What are the common signs of a peptic ulcer. How do doctors diagnose stomach ulcers. What treatments are available for peptic ulcers. Can peptic ulcers be prevented. What complications can arise from untreated ulcers. Who is most at risk for developing peptic ulcers. How long does it take for a peptic ulcer to heal.

Understanding Peptic Ulcers: Causes and Risk Factors

Peptic ulcers are open sores that develop on the inner lining of the stomach and upper portion of the small intestine. Contrary to popular belief, stress and spicy foods do not cause ulcers. The two main causes are:

• Infection with Helicobacter pylori (H. pylori) bacteria
• Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen

H. pylori infection is believed to be the primary cause in most cases. This bacteria weakens the protective mucus layer of the stomach and small intestine, allowing stomach acid to damage the underlying tissue. An estimated 30% of Americans are infected with H. pylori, though only a small percentage develop ulcers.

Other risk factors that can increase your chances of developing a peptic ulcer include:

• Smoking
• Excessive alcohol consumption
• Being over 50 years old
• Family history of ulcers
• Liver, kidney, or lung disease

Recognizing the Symptoms of Peptic Ulcers

Peptic ulcers don’t always cause noticeable symptoms. When symptoms do occur, they can vary from person to person. Common signs and symptoms include:

• Burning pain in the middle or upper abdomen, often worse when your stomach is empty
• Feeling of fullness, bloating, or belching
• Nausea or vomiting
• Intolerance to fatty foods
• Heartburn
• Loss of appetite

Does the pain from peptic ulcers come and go? Yes, ulcer pain is often intermittent. It may last for a few minutes to several hours and can occur at any time of day or night. Some people experience relief after eating, while others find that food worsens their discomfort.

Warning Signs of Severe Ulcers

In some cases, peptic ulcers can lead to more serious complications. Seek immediate medical attention if you experience any of these symptoms:

• Vomiting blood or material that looks like coffee grounds
• Dark, tarry stools
• Severe, persistent abdominal pain
• Unexplained weight loss
• Difficulty swallowing

Diagnosing Peptic Ulcers: Tests and Procedures

If your doctor suspects you have a peptic ulcer, they will likely start with a thorough medical history and physical examination. To confirm the diagnosis and determine the underlying cause, several tests may be ordered:

1. H. pylori Testing

There are several ways to test for H. pylori infection:

• Blood test: Detects antibodies to H. pylori
• Breath test: Involves drinking a solution containing urea and measuring exhaled carbon dioxide
• Stool test: Checks for H. pylori antigens in a stool sample

2. Upper Endoscopy

An upper endoscopy, also known as an esophagogastroduodenoscopy (EGD), is a procedure that allows the doctor to visually examine the upper digestive tract. During this procedure:

• A thin, flexible tube with a camera is inserted through the mouth and into the stomach and small intestine
• The doctor can see any abnormalities and take small tissue samples (biopsies) for further testing
• This test can definitively diagnose an ulcer and rule out other conditions like stomach cancer

3. Upper GI Series

Also called a barium swallow, this test involves:

• Drinking a chalky liquid containing barium
• Taking a series of X-rays as the barium coats the upper digestive tract
• This can reveal the presence and location of ulcers

Treatment Approaches for Peptic Ulcers

The treatment for peptic ulcers depends on the underlying cause. The main goals are to eliminate the H. pylori infection if present, reduce stomach acid, and protect the lining of the stomach and small intestine.

Medications

Several types of medications may be prescribed:

• Antibiotics: To eradicate H. pylori infection
• Proton pump inhibitors (PPIs): To reduce stomach acid production
• H2 blockers: Another class of acid-reducing medications
• Antacids: For symptom relief
• Cytoprotective agents: To protect the lining of the stomach and small intestine

How long does it take for ulcer medications to work? Most people experience significant improvement within 2-4 weeks of starting treatment. However, it’s important to complete the full course of medication as prescribed, even if symptoms improve.

Lifestyle Changes

In addition to medication, certain lifestyle modifications can help promote healing and prevent future ulcers:

• Quit smoking
• Limit or avoid alcohol
• Reduce stress through relaxation techniques or counseling
• Avoid foods that trigger discomfort
• Eat smaller, more frequent meals

Complications of Untreated Peptic Ulcers

Left untreated, peptic ulcers can lead to serious complications. These include:

Internal Bleeding

Ulcers can gradually erode blood vessels in the stomach or small intestine, leading to slow blood loss over time or sudden, severe bleeding. Signs of internal bleeding include:

• Vomiting blood or material that looks like coffee grounds
• Dark, tarry stools
• Lightheadedness or fainting

Perforation

In some cases, an ulcer can create a hole through the wall of the stomach or small intestine. This is a medical emergency that requires immediate surgery. Symptoms of perforation include:

• Sudden, severe abdominal pain
• Fever
• Nausea and vomiting

Obstruction

As ulcers heal, they can produce scar tissue that narrows the digestive tract, leading to a blockage. Signs of obstruction include:

• Feeling full quickly when eating
• Vomiting
• Weight loss
• Bloating

Preventing Peptic Ulcers: Strategies for Reducing Risk

While not all peptic ulcers can be prevented, there are steps you can take to reduce your risk:

1. Practice Good Hygiene

H. pylori can spread through contaminated food and water or person-to-person contact. To reduce your risk of infection:

• Wash your hands thoroughly and frequently
• Eat food that has been properly prepared and cooked
• Drink water from clean, safe sources

2. Use Caution with NSAIDs

If you regularly use NSAIDs:

• Take the lowest effective dose
• Consider taking them with food or milk to reduce stomach irritation
• Ask your doctor about alternative pain relief options
• Consider taking a PPI or H2 blocker along with NSAIDs if you’re at high risk for ulcers

3. Manage Stress

While stress doesn’t cause ulcers, it can worsen symptoms and slow healing. Try stress-reduction techniques such as:

• Meditation or deep breathing exercises
• Regular exercise
• Getting adequate sleep
• Seeking support from friends, family, or a mental health professional

When to See a Doctor: Recognizing the Need for Medical Attention

While some cases of peptic ulcers may heal on their own, it’s important to seek medical attention if you suspect you have an ulcer. Prompt diagnosis and treatment can prevent complications and provide relief from symptoms.

When should you consult a healthcare provider? Consider making an appointment if you experience:

• Persistent abdominal pain lasting more than a few days
• Pain that doesn’t improve with over-the-counter antacids
• Unexplained weight loss
• Difficulty swallowing
• Persistent nausea or vomiting

Remember, severe symptoms such as vomiting blood, passing black stools, or experiencing sudden, severe abdominal pain require immediate medical attention.

Living with Peptic Ulcers: Long-term Management and Outlook

With proper treatment, most peptic ulcers heal within 4 to 8 weeks. However, some people may experience recurring ulcers or ongoing symptoms. To manage your condition long-term:

Follow-up Care

• Attend all scheduled follow-up appointments
• Undergo repeat testing to ensure H. pylori has been eradicated
• Discuss any ongoing symptoms with your healthcare provider

Dietary Considerations

While there’s no specific “ulcer diet,” some people find that certain foods trigger discomfort. Keep a food diary to identify and avoid potential triggers. Some general tips include:

• Eating smaller, more frequent meals
• Avoiding foods that increase stomach acid production, such as caffeine and alcohol
• Incorporating foods rich in flavonoids, such as apples, cranberries, and garlic, which may inhibit H. pylori growth

Monitoring for Recurrence

Be vigilant for signs of ulcer recurrence, such as:

• Return of burning abdominal pain
• Nausea or vomiting
• Changes in appetite

Early detection and treatment of recurring ulcers can prevent complications and improve overall quality of life.

By understanding the causes, symptoms, and treatment options for peptic ulcers, you can take an active role in managing your digestive health. Remember, while ulcers can be painful and disruptive, most cases respond well to treatment, allowing you to return to your normal activities and enjoy a better quality of life.

Diagnosis of Peptic Ulcers (Stomach or Duodenal Ulcers)

How do doctors diagnose a peptic ulcer?

Your doctor may ask you about your medical and family history, perform a physical exam, and order tests to diagnose a peptic ulcer, find its cause, and check for complications.

Medical and family history

To help diagnose peptic ulcers and check for factors that cause ulcers, your doctor will take a medical and family history. Your doctor may ask about

• your symptoms
• your medical history, including any past peptic ulcers or Helicobacter pylori (H. pylori) infections
• medicines you take, especially nonsteroidal anti-inflammatory drugs (NSAIDs)
• your family history of peptic ulcers, H. pylori infection, or cancer in the digestive tract

To help diagnose a peptic ulcer, your doctor will take a medical and family history.

Physical exam

A physical exam may help a doctor diagnose peptic ulcers or ulcer complications. During a physical exam, a doctor most often

• checks for swelling in your abdomen
• listens to sounds within your abdomen using a stethoscope
• taps on your abdomen checking for tenderness or pain

What tests do doctors use to diagnose peptic ulcers?

Doctors may order medical tests to help diagnose peptic ulcers, find the cause, and check for complications.

Blood test

Doctors may use blood tests to check for signs of H. pylori infection or complications of peptic ulcers. For a blood test, a health care professional will take a blood sample from you and send the sample to a lab.

Urea breath test

Doctors may use a urea breath test to check for H. pylori infection. For the test, you will swallow a capsule, liquid, or pudding that contains urea “labeled” with a special carbon atom. If H. pylori is present, the bacteria will convert the urea into carbon dioxide. After a few minutes, you will breathe into a container, exhaling carbon dioxide.

A health care professional will test your exhaled breath. If the test detects the labeled carbon atoms, the health care professional will confirm an H. pylori infection in your digestive tract.

Stool test

Doctors may use stool tests to check for H. pylori infection. Your doctor will give you a container for catching and holding a stool sample. You will receive instructions on where to send or take the kit for testing.

Upper gastrointestinal (GI) endoscopy and biopsy

Doctors may order an upper GI endoscopy to confirm the diagnosis of a peptic ulcer and try to find its cause.

For an upper GI endoscopy, a doctor uses an endoscope—a flexible tube with a camera—to see the lining of your upper GI tract, including your esophagus, stomach, and duodenum. During upper GI endoscopy, a doctor obtains biopsies by passing an instrument through the endoscope to take small pieces of tissue from your stomach lining. A pathologist will examine the tissue under a microscope.

Upper GI series

In some cases, doctors may order an upper GI series to help diagnose peptic ulcers or ulcer complications. Upper GI series uses x-rays and a chalky liquid you swallow called barium to view your upper GI tract.

Ulcers: Common Symptoms, Causes and Treatment

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Authored by Revere Health

August 17, 2016 | Gastroenterology

You may be familiar with the burning pain of acid reflux that travels from your stomach up to your chest after a meal, but this new pain feels different. It’s more like a constant gnawing in your middle or upper stomach between meals. You also feel bloated and often nauseous. What’s going on?

Chances are good that you are one of the 500,000 new cases of peptic ulcers diagnosed each year. Approximately 5 million Americans suffer with an ulcer of some sort, although not every person experiences symptoms.

In addition to the more common burning, bloating and nausea, severe symptoms include:

Dark stool caused by bleeding

Vomiting blood that might resemble coffee grounds

Severe pain in the mid to upper abdomen

Weight loss

What Causes Peptic Ulcers?

This disorder of the upper gastrointestinal tract is the result of damage to the mucosa, the moist tissue that lines the esophagus, stomach, the duodenum region of the small intestine and other digestive organs.

For many years, excess stomach acid was thought to be the cause of ulcers, but doctors now believe the key cause of most ulcers is an infection with a common bacterium called Helicobacter pylori, or H. pylori. Scientists believe the bacterium causes chronic inflammation of the stomach or duodenum, weakening the mucosa, and allowing acid to cause an open sore, or ulcer, in the lining. An estimated 30 percent of Americans are infected with H. pylori, and one in six will develop ulcers. Ulcer disease primarily affects older individuals, most commonly occurring between 55 and 65 years of age.

Factors that damage your sensitive mucosa and put you at risk for ulcers include:

Chronic use of nonsteroidal anti-inflammatory drugs, such as aspirin or ibuprofen, that interfere with the body’s production of prostaglandins – the protective, hormone-like chemicals that keep your stomach lining healthy

Although the exact relationship between cigarette smoking and H. pylori is unclear, “smokers are about two times as likely to develop ulcer disease as nonsmokers,” advises U.S. News &

World Report

Excessive drinking of alcohol

Radiation treatment to the area

Diagnosing Your Ulcer

Your gastroenterologist may prescribe an acid-blocking medication used to treat heartburn to see if your symptoms improve. You may undergo a diagnostic upper endoscopy if your symptoms are severe.

Although ulcers sometimes heal on their own, it’s important to recognize their warning signs. If not properly treated, ulcers can lead to serious health problems, including bleeding or perforation of the organ lining, a life-threatening condition requiring emergency surgery. 35 percent of patients diagnosed with gastric ulcers will suffer serious complications.

Treating Your Ulcer

Your doctor will advise lifestyle changes that might include giving up smoking, NSAIDs and alcohol. He might prescribe medications that include:

•Antibiotics if you have H. pylori infection

•Proton pump inhibitors to reduce acid levels and allow the ulcer to heal

•Upper endoscopy to treat a bleeding ulcer

•Surgery if the ulcer has created a hole in the wall of the stomach, or if there is serious bleeding that can’t be controlled with an endoscope

In the majority of cases, a peptic ulcer will heal in time with proper treatment.

Are you concerned about a loved one’s ulcer or your own stomach pain? Revere Health’s gastroenterologists are specialists who diagnose and treat a wide variety of disorders of the gastrointestinal tract, including ulcers and acid reflux. We offer compassionate, patient-centered care in multiple Utah locations and work with you to develop a treatment plan based on your individual needs and goals.

Revere Health’s experienced gastroenterology professionals offer comprehensive prevention, diagnosis and treatment of digestive disorders. We will work with you to develop a treatment plan based on your individual needs and goals.

Sources:
Web MD
U.S. News: Health

WRITTEN BY:

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What is a stomach ulcer – symptoms, causes and treatment of a stomach ulcer

A stomach ulcer is a chronic gastrointestinal disease that requires constant medical supervision and competent treatment. It affects the mucous membrane of the stomach, and sometimes also the duodenum. If a peptic ulcer is not diagnosed and treated in a timely manner, it can lead to dangerous consequences up to oncology.

With symptoms of this disease, you can contact the Medical and Diagnostic Center “Kutuzovsky” for advice from an experienced gastroenterologist.

How a stomach ulcer is formed and why it is dangerous

In essence, a peptic ulcer is a defect in the lining of the stomach or the next section of the intestine. The ulcer looks like a local inflammation, which is much less protected from the corrosive acid environment of the stomach than healthy areas of the mucous membrane.

The inflamed area is irritated by hydrochloric acid and other aggressive substances contained in gastric juice. Therefore, without treatment and correction of the diet, the condition only worsens.

This can lead to dangerous consequences such as:

• Internal bleeding.
• Perforation, or perforation of an ulcer, when a defect forms at the site of inflammation, through which the contents of the stomach or intestines enter the abdominal cavity. This is an extremely dangerous condition that requires urgent surgery.
• Oncological diseases of the gastrointestinal tract, provoked by an ulcer without timely treatment. If an ulcer is present in the stomach for more than six months, the patient may be referred to an oncologist for control.

Like any chronic pathology, gastric ulcer can go into a phase of exacerbation or remission. The task of the doctor in the treatment of ulcers is to alleviate the acute manifestations of the disease as soon as possible and prevent serious complications.

What symptoms indicate an ulcer

You can recognize peptic ulcer by persistent discomfort associated with the digestive system.

The first and main symptom of the disease is burning pain. It is usually felt at night or between meals when you are hungry. If you take an emollient for heartburn or have lunch, the intensity of the pain decreases. The pain caused by a stomach ulcer does not necessarily recur every day; it may return once every few days or less frequently.

What other symptoms of stomach ulcers usually bother in the acute phase:

• Decreased appetite and weight;
• Sour or bitter eructations;
• Heaviness in the region of the stomach;
• Nausea and vomiting;
• Black stools (in case of an ulcer, this indicates occult bleeding).

These signs accompany not only an ulcer, but also most other pathologies of the gastrointestinal tract – from the most harmless to serious. It is important not to delay contacting a gastroenterologist at the Kutuzovsky LDC if you are concerned about these symptoms. Only a specialist will be able to distinguish peptic ulcer from other gastrointestinal pathologies in adults and prescribe the correct treatment.

Causes of disease

Occurrence and exacerbation of stomach ulcers can be triggered by factors such as:

• Power supply errors over time;
• The bacterium Helicobacter pylori, which often causes gastritis or ulcers in the stomach and duodenum;
• The habit of smoking on an empty stomach, as well as the frequent use of alcohol;
• Severe stress and nervous tension;
• Metabolic disorders.

In addition, some people have a genetic predisposition to peptic ulcers.

Diagnosis of gastric ulcer

At the first sign of a stomach ulcer, the doctor should order an examination. This is important to locate the inflamed areas in the stomach or intestines and confirm that they are indeed present.

What diagnostic methods are used to detect a stomach ulcer and determine the cause of its occurrence:

• Endoscopic examination of the stomach and duodenum;
• Abdominal x-ray with or without contrast;
• Fecal analysis – general, occult blood, coprogram;
• Blood test – general clinical and biochemical;
• Breath test for Helicobacter Pylori.

If the diagnosis is confirmed, it is important to find out what caused the ulcer. This information will be given to the doctor by a conversation with the patient. Be ready to answer the questions of the specialist in detail during the consultation and tell about any unpleasant symptoms, your eating habits, medications, etc.

How to treat ulcers

It is important that the treatment of gastric ulcers be prompt and timely, otherwise the disease can lead to serious consequences.

Provided that the therapy is chosen correctly, the ulcer heals and stops bothering the person in a fairly short period of time (from 2 weeks to 1 month, in rare cases – a little longer). This is usually not about a complete recovery, but about the remission phase, into which chronic peptic ulcer passes.

What means and methods of treatment will the attending physician recommend, depending on the reasons that provoked the exacerbation:

• Antibacterial drugs if the peptic ulcer is caused by H. pylori.
• Refusal of NSAIDs – anti-inflammatory and analgesic drugs that irritate the mucous membranes. The doctor, together with other specialized specialists, can choose a gentle replacement for these medicines, if there is a need to take them constantly due to pain.
• Medicines that relieve the symptoms of peptic ulcer. For 1-2 weeks, while healing is taking place, prescription medications can be taken that reduce the secretion of hydrochloric acid in the stomach. Due to their action, the inflamed area of ​​​​the mucosa is less irritated.

At the same time, people’s advice on how to treat a stomach ulcer cannot be guided: the process must be controlled by a doctor. Procrastination and trying to alleviate the condition on your own can be very dangerous.

Peptic ulcer prevention

In order not to face the symptoms of a stomach ulcer and not treat it for several weeks, it is worth adhering to preventive measures.

Their main principle is to avoid exposures that provoke disease:

• Strong spirits. Under the influence of alcohol, more gastric juice is released, and the gastrointestinal mucosa is irritated.
• Smoking, especially on an empty stomach. Tobacco smoke weakens the protection of the mucosa from an aggressive environment, irritates the inner surface of the stomach and esophagus.
• Mucosal irritants. Use NSAIDs only when absolutely necessary and on the advice of your doctor.
• Stress. Often, peptic ulcers are provoked by psychological causes, so it is important to maintain a normal emotional state. Enough sleep, walking, sports – simple measures will help maintain the health of all systems and organs, including the stomach.

As a preventative measure, it is important to repeat your gastrointestinal exam regularly if you have previously been diagnosed with an exacerbation of peptic ulcer.

Special diet for peptic ulcer disease

The therapeutic diet for gastric ulcer is indicated not only in the phase of exacerbation of the disease, but also after healing of inflammation on the mucous membrane. Chronic problems with the digestive system require special nutrition throughout life.

What can patients with peptic ulcer eat:

• Cereals with water or milk;
• Diet boiled poultry meat;
• Low-fat fish and other healthy foods that do not irritate the gastric mucosa.

All heavy, spicy, fatty foods will have to be excluded from the menu. It is better to choose food that is soft in texture and chew it thoroughly. You need to eat little, but quite often. Detailed dietary advice and a complete list of allowed foods will be given by your doctor at the appointment.