Stomach ulcers: Symptoms, treatment, causes

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Stomach ulcers are sores in the lining of the stomach or small intestine. They cause pain and indigestion, but over-the-counter and prescription medications can bring relief. Dietary and lifestyle changes may also be necessary.

The stomach produces a strong acid to help digest food and protect against microbes. To protect the bodily tissues from this acid, the stomach also secretes a thick layer of mucus.

If the mucus layer is worn away and stops functioning effectively, the acid can damage the stomach tissue, causing ulcers.

An estimated 1 in 10 people in Western countries will have an ulcer in the stomach or small intestine at some point in their lives.

Stomach ulcers are relatively easy to cure, but they can cause significant problems if left untreated.

Fast facts on stomach ulcers

• Stomach ulcers are common in the West and easy to treat but can become serious.
• The most common causes are bacteria and use of nonsteroidal anti-inflammatory drugs (NSAIDs).
• The classic symptom of a stomach ulcer is indigestion.
• Treatment for stomach ulcers normally focuses on removing the cause.

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The classic symptom of a stomach ulcer is indigestion, also called dyspepsia.

Indigestion causes pain or discomfort in the stomach area. This symptom can be mistaken for heartburn, which can occur at the same time.

Acid reflux or gastroesophageal reflux disease may cause heartburn. It occurs slightly higher up from the stomach, and people will feel it in the lower part of the chest.

Stomach ulcer symptoms tend to be more distinct than heartburn, but symptoms can still be vague.

An ulcer also tends to produce a burning or dull pain in the center of the abdomen. People sometimes describe the pain as a biting or gnawing pain. Some individuals may describe a hungry sensation.

Other symptoms include:

• unexplained weight loss
• nausea and vomiting
• not eating because of pain
• burping
• bloating
• a feeling of fullness and problems drinking as much fluids as usual
• bloody or black, tarry stools
• chest pain
• fatigue

Individuals may also be able to relieve pain by eating, drinking, or taking antacids.

Some stomach ulcers go unnoticed and show no typical indigestion-type pains. These ulcers are less common, and doctors tend them after they have started bleeding.

Some ulcers can cause a hole in the stomach wall. Health experts call this perforation, which is a severe condition.

Stomach ulcer symptoms often change over time and can be difficult to spot.

Dietary changes can help prevent stomach ulcers from developing.

People at risk of stomach ulcers should include more of the following nutrients in their diet:

• Fruit and vegetables: Eating a variety of fruit and vegetables is key to a healthy digestive tract lining. These foods are rich in antioxidants, inhibit acid secretion, and contain cytoprotective and anti-inflammatory properties. A 2017 study states that these are all important factors for preventing and treating ulcers.
• Fiber: Diets high in soluble dietary fiber reduce the risk of developing stomach ulcers.
• Probiotics: Food that contains active bacterial content, such as probiotic yogurt, can help reduce a Helicobacter pylori (H. pylori) infection. Probiotics have been shown to slightly improve symptoms of indigestion and the side effects of antibiotics.
• Vitamin C: This powerful antioxidant may be effective in helping eradicate H. pylori, especially when taken in small doses over an extended period. Fruit, legumes, and vegetables, such as oranges and tomatoes, contain high levels of vitamin C.

Avoiding alcohol and caffeine can also help reduce the risk, as they both cause the body to produce more gastric acid. This in turn can lead to stomach ulcers.

However, for the most effective outcome, instead of relying only on a diet, it is important to follow dietary recommendations alongside a treatment plan.

The two main causes of ulcers of the stomach and the small intestine are H. pylori bacteria and a class of pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs).

Less common causes of stomach ulcers include excess stomach acidity, or hyperacidity, and Zollinger-Ellison syndrome.

Excess stomach acidity can occur for a range of reasons, including genetics, smoking, stress, and some foods.

Zollinger-Ellison syndrome is a rare condition that causes an excess of stomach acid to be produced.

NSAIDs and stomach ulcers

NSAIDs carry a risk of stomach ulcers. The two most popular NSAIDs are aspirin and ibuprofen.

The risk of ulcers increases if the drugs are taken in high doses or regularly for a long time.

Stronger NSAIDs, such as those available on prescription, carry a greater risk of stomach ulcers than those that people can buy over the counter.

A person should always check labels and consult a pharmacist or a doctor about any concerns regarding using pain relief medication. They may recommend an alternative, such as acetaminophen.

Risk factors

Certain factors increase the likelihood of developing a stomach ulcer, including:

• using steroids often
• having hypercalcemia, or too much calcium in the blood
• frequently consuming alcohol

Stomach ulcers are more common in individuals over 60 years. People can develop a stomach ulcer at any age, but they are much less common in children. The risk in children is higher if their parents smoke.

If a doctor thinks a person has a stomach ulcer, and if they suspect the cause is an NSAID, they may try changing the type of pain reliever the person is using and recommend another one, such as paracetamol.

However, if the doctor suspects the stomach ulcer is due to H. pylori bacteria, they may try the “test-and-treat” approach. This approach involves a noninvasive test, such as a urea breath test or stool test for H. pylori infection, followed by eradication of the bacteria if they are present.

Once the doctor determines what may be causing the ulcer, they will try to treat its symptoms by protecting it from acid while it heals.

Doctors may prescribe the following drugs:

• proton pump inhibitors, which block acid-producing cells
• h3 receptor antagonists, which prevent the stomach from producing excess acid
• antacids or alginate, available to purchase over the counter or online
• drugs that protect the stomach lining, such as Pepto-Bismol, available to purchase online

Symptoms often subside quickly following treatment. However, doctors continue the treatment, especially if the ulcer is due to an H. pylori infection.

It is also important to avoid drinking alcohol, smoking tobacco, and consuming any trigger foods during treatment.

Surgical treatments

In certain cases — for instance, if the ulcer continues to return, will not heal, bleeds, or prevents food from leaving the stomach — surgery may be an option.

Surgery can include:

• removing the ulcer
• tying off bleeding blood vessels
• sewing tissue from another site onto the ulcer
• cutting the nerve that controls stomach acid production

Complications from stomach ulcers such as bleeding or perforation are rare. Either of these complications requires urgent medical attention.

Stomach ulcers are one type of peptic ulcer. Two other types are esophageal and duodenal ulcers.

Esophageal ulcers develop inside the esophagus or food pipe. Duodenal ulcers occur in the uppermost part of the small intestine, or duodenum.

The ulcers have similar characteristics, but doctors identify them by their location in the body.

Doctors follow the symptoms of a stomach ulcer by asking questions about how the pain feels, where and when it happens, and how frequent and long lasting it has been.

This process helps determine whether there is a stomach ulcer or not. A doctor may also order a stool test or a breath test to find out whether the stomach ulcer is due to H. pylori bacteria.

If there are more severe symptoms, such as bleeding, the doctor may require further testing. This may include endoscopy or the barium enema test.

During endoscopy, a doctor inserts a camera at the end of a long, thin, flexible tube to look at the gut lining. They may also carry out a biopsy.

The barium enema test involves using a thick liquid that allows X-rays to be taken of the gut.

Anyone who thinks they may have an ulcer in their stomach should consult a doctor. Any stomach symptoms that last for more than a few days or keep happening need evaluation and treatment.

Symptoms of anemia, such as tiredness and breathlessness, may signal a slow-bleeding ulcer. More serious bleeding is an urgent medical problem, as people may vomit up blood, or stools are black and sticky.

Perforation is also an emergency. Without quick treatment, the wall of the stomach can become infected. Sudden stomach pain that gets worse can indicate perforation, and any signs of being very unwell with infection need treatment as soon as possible.

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Can Stomach Ulcers Cause Headaches and Dizziness?

Peptic ulcer disease is a condition in which ulcers or open sores develop in the stomach or duodenum. Around 25 million Americans have this condition. The CDC estimates that 1 in 10 people in the US will develop an ulcer at some point in their lives. 

Peptic ulcers can be stomach ulcers that occur in the stomach’s inner lining or duodenal ulcers in the first part of the small intestine. Stomach and duodenal ulcers develop when the lining of the stomach is exposed to excessive amounts of acidic digestive juices.  

Ulcers can cause a range of symptoms. Please continue reading to find out whether headaches and dizziness can be symptoms of peptic ulcers.

Why do stomach ulcers occur?

The most common causes of peptic ulcers are:

• Helicobacter pylori (H. pylori) bacterial infection 
• Long-term use of NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen and naproxen 

Spicy foods, chronic stress, smoking, and drinking alcohol do not cause peptic ulcers but can worsen the symptoms.

Do stomach ulcers make you feel unwell?

Gastric ulcers can cause various symptoms, the most common being gnawing abdominal pain and a burning sensation in the upper abdomen between the belly button and the chest. 

The symptoms of stomach ulcers tend to be worse on an empty stomach, such as between meals, at night, and early in the morning. Ulcer symptoms can last from a few minutes to several hours.  

Other symptoms of stomach ulcers may include:

• A dull ache in the stomach
• Bloating
• Belching
• Nausea and vomiting
• Bloody vomit
• Worsening stomach pain with spicy foods, acidic foods, or fatty foods
• Early satiety (feeling full quickly)
• Loss of appetite
• Weight loss
• Heartburn and acid reflux
• Dark stools 

Is dizziness a symptom of stomach ulcers?

A stomach ulcer does not directly cause dizziness. However, a bleeding ulcer can lead to blood loss and anemia, which can cause dizziness. 

Can a stomach ulcer cause headaches?

Stomach ulcers do not directly cause headaches. However, some studies have shown that infection with Helicobacter pylori bacteria is a risk factor for migraine headaches. As noted above, H. pylori infection is a common cause of stomach ulcers. Therefore, people who have a stomach ulcer may have headaches.

What are the complications of a gastric ulcer?

A stomach ulcer is a serious condition. It is important to seek medical attention if you have warning signs or frequent symptoms of peptic ulcers, such as pain in the upper middle part of the abdomen. If left untreated, peptic ulcer disease can result in serious complications, such as:  

• Peptic ulcer bleeding: Internal bleeding from ulcers in the stomach lining can lead to blood loss and anemia. Severe blood loss from bleeding ulcers can lead to low blood pressure. Serious bleeding in the stomach or duodenum is a medical emergency for which you should see a doctor immediately. You may require hospitalization, a blood transfusion, or emergency surgery. 
• Perforation: Peptic ulcers can eat through the stomach wall and cause a perforation (hole). This can lead to a serious infection of the abdominal cavity called peritonitis.
• Obstruction: A peptic ulcer can cause a blockage in the digestive system due to swelling or inflammation. Symptoms of obstruction include feeling full quickly, vomiting, and weight loss. 
• Stomach cancer: People with H. pylori infections are at a higher risk of stomach cancer.

If you have stomach and duodenal ulcer complications, your primary care provider may refer you to a specialist in digestive and kidney diseases for treatment.

How can I prevent a stomach ulcer?

You can reduce your risk of developing a peptic ulcer by:

Protecting yourself from H. pylori infection

H. pylori bacteria spread through food and water and can be passed from person to person. Wash your hands with soap and water frequently, especially before preparing food and eating. Eat foods that are thoroughly cooked.

Using pain relievers with caution

Regular use of non-steroidal anti-inflammatory drugs and certain medications can increase your risk of ulcers. Talk to your doctor about taking the lowest dose of these medications for the shortest time to treat your health conditions. Take your medications with food. Avoid drinking alcohol while on pain relievers. Ask your doctor if you need to take additional medications such as antacids, acid blockers, or proton pump inhibitors to protect your stomach lining. 

What is the treatment for a peptic ulcer?

Treatment depends on the cause. Doctors can diagnose peptic ulcers with tests such as breath tests. If the cause of the open sore is Helicobacter pylori infection, it may be treated with triple or quadruple therapy consisting of a proton pump inhibitor and a combination of antibiotics. Peptic ulcers that are due to NSAID use can be treated by eliminating or reducing the use of these medications and taking medications to help heal the ulcer. 

Some medications that can be used to treat peptic ulcer disease include:

• Antacids that neutralize the acid in the stomach and provide quick pain relief. However, these medicines can cause side effects such as diarrhea or constipation. Keep in mind that while antacids may provide relief from symptoms, they do not heal an ulcer.
• Proton pump inhibitors or PPIs that block the production of acid in the stomach and encourage healing of the inner lining of the stomach. PPIs are available by prescription and over-the-counter. Examples include omeprazole (Prilosec), pantoprazole (Protonix), esomeprazole (Nexium), rabeprazole (Aciphex), and lansoprazole (Prevacid). You should know that long-term use of PPIs, especially at high doses, can increase the risk of bone fractures. 
• Histamine receptor blockers or h3 blockers that reduce the amount of stomach acid and promote healing. They are available by prescription and over the counter. Examples include cimetidine (Tagamet HB), nizatidine (Axid AR), and famotidine (Pepcid AC).
• Cytoprotective agents that protect the lining of the stomach and small intestines. These are prescription medications. Examples include misoprostol (Cytotec) and sucralfate (Carafate).
   

References:

1. https://www.mayoclinic.org/diseases-conditions/peptic-ulcer/symptoms-causes/syc-20354223
2. https://www.cdc.gov/museum/disease/ulcers1.pdf
3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3258796/

Ulcer: causes and symptoms of gastric and duodenal ulcers MEDSI-Dialine

Gastric ulcers (peptic ulcer) are relatively common in our time. They affect more than 5% of the population. Do you often experience stressful situations, feel unwell, abuse alcohol and drugs that can damage the gastric mucosa? Perhaps you are at a potential risk zone for this insidious disease.

Main causes of peptic ulcer

More than 150 years ago, the first known illness of the famous Dr. Cruvelier was described. At one time, he said that the causes of peptic ulcer disease are shrouded in deep darkness. Since then, views on the origin of the disease have changed. The key event was the testimony of J. Warren and B. Marshall, who first described Helicobacter pylori in 1983.

Helicobacter pylori

Helicobacter pylori is a bacterium that causes inflammation in certain parts of the stomach. First of all, the bacterium affects the “weak” stomachs.

Helicobacter pylori is a specific bacterium. This is an illustrative example of the adaptation of a living organism to extreme conditions of life. Since this bacterium lives in a very acidic environment, infection with it is the most common infection of mankind. It has been reported to affect up to 90% of the population in developing countries.

Interestingly, however, not everyone can develop peptic ulcers. One possible explanation is the presence of specific aggressive strains that resist ulcers. A higher incidence of ulcers was also observed in patients with blood type 2.

Other causes of ulcers

Although Helicobacter pylori is a key cause of ulcers, there are others. The influence of various drugs (acetylsalicylic acid, non-steroidal, anti-inflammatory drugs) is also important. They change the chemical composition of the stomach mucus, which protects its membrane from the action of hydrochloric acid.

Another cause of ulcers is the harmful effect of the contents of the duodenum on the gastric mucosa.

Also among the causes of peptic ulcer disease, although not fully understood, include the harmful effects of smoking.

Finally, the last, but often the most popular cause (or a kind of “trigger” mechanism) of peptic ulcer disease is stress.

How peptic ulcer disease manifests itself

This peptic ulcer disease most often affects people between 20 and 40 years of age. Its frequency is the same for men and women.

Main symptoms

A significant symptom for this disease is pain in the mid-abdominal line or to the right of it, most often occurring 2 hours or more after eating. She can even wake the patient at night. This pain usually subsides after eating and appropriate medications. In this case, it is not uncommon for patients to come to the doctor with suspected gallbladder problems.

Other symptoms include heartburn, bruising, constipation or vomiting. Fear of illness develops and this can lead to overeating and subsequent obesity. Some patients, on the other hand, do not eat or lose weight due to pain. A secondary symptom of this disease can also be drowsiness and fatigue.

If you cannot cope with the disease on your own, seek help from the doctors of the DIALINE multidisciplinary clinic. After passing a full examination, the specialist will give professional recommendations for maintaining health, and, if necessary, the most optimal and effective treatment plan will be prescribed.

Do not delay treatment, see a doctor right now:

Treatment of gastric and duodenal ulcers

Gastric ulcer is a very common disease of the stomach. Both adult men and women and adolescents can be affected by them, and recently, peptic ulcer disease has been increasingly observed in children.
This is connected, of course, with the quality of nutrition of a modern person, which is saturated with preservatives, as well as heredity and ecology.

What is an ulcer?

An ulcer is a violation of the integrity of the tissues of the walls of the stomach, when gastric juice corrodes the walls of the stomach. An ulcer affects the lining of the stomach or duodenum.

Methods for the diagnosis and treatment of gastric and duodenal ulcers in Nizhny Novgorod are offered by many medical centers. One of the leading private clinics, Only Clinic, is attended by highly qualified gastroenterologists who have developed unique methods for treating ulcers and apply these effective modern methods in practice.

Causes of gastric and duodenal ulcers

It has been proven that the main cause of the occurrence and development of gastric and duodenal ulcers are spiral-shaped bacteria Helicobacter pylori, which enter the environment of the stomach and affect it. Helicobacter pylori neutralize the natural acidic environment of the stomach, form an infection center in a certain place, provoke the death of mucosal cells, which subsequently forms an ulcer.

The bacterium Helicobacter pylori, being the main cause of ulcers, at the same time is not the only factor leading to the occurrence and development of peptic ulcer. The provoking factors for the development of an ulcer are the general state of human health, his lifestyle, bad habits, quality of nutrition, etc.

Factors that provoke the appearance of stomach ulcers can be briefly described as an unhealthy lifestyle:

• smoking
• alcoholism
• abuse of caffeinated drinks and carbonated drinks
• regular eating disorder (unbalanced diet)
• caries
• poor quality food
• regular consumption of too hot or, on the contrary, ice-cold food, which can cause damage to the mucous membranes
• regular use of drugs with anti-inflammatory effects, such as aspirin, iboprofen, etc.
• chronic fatigue syndrome
• mental and physical exhaustion
• stress

Stomach and duodenal ulcer – symptoms and manifestations

Problems with the stomach, including the first signs of an ulcer, the patient notices immediately. As a rule, an ulcer causes very great discomfort and is accompanied by severe pain in the abdomen, vomiting and heartburn. Vomiting begins at the very peak of pain, alleviating the patient’s condition. Vomit is characterized by acid content. Often, patients with stomach ulcers themselves provoke vomiting to calm the pain. Also, another sign of an ulcer is belching, which is a sign of a malfunction of the stomach.

An important symptom and manifestation of an ulcer is hunger pains: this is when the pain in the stomach and intestines increases during periods of hunger, and disappears after eating. Another symptom of a developing ulcer may be night pains that go away after eating or taking medication.

Manifestations of an ulcer and possible complications of an advanced form of an ulcer

Bleeding. Due to acid erosion of the walls of the stomach, bleeding may open, which, as a rule, opens with a duodenal ulcer, less often with a stomach ulcer.

Perforation (perforation of the ulcer) . The wall of the stomach affected by an ulcer can break through, causing the contents of the stomach to enter the peritoneum. This situation is accompanied by severe pain. When this condition occurs, emergency hospitalization and surgical intervention are required.

Obstruction, i.e. blockage at the point of exit from the stomach. This situation occurs if the ulcer is located at the exit from the stomach and this exit is blocked. The contents of the stomach cannot enter the intestines, pain, nausea, vomiting, and a feeling of bloating occur. Such cases require planned surgical intervention.

Relapses are exacerbations of peptic ulcers that occur as a result of stressful situations, alcohol abuse, smoking or taking certain medications.

Oncology (cancer of the stomach or duodenum) develops as a result of an increase in the number of Helicobacter bacteria, which create favorable conditions for the occurrence of a malignant tumor. An ulcer can turn into cancer.

Treatment of gastric and duodenal ulcers in a private clinic in Nizhny Novgorod

At the first visit to a gastroenterologist and a suspected ulcer, the patient is prescribed a diet. Next, a series of examinations is carried out, including FGDS (gastroscopy), an analysis is taken for the presence of Helicobacter bacteria in the stomach. Based on the results of tests and examinations, a course of treatment is prescribed, consisting mainly of drug therapy, in particular antacids (almagel, magnesium oxide, etc.), antispasmodics, such as no-shpa or papaverine, astringents and enveloping drugs. In modern medical centers, including the Only Clinic, gastric and duodenal ulcers are treated in a hospital setting using certain antibiotics or specialized anti-ulcer drugs, such as Omez. Physiotherapy and magnetotherapy are also prescribed.

Treatment regimens in each case are individual and are prescribed strictly by the gastroenterologist of Only Clinic, taking into account many factors, such as the patient’s age, state of his health, chronic diseases, etc.

Faced with a peptic ulcer, the patient must understand that at the first symptoms of diseases of the stomach and duodenum, you should immediately consult a doctor – a gastroenterologist.

Modern methods of dealing with peptic ulcer and Helicobacter pylori bacteria are very effective and timely treatment and during the treatment can permanently save the patient from the manifestations of the ulcer.

It is also very important for a patient who has been ill with an ulcer to constantly follow a diet and diet. Folk remedies for peptic ulcer disease are only an addition to the main therapy, since they are not able to destroy Helicobacter pylori, which is the main cause of ulcer disease.