualified specialist.

Diagnostics

Diagnosis of diseases that cause stomach pain begins with interviewing the patient (here the above information will be very useful to you) and an external examination, including palpation of the abdomen, listening to the heart rate and lung function.

Then the doctor will without fail send you to the delivery of biomaterial for laboratory tests. Typically, this list includes urine and feces analysis, general and biochemical blood tests, and gastric juice analysis.

For an accurate diagnosis, instrumental studies are also necessary – ultrasound of the abdominal organs, less often – an X-ray with contrast, CT or MRI.

In the vast majority of cases, the diagnosis is clarified after these basic studies. Much less often, more serious diagnostic measures are required, such as laparoscopy, in which a microcamera on a flexible probe is inserted through a small incision into the hollow organs, which allows the doctor to assess their condition visually.

Treatment of diseases and conditions that provoke pain syndrome

The treatment regimen for stomach pain depends entirely on the reasons that caused these unpleasant sensations.Consider the principles of therapy for the most common causes of stomach pain.

Elimination of heartburn

Heartburn is a burning sensation behind the breastbone, in the upper abdomen. The reason is the ingress of stomach contents into the esophagus. Most often, it appears half an hour after eating. Heartburn is not an independent disease, but a symptom of diseases such as gastritis, duodenitis, stomach or intestinal ulcers, cholecystitis and others. Heartburn is often confused with the manifestations of certain heart diseases – angina pectoris and hypertension, in which a similar sensation appears, in no way, however, not related to the gastrointestinal tract.However, most often heartburn is the result of gastritis or gastric ulcer.

Measures to eliminate heartburn are to treat the underlying condition that caused it. In addition, a special diet is recommended: for any type of heartburn, you need to eat often (5-6 times a day), but little by little, completely eliminating fatty foods, hot spices, smoked meats and pickles, carbonated drinks and alcohol, legumes and vegetables with a high content fiber (they can cause flatulence and worsen the condition). If heartburn is associated with high acidity, antacids and antisecretory drugs are prescribed.

Treatment of gastritis

Gastritis is an inflammation of the gastric mucosa. Its development can be provoked by frequent prolonged stress, the presence of pathological microflora, metabolic disorders, chronic infectious diseases, excessive consumption of alcoholic beverages, autoimmune diseases, long-term use of certain types of medications (most often non-steroidal anti-inflammatory drugs) and some other reasons.

In the treatment of stomach pain caused by gastritis, drugs based on acetylsalicylic acid and ibuprofen are not used – these are effective pain relievers, but they irritate the gastric mucosa.Usually, absorbents and agents that envelop the stomach from the inside are prescribed. If gastritis is caused by a bacterial infection, a course of antibiotics is needed. A diet for gastritis involves avoiding spicy, fatty and salty foods, as well as foods rich in fiber and foods that can cause fermentation processes (primarily milk and baked goods, as well as some fruits, such as grapes).

Stomach ulcer treatment

Without proper treatment, gastritis can lead to the development of peptic ulcer disease.A stomach ulcer most often develops due to the activity of the bacterium Helicobacter pylori or the regular intake of large doses of acetylsalicylic acid preparations. Stress, as has long been believed, does not cause ulcers by itself, but significantly accelerates the progression of the disease. With a peptic ulcer, a burning and rather severe pain in the stomach appears about 4 hours after eating, is localized in the middle of the abdomen and is often accompanied by belching, a feeling of heaviness, vomiting or nausea.

Stomach ulcer is a dangerous disease that can lead to complications such as bleeding and peritonitis.Therefore, treatment should be started immediately. Usually, antibiotics are prescribed to kill hostile bacteria, anti-inflammatory drugs, antacids to reduce acidity. There are also drugs with complex effects: they simultaneously kill the Helicobacter pylori bacteria and protect the gastric mucosa from aggressive effects.

The diet for peptic ulcer disease should consist of light, low-fat food: food should be taken in a grated form (mousse, puree), since the chewing process itself stimulates the production of gastric juice.

Stomach pain cannot be tolerated!

It must be remembered that stomach pain cannot be tolerated, suppressed with pills and treated with folk remedies. Many diseases and pathologies that cause stomach pain are characterized by rapid development, so the sooner you seek qualified help, the higher the chances of recovery.

For example, appendicitis, one of the most common diseases that emergency department doctors have to deal with, is easily treatable with medication in its earliest stages.And on time, the operation to remove the appendix is ​​considered relatively simple, and the prognosis after it is favorable. However, until now, approximately 0.75% of patients who see a doctor only a day after the onset of the first pains die from this disease. The reason is the very rapid development of the disease (from the first signs to the appearance of foci of gangrene, only three days pass) and the implicit severity of symptoms. About a fifth of patients with necrotic appendix changes experience only minor pain and ignore it until it’s too late.

Delay in stomach pain is also extremely dangerous in case of poisoning, ulcers and infections – the consequences can be not only sad, but also tragic.

So, unpleasant sensations in the stomach area may indicate both minor malfunctions in the body, and extremely serious pathologies. In any case, ignoring pain is unacceptable. Correctly selected medications and procedures in most cases can eliminate not only pain, but also its causes.

Stomach ulcer

Stomach ulcer is a disease, the main symptom of which is the formation of a defect (ulcer) in the wall of the stomach. The disease proceeds with periods of exacerbations (more often in spring and autumn) and periods of remission. Often, ulcers form not only in the stomach, but also in the duodenum.

Peptic ulcer is one of the most common diseases of the digestive system, about 30-50% of patients in the gastroenterology department in the city hospital are patients with gastric ulcers or duodenal ulcers.Since the mechanisms of occurrence of stomach and duodenal ulcers are largely similar, in our country it is customary to talk about gastric ulcer and duodenal ulcer.

In developed countries, peptic ulcer disease affects 6-10% of the adult population, with duodenal ulcer prevailing.

The disease is 4 times more common in men than in women.

At a young age, a duodenal ulcer develops more often, at an older age – a stomach ulcer.

Peptic ulcer disease is more common among city residents than among rural population.

Check yourself

The following may indicate the disease:

Pain in the upper abdomen, which, depending on the location of the ulcer, can radiate to the left half of the chest, scapula, thoracic and lumbar spine, left and right hypochondrium, various parts of the abdomen.

With an ulcer in the upper part of the stomach, pain occurs immediately after eating, with an ulcer in the middle part of the stomach – an hour and a half after eating, with a duodenal ulcer – 2-3 hours after eating.Also, with such localization of ulcers, there is “hungry” pain, which occurs on an empty stomach and decreases or completely disappears after eating, and night pain.

Sleep pain is a common occurrence in duodenal ulcers. It is observed due to an increase in acid secretion that occurs after dinner.

Nausea and vomiting are observed in 10-15% of patients with duodenal ulcer.

Tendency to constipation.

Diagnostics

To detect gastric and duodenal ulcers you need:

Gastroduodenoscopy is the most informative research method that allows you not only to detect an ulcer, but also to determine its size, depth, distinguish an ulcer from cancer, take a scraping from the mucous membrane to detect the bacteria Helicobacter pylori.

X-ray examination – this method is somewhat outdated, nevertheless, it is best to identify the ulcerative niche and the violation of the contractile function of the stomach.

pH-metry – study of gastric acidity. With a peptic ulcer, acidity is often increased.

Fecal occult blood test reveals bleeding.

SOS!

A neglected disease can lead to complications: gastric bleeding or perforation, in which the wall of the stomach or duodenum is disturbed, the contents from these organs flow into the abdominal cavity and cause peritonitis, a life-threatening condition.

Memo to the patient

Causes of peptic ulcer:

1) Imbalance between aggressive and protective factors of influence on the mucous membrane of the stomach and duodenum. Protective factors include mucus, which is produced by the mucous membrane of the stomach and intestines. To aggressive factors – hydrochloric acid, bile acids, throwing the contents of the duodenum into the stomach.

2) Infection with the bacterium Helicobacter pylori.However, the number of people infected with it is much higher than the number of people with an ulcer. Apparently, the state of immunity is of great importance.

3) Hereditary predisposition to the disease. It is detected in 30-40% of patients with duodenal ulcer, but is much less common with stomach ulcers. The predisposition to duodenal ulcer is transmitted through the male line.

4) Taking non-steroidal anti-inflammatory drugs.

5) Severe stress.

Factors that contribute to the exacerbation of the disease:

• Incorrect power supply
• smoking
• abuse of strong alcoholic beverages
• work a night shift (the risk of developing the disease increases by 50%).

Treatment

Drug treatment involves taking drugs prescribed by a doctor to suppress Helicobacter pylori and drugs that affect the process of ulcer scarring and mucosal restoration. An exacerbation is best treated in a hospital setting.

Patients are also prescribed a diet. Meals should be fractional – 5-6 times a day in small portions.

Meat and fish broths, any canned food, smoked meats, marinades and pickles, carbonated fruit waters, coffee, cocoa and strong tea, confectionery, soft white bread and any black bread are excluded from food.

Soups must be pureed, vegetarian or dairy. Boiled meat and fish – in the form of steam cutlets and meatballs, minced meat. After 1–2 weeks, with a decrease in pain, meat and fish can be eaten in chunks, but well-cooked. From other dishes, soft-boiled eggs, stewed, and then mashed vegetables, jelly from sweet berries, baked or raw grated sweet apples, stale white bread or dry biscuit biscuits, mashed liquid porridge, milk, cream, butter are recommended.

After scarring of the ulcer, the patient must continue to follow the diet, do not use canned food, smoked meats, spices, marinades and pickles.Soups should be cooked in weak broths from lean meats and fish. Smoking and alcohol will have to be completely eliminated.

Published: 12 September 2016

90,000 Upper abdominal pain :: Clinician

Pain in the upper abdomen is common in common gastrointestinal conditions such as gastritis, stomach cramps and gallbladder problems.

Sometimes pain is accompanied by other symptoms, such as: nausea, vomiting, diarrhea, etc. Stomach pain can sometimes be caused by binge eating. In addition, certain foods, an abundance of fat, increased gas production, lactose intolerance when consuming dairy products can all cause pain, which, as a rule, will be temporary and will go away after a few hours.

With pneumonia of the right lung , abdominal pain often occurs, while the diseased organ is outside of it.

Pain around the navel may be associated with an upset bowel movement or inflammation of the appendix.

Pain just above the navel is usually associated with stomach problems. Among the culprits of this pain will be gastritis, stomach ulcers, and increased acidity of the stomach. Persistent pain in this place informs about the problems of the duodenum, pancreas and gallbladder.

Pain in the left upper abdomen indicates a malfunction of the colon, stomach and pancreas.

Pain in the upper right side , especially severe, indicates inflammation of the gallbladder. This pain can last up to the central abdomen and also radiate to the back. Other causes of such pain are pancreatitis and disorders of the duodenum.

Pain in the abdominal cavity can also occur with diseases of the lungs and heart.

Which doctor should I contact if there is pain in the upper abdomen:

What research will help determine the cause of the pain in the upper abdomen:

If you have previously undergone any research or have already been with a specialist, be sure to take their results for a consultation with a doctor. If you have not had experience attending studies or seeing a doctor, we will do everything necessary at our centers.

You must be very careful about your health.People do not pay enough attention to the symptoms of diseases and do not realize that they can develop into a life-threatening condition. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that it is too late to treat them. Therefore, identifying symptoms is the first step in diagnosing diseases in general. To do this, it is necessary at least once a year to be examined by a doctor , in order not only to prevent a terrible disease, but also to maintain a healthy state of all internal organs and systems.

If you want to ask a question to our specialists – use the section of the online consultation. You will also find answers to frequently asked questions there. If you are interested in reviews about visiting our centers, there is a special Reviews section for you, where you can also help other patients and leave your message after visiting our centers. We will be grateful to you!

90,000 Stomach pain – Euromed

Where is the stomach pain?

Pain in the upper abdomen (epigastrium) is associated in patients with stomach diseases, however, similar localization of pain may be associated with other organs.

Pain in the epigastrium can be aching, manifested by a feeling of heaviness, can appear both on an empty stomach and after eating certain foods (acute, irritating to the mucous membranes), and also be accompanied by nausea, vomiting, or even shortness of breath.

Pain can be sudden and so severe that it knocks you off your feet (“dagger pain”). Patients describe her as being stabbed in the stomach with a dagger. Such an attack is a formidable symptom of perforation of a stomach ulcer, when the ulcer defect completely destroys the wall of the stomach, perforating it, which is accompanied by bleeding and the outflow of gastric contents into the abdominal cavity.The latter circumstance causes inflammation of the peritoneum – peritonitis .

Ulcer perforation requires prompt surgical intervention and subsequent intensive treatment.

• In addition to peptic ulcer disease, the causes of epigastric pain can be gastritis, duodenitis (inflammation of the duodenum), pancreatitis (inflammation of the pancreas), cholecystitis, cholelithiasis.
• In addition to the above, the causes of pain in the epigastric region can be myocardial infarction (especially the lower wall of the left ventricle), dissecting aortic aneurysm.

Why does the stomach hurt?

If the stomach hurts after eating, then, as already mentioned, the pain in the upper abdomen is not necessarily associated with the stomach, however, pain in the stomach after eating may also appear after eating, which is associated with the nature of the food (sharp, irritating mucous ).

In addition, pain can be associated with overeating and excessive stress on the liver and pancreas. A single plentiful intake of fatty foods can provoke pancreatitis, especially if the meal was accompanied by libation.

About the clinic

Euromed Clinic is a multidisciplinary family clinic in the center of St. Petersburg.

• Home call
• 24-hour reception of a therapist
• Analyzes, ultrasound, X-ray
• Diagnostics of the whole body
• Hospital and surgery
• Vaccination

Learn more about the clinic

00

Reasons abdominal pain / Blog / Gastro-hepatocenter EXPERT

How to treat abdominal pain

Common pain from an eating disorder, poisoning or overeating should be treated at home with bed rest and proper diet.Analgesics and antispasmodics will help reduce discomfort. It is also advisable to take enzymes to improve digestion, probiotics to normalize the intestinal microflora. If you are severely poisoned, sorbents will help to save the situation (they cleanse from toxins and poisons, the remnants of undigested food), as well as anti-dehydration drugs (Regidron).

For the period of the diet, give up tonic drinks, alcohol and smoking. To normalize digestion will help the intake of medicinal broths with a bite with breadcrumbs or lean rice.Do not use enemas, laxatives, or manganese solution to induce vomiting on your own. All these methods are outdated and can lead to intestinal dysbiosis and severe dehydration.

If you asked a therapist for help, be prepared to describe in detail the nature and intensity of pain, frequency of occurrence, area of ​​localization, etc. Next, the doctor will conduct a visual examination, prescribe additional tests (feces, urine, blood) and laboratory tests.He will also write out a referral to highly specialized doctors (gynecologist, gastroenterologist, surgeon, infectious disease specialist, etc.).

Appendicitis is treated by a gastroenterologist and surgeon. Anti-inflammatory drugs and antibiotics are prescribed, and sometimes surgery is required to remove the appendix. Treatment is carried out in a hospital.

Treatment of diverticulitis involves cleaning the intestines from toxins and relieving inflammation. For this, antibiotics and antispasmodics are prescribed, bed rest, a liquid diet (grated soups, minced meat, mucous cereals), the obligatory intake of dietary fiber, an enhanced water diet.

Diseases of the gallbladder involve taking medications that normalize the level of bile, as well as pain relievers. A diet that excludes the intake of fatty, fried and spicy foods is also required.

Irritable bowel syndrome can be treated at home. It is necessary to increase the content of vegetables and fruits in the diet, drink plenty of juices and fluids (to prevent dehydration). However, this disease is often associated with the patient’s psychosomatic state, therefore, the consultation of a psychotherapist may be necessary.

Problems with women’s health are treated by a gynecologist, depending on the symptoms and causes of the disease.

Timely elimination of the causes of abdominal pain and adherence to the correct diet will help maintain the health of the digestive tract for many years.

If stomach hurts

The nature of abdominal pain		Possible causes of abdominal pain	How to proceed?
Severe abdominal pain		Severe abdominal pain: acute intestinal infection, poisoning, appendicitis, intestinal obstruction	Call an ambulance as soon as possible. It is strictly forbidden to take laxatives Do not give food or drink!
Acute, cutting, unbearable pain in the side		Acute pain in the right side of the abdomen: If the pain radiates up to the shoulder or neck – acute cholecystitis or hepatic colic. If the pain radiates down the abdomen, to the genital area, renal colic. If severe pain is located at the bottom, acute appendicitis is possible Acute twisting pain in the abdomen, which subside after a bowel movement and are accompanied by diarrhea (without blood) – irritable bowel syndrome Periodic abdominal pain on the right or left associated with bloody diarrhea – disease Crohn’s or ulcerative colitis Acute pain in the left side of the abdomen: renal colic, heart attack or rupture of the spleen
Drawing or dull pain in the lower abdomen		Drawing pains in the lower abdomen on the right or left in women: salpingo-oophoritis, ectopic pregnancy, inflammation of the fallopian tubes or ovaries (pulling pains in the lower abdomen (in the center) radiating to the genitals in men and women: cystitis, urethritis. Drawing pains in the lower abdomen in men: prostatitis, vesiculitis (inflammation of the seminal vesicles).	Call an ambulance as soon as possible. It is strictly forbidden to take laxatives Do not give food or drink!
Pain in the lower back and abdomen		Acute or dull pain in the lower back and abdomen in men and women: pyelonephritis, glomerulonephritis, kidney tumors, urolithiasis.
Constant pain in the epigastric region, which radiates to the shoulders and shoulder blades and has a girdle character, repeated vomiting that does not bring relief, the abdomen is distended and tense)		Constant pain in the epigastric region – acute pancreatitis (inflammation of the pancreas)
Pain occurs suddenly, “as if struck with a dagger in the stomach”	Pain, “as if struck with a dagger in the stomach” – perforated stomach ulcer, duodenal ulcer		It is strictly forbidden to take laxatives Do not give food or drink! Call an ambulance as soon as possible.

90,000 🩺 🧬 Why does the right side hurt

Why can the right side hurt?

The causes of this symptom are usually related to internal organs. “This is a sign that something located on the right side of the abdomen is suffering,” says Bulat Yunusov, surgeon at GMS Clinics and Hospitals. “The cause of damage to these organs can also be different, for example, inflammation, oncological processes, trauma, the consequences of previous operations, neurological disorders.”

However, this symptom may have other reasons. “The unpleasant sensation in the right side can be muscular in nature, especially if it occurs after physical exertion. If the person falls on their right side, the pain may be associated with muscle contusion or injury, such as myositis. Gallstones can also cause unpleasant tingling sensations in the side. The stones close the ducts, which leads to a swelling of the bladder and, as a result, to the occurrence of calculous cholecystitis, that is, an inflammatory process.All this, of course, is accompanied by pain, ”commented an invited specialist from another medical center. Let’s consider the main causes of pain in the right side.

Inflammatory diseases of the gastrointestinal tract

Pain and cramps in the right side can be caused by a whole bunch of inflammatory processes in the gastrointestinal tract. “These are, for example, appendicitis, diverticulitis, colitis, gastroenteritis, stomach and duodenal ulcers,” says Bulat Yunusov.

Most often, with these diagnoses, pain is felt as aching, moderate, with a gradually increasing intensity.With appendicitis, pain may increase when walking, coughing, changing body position, and decrease at rest. Also, with this diagnosis, there is an increase in temperature, nausea, and vomiting.

With a stomach ulcer, the pain becomes more noticeable after eating fatty, spicy or fried foods, alcohol, as well as intense physical exertion. Additional symptoms may include heartburn, nausea, and vomiting.

With colitis (inflammation of the intestines), the pain can be pulling or paroxysmal.The disease is also accompanied by diarrhea, fever, general weakness, headaches, the presence of mucus in the feces.

With diverticulitis (protrusion of the intestinal walls), acute pain is felt to the right of the navel, the temperature rises, and diarrhea appears (with blood and mucus).

With gastroenteritis (inflammation of the mucous membrane of the stomach and small intestine), pain in the right side is accompanied by a lack of appetite, nausea, vomiting, abdominal cramps, etc.

With pancreatitis (inflammation of the pancreas), the pain begins suddenly and is constant and intense. Sometimes it can “give” to the left side or intensify after eating heavy, fatty or spicy foods.

Diseases of the urinary system

Often the side hurts on the right side due to the organs of the excretory system. “These include urolithiasis and pyelonephritis,” says Bulat Yunusov.

Pyelonephritis is an inflammatory kidney disease, in which, in addition to pain in the right side, weakness, nausea, vomiting, “jumping” pulse, dry mouth, high temperature may also occur.

Pain in the side with urolithiasis can be constant or wavy, dull or acute, it can only bother at rest or intensify when walking. It depends on the location of the stone, but sometimes pain can first be felt in the lumbar region (the so-called “renal colic”), and only then “settle” in the right side.

Liver diseases

“Pain in the right side can occur with damage to the liver and organs of the hepatobiliary system,” says Bulat Yunusov. “Such diseases include cholecystitis, obstructive jaundice, liver cysts, hepatitis, cirrhosis.” All these diagnoses are characterized by a rather sharp pain in the right side, which can “radiate” to the right shoulder, neck or shoulder blade.

Often, on the right side at the bottom it hurts in women due to malfunctions of the pelvic organs.“Such disorders in work include inflammatory diseases (salpingitis, salpingo-oophoritis) and non-inflammatory (corpus luteum cyst, ovarian tumors, endometriosis, ovarian cysts, ectopic pregnancy),” notes Bulat Yunusov.

With salpingitis (inflammation of the fallopian tubes) and salpingo-oophoritis (inflammation of the fallopian tubes and ovaries), the pain is most often felt as pulling in the groin area, but it can also “give” to the right or left side. It is accompanied by fever, nausea, severe headache, vaginal discharge and intensifies during sexual intercourse.

With ovarian or corpus luteum cysts, pulling or stabbing pain is mainly localized in the lower abdomen or lower back, but can also be felt in the right side.

With endometriosis, pain is most often acute, cramping, and may disappear and return. It is felt, as a rule, in the lower abdomen, in the left or right side (closer to the lower back).

Reaction to physical activity

Sometimes the right side hurts not at all due to malfunctions of internal organs (which we discussed above).If you feel pain on the right during (or immediately after) physical activity, chances are that it is:

• Muscle spasm due to weakness in the muscles of the back or peritoneum.
• Spasm of the diaphragm. It is most often encountered while running: rapid breathing causes the diaphragm to contract faster, which can cause it to spasm and “give off” pain in the right side.
• Enhanced liver function. This organ is considered the “blood” depot of the body.During exercise, the liver may slightly increase in volume and “press” on its outer capsule, where there are many nerve endings, which will feel like pain in the right side. And similar discomfort can arise due to an improper diet: for example, if before training you “went too far” with carbohydrates or fats. In this case, during the lesson, the liver will be forced to work with increased stress, which can also provoke pain syndrome.

How to determine why your right side hurts

Of course, you will not be able to make an accurate diagnosis on your own.However, you can get some idea of ​​it, starting from how exactly your right side hurts. “In acute diseases, pain occurs suddenly, increasing in intensity in a short period of time (hours, sometimes days),” says Bulat Yunusov. “If the reason is some kind of chronic disease, then the pain syndrome is either permanent or wavy in nature, not differing in great intensity.”

It’s also important to check for additional symptoms.“To correctly determine the cause of pain in the right side, it is necessary to listen to the nature of this pain. For example, muscle pain is usually dull and aching, – commented the invited specialist. – However, muscle pain can be acute, because in addition to muscles in the right side there are intervertebral joints, which can be a source of discomfort. With gallstone disease or acute cholecystitis, an increased temperature joins the pain. This situation can be called “pain-plus” – pain and temperature.The discomfort caused by renal colic can also be “pain-plus”, but already pain plus frequent urination or the presence of blood in the urine. Pain caused by bowel problems – pain plus diarrhea. ”

What to do if your right side hurts

As you can see, side pain can be a symptom of a wide variety of health problems. Therefore, you should not ignore it – be sure to see a doctor. “It is not always possible to determine the severity of the disease that caused the situation by the nature of the pain syndrome.This applies, first of all, to the elderly and patients suffering from diabetes mellitus – serious diseases of the abdominal cavity can be erased (pain syndrome may not be expressed at all or disappear completely), says Bulat Yunusov. – Thus, if abdominal pain does not go away within a few hours and is accompanied by an increase in body temperature, nausea, vomiting, loss of appetite, stool disorders (constipation or diarrhea), discomfort during urination, a decrease in blood pressure, then the only correct solution is an in-person consultation doctor “.

Can you take medicine if you have severe pain in your right side? Yes, but with caution. “You should not resort to taking analgesics on your own, as this can“ blur ”the clinical picture of the disease, which will lead to an untimely formulation of the correct diagnosis,” says Bulat Yunusov. “The only thing is that it is possible to take antispasmodics (for example, no-shpy): these drugs relieve spasm of the muscles of internal organs and are aimed at eliminating the cause of the pain syndrome, in inflammatory diseases, they usually do not give an analgesic effect.”

In general, doctors have a negative attitude towards self-medication. “It is impossible to guarantee pain relief at home without harming the body as a whole. You can dull the feeling of discomfort, thereby relieving your torment only for a while. In addition, by self-medication, completely unintentionally, you can cripple some other organ, which initially had nothing to do with pain in the right side. Home treatment is not a safe remedy. ”

The best way out is to make an appointment with a general practitioner and discuss your condition with him.