Types of Ulcers | Peptic Ulcers

When acid in the digestive tract destroys the delicate lining of the stomach, small intestine or esophagus, it can cause an open sore called an ulcer. Ulcers in the gastrointestinal tract can be very painful and may sometimes bleed. There are a few different types of ulcers named by their anatomic location, including peptic ulcers and esophageal ulcers. Typically, a layer of mucus protects the lining of your stomach, small intestine and esophagus, but sometimes there’s too much acid or not enough mucus. Either of these situations can allow an ulcer to form. These types of ulcers are common in the United States, particularly peptic ulcers.

Peptic Ulcers: Gastric and Duodenal Ulcers

Peptic ulcers can form in two places. Those that develop in the stomach lining are gastric ulcers, and those that occur in the upper part of the small intestine (the duodenum) are duodenal ulcers.

Peptic ulcer causes

Different types of ulcers have different causes, and they might not be what you’d expect. For example, gastric ulcers (also called stomach ulcers) aren’t caused by spicy food or stress, though these can worsen symptoms of a gastric ulcer.

Both gastric ulcers and duodenal ulcers are most commonly caused by a bacterial infection or from using nonsteroidal anti-inflammatory drugs (NSAIDs) for an extended time. The bacterium, Helicobacter pylori, can live in the mucus layer without causing any symptoms. But, in some cases, it causes inflammation and erodes the mucus coating, which results in an ulcer. Long-term use of NSAIDs, such as ibuprofen and naproxen sodium, can interfere with the role of prostaglandins that protect the mucosal lining, leading to an ulcer. (Prostaglandins are lipids with hormone properties; they have many functions, including the inflammatory response.)

Pairing NSAIDs with other drugs, such as steroids, blood thinners, and osteoporosis medications, can also cause an ulcer.

Peptic ulcer symptoms

Burning stomach pain—anywhere from your belly button up to your breastbone—is the most common symptom of peptic ulcers. Both stomach acid and having an empty stomach can worsen the pain. Some people with peptic ulcers may not be able to tolerate fatty foods.

Other common symptoms of peptic ulcers include:

Less common symptoms include:

Peptic ulcer treatment

Peptic ulcers can heal when the cause is treated. This may be an antibiotic to kill bacteria, or avoiding—possibly even eliminating—the use of NSAIDs. Avoiding coffee and caffeinated soda can also help. You may also need to take a medication to reduce, block or neutralize stomach acid while the ulcer heals. Stopping smoking, avoiding alcohol and reducing stress are also good ways to relieve peptic ulcer pain. Emotional stress is not a direct cause of an ulcer, but it can impair your body’s ability to heal and make you more prone to developing one.

Similar to peptic ulcers, esophageal ulcers—those that form in the esophagus—are open sores that can be quite painful. The treatment for both peptic and esophageal ulcers is similar; however, they have different causes and symptoms.

Esophageal ulcer causes

Ulcers in the esophagus are most commonly caused by gastroesophageal reflux disease (GERD). This condition occurs when the valve separating the stomach from the bottom of the esophagus stops preventing stomach acid from rising upstream into the esophagus, which is called reflux. Frequent acid reflux can wear away the mucus lining of the esophagus and cause ulcers. Esophageal ulcers can also have other causes, including infection, excessive vomiting, alcohol, and chemotherapy.

Esophageal ulcer symptoms

The location of esophageal ulcers produces different symptoms from peptic ulcers. These symptoms include:

• The feeling of food not going down right or getting stuck in your throat

Chest pain can also be a symptom of heart attack. If you believe you may be having a heart attack, call 911 for emergency medical treatment.

Esophageal ulcer treatment

Ulcers in the esophagus can heal, but it takes time. For ulcers related to acid reflux, seeking treatment for GERD is the first step and, in addition to medication to reduce stomach acid, you may need to make some lifestyle changes. These may include:

• Don’t eat for several hours before bedtime

• Avoid foods that make your symptoms worse, such as spicy or acidic foods

If an infection is the cause of the esophageal ulcer, your doctor will prescribe a course of antibiotics. It may also help to raise the head of your bed about 6 to 8 inches to reduce acid reflux, and avoid taking NSAIDs. Both of these practices will help prevent further erosion of the lining of the esophagus giving your esophagus more time to heal.

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.

Ulcers | Cedars-Sinai

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Overview

An ulcer occurs when part of the lining of the stomach or intestines becomes deeply eroded. This typically happens in the stomach (gastric ulcer) or the in the duodenum (duodenal ulcer), which is located at the lower end of the stomach and the beginning of the small intestine. Ulcers range from quite small to an inch or more in size.

Symptoms

Symptoms vary depending on where the ulcer is and how old the patient is. Many patients, especially older ones, may have no symptoms. When symptoms do occur, they tend to come back again and again.

Stomach (or peptic) ulcers may produce few or no symptoms, or they may cause burning, gnawing pain in the upper middle part of the abdomen that is relieved by eating or taking an antacid. Stomach ulcers often are not consistent. For example, eating sometimes will make the pain worse rather than better with certain types of ulcers, such as pyloric channel ulcers, which are often associated with bloating, nausea and vomiting, symptoms of a blockage caused by swelling (edema) and scarring.

Duodenal ulcers tend to cause consistent pain. A patient may feel no pain when he or she awakens, but by midmorning it is present. The pain can be relieved by eating, but it usually returns two to three hours later. Pain that wakes a patient at night is common for duodenal ulcers.

Causes and Risk Factors 

At one time ulcers were believed to be the result of too much stomach acid. It is now known that the main factors that lead to ulcers are the bacteria H. pylori and non-steroidal anti-inflammatory drugs (NSAIDS). These disturb the normal defense and repair processes of the mucosal linings, making them more vulnerable to attack from stomach acid.

How H. pylori causes ulcers is not entirely clear. One theory is that the organism causes ammonia to be created so that it can survive in the stomach’s acid. The ammonia may then erode the mucous barrier that protects the cells of the digestive tract. Other poisons and enzymes from the bacteria may also be a cause, and proteins produced by the body in response to inflammation may play a role.

NSAIDs tend to cause inflammation of the GI tract lining. Weak acids themselves, NSAIDS cause a number of changes within the stomach, including reduced flow of blood to the stomach, less mucus production, and less cell repair and reproduction. All of these tend to break down the process of defense and repair that keeps the mucosa healthy.

Diagnosis

A doctor usually bases a diagnosis of peptic ulcer on the patient’s history. A physician will want to rule out the presence of stomach cancer, which can have similar symptoms. This is especially true in patients who are older, have lost weight, have severe symptoms or do not respond to treatment.

The diagnosis can be confirmed through a variety of studies, such as:

• Endoscopy, which uses a camera attached to the end of a flexible tube to allow the doctor to see inside the body. This can reliably detect swelling and irritation (inflammation) of the esophagus and esophageal ulcers as well as H. pylori infection.
• Barium swallow
• Cytology (examination under a microscope of cells from the affected area)
• Multiple biopsies
• X-rays or CT scans to identify ulcers that have caused holes in the stomach or intestines

Treatment

In the past, ulcers were treated by trying to neutralize or decrease the amount of acid in the stomach. Current treatment focuses on eliminating H. pylori through antibiotics. Antibiotic treatment should be given to all ulcer patients who have been diagnosed with H. pylori, even if they have no symptoms or are being treated to reduce stomach acid. Antibiotic treatment is especially important for patients who have had complications in the past. Antibiotics to treat H. pylori are evolving, and a combination of antibiotics is usually prescribed.

The symptoms of an ulcer can be relieved by taking antacids, which can also help prevent the symptoms from coming back and help promote healing of the ulcer. Antacids must be taken five to seven times a day and can interfere with the body’s ability to absorb other drugs. The two general types of antacids are:

• Ones that the body can absorb, such as baking soda. These are quick and effective but may have side effects when taken on a regular basis
• Ones that interact with stomach acid to create salts that are not absorbed by the body and are excreted

While there is currently no evidence that changing the diet helps an ulcer heal faster or prevents its return, a doctor may suggest that any food that causes distress be eliminated. These may include fruit juices, spicy foods and fatty foods.

Alcohol tends to increase the acid in the stomach, and ulcer patients are usually advised to restrict their drinking of alcohol. Persons who smoke are at a higher risk of developing ulcers and complications. Smoking also slows the healing process and makes the return of ulcers more likely.

Although surgical treatment is being prescribed less often, surgery may be necessary if complications do not respond to medical therapy, symptoms are severe or there is a suspicion that the ulcer may be cancerous.

More than 60% of people have a return of their ulcers a year after traditional treatment has ended. Fewer than 10% of people have a recurrence of ulcers after anti-H. pylori therapy. The use of non-steroidal anti-inflammatory drugs might also affect recurrence of ulcers.

Complications

Certain complications can also result from peptic ulcers, including:

• Bleeding
• A hole in the wall of the stomach or duodenum. This causes intense, ongoing pain that may be felt in locations other than the abdomen. The pain may change with shifts in body position.
• A hole into the peritoneal cavity, which surrounds the organs of the abdomen. This causes sudden, intense pain that spreads quickly throughout the abdomen and is worse with movement.
• A blockage. The outlet of the stomach may become blocked as a result of scarring, muscle spasms or inflammation related to an ulcer. This causes repeated, high volume vomiting, usually at the end of the day. There may also be a feeling of bloating after eating and a loss of appetite. Dehydration and weight loss are risks if vomiting continues.

Treatment of complications varies. For example:

• Bleeding may be stopped using a variety of minimally invasive techniques.
• Acid-suppressing drugs may be given intravenously and continued until the condition stabilizes.
• Emergency surgery may be necessary if the patient gets worse even with treatment and blood transfusions and if their pulse rate and blood pressure are not stable.

Persons who have H. pylori-related ulcers may be at higher risk for certain forms of cancer and lymphoma.

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

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Peptic Ulcer Disease: Treatment, Symptoms, Causes, Prevention

Overview

What is peptic ulcer disease?

Peptic ulcer disease is a condition in which painful sores or ulcers develop in the lining of the stomach or the first part of the small intestine (the duodenum). Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing stomach acid to damage the tissue.

Who is more likely to get ulcers?

One in 10 people develops an ulcer. Risk factors that make ulcers more likely include:

• Frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs), a group of common pain relievers that includes ibuprofen (Advil® or Motrin®).
• A family history of ulcers.
• Illness such as liver, kidney or lung disease.
• Regularly drinking alcohol.
• Smoking.

Symptoms and Causes

What causes ulcers?

People used to think that stress or certain foods could cause ulcers. But researchers haven’t found any evidence to support those theories. Instead, studies have revealed two main causes of ulcers:

H. pylori bacteria

H. pylori commonly infects the stomach. About 50% of the world’s population has an H. pylori infection, often without any symptoms. Researchers believe people can transmit H. pylori from person to person, especially during childhood.

The H. pylori bacteria stick to the layer of mucus in the digestive tract and cause inflammation (irritation), which can cause this protective lining to break down. This breakdown is a problem because your stomach contains strong acid intended to digest food. Without the mucus layer to protect it, the acid can eat into stomach tissue.

However, for most people the presence of H. pylori doesn’t have a negative impact. Only 10% to 15% of people with H. pylori end up developing ulcers .

Pain relievers

Another major cause of peptic ulcer disease is the use of NSAIDs, a group of medications used to relieve pain. NSAIDS can wear away at the mucus layer in the digestive tract. These medications have the potential to cause peptic ulcers to form:

• Aspirin (even those with a special coating).
• Naproxen (Aleve®, Anaprox®, Naprosyn® and others).
• Ibuprofen (Motrin®, Advil®, Midol® and others).
• Prescription NSAIDs (Celebrex®, Cambia® and others).

Acetaminophen (Tylenol®) is not an NSAID and won’t cause damage to your stomach. People who can’t take NSAIDs are often directed to take acetaminophen.

Not everyone who takes NSAIDs will develop ulcers. NSAID use coupled with an H. pylori infection is potentially the most dangerous. People who have H. pylori and who frequently use NSAIDs are more likely to have damage to the mucus layer, and their damage can be more severe. Developing an ulcer from NSAID use also increases if you:

• Take high doses of NSAIDs.
• Are 70 years or older.
• Are female.
• Use corticosteroids (drugs your doctor might prescribe for asthma, arthritis or lupus) at the same time as taking NSAIDs.
• Use NSAIDS continuously for a long time.
• Have a history of ulcer disease.

Rare causes

Infrequently, other situations cause peptic ulcer disease. People may develop ulcers after:

• Being seriously ill from various infections or diseases.
• Having surgery.
• Taking other medications, such as steroids.

Peptic ulcer disease can also occur if you have a rare condition called Zollinger-Ellison syndrome (gastrinoma). This condition forms a tumor of acid-producing cells in the digestive tract. These tumors can be cancerous or noncancerous. The cells produce excessive amounts of acid that damages stomach tissue.

Can coffee and spicy foods cause ulcers?

It’s a common misconception that coffee and spicy foods can cause ulcers. In the past, you might have heard that people with ulcers should eat a bland diet. But now we know that if you have an ulcer, you can still enjoy whatever foods you choose as long as they don’t make your symptoms worse.

What are some ulcer symptoms?

Some people with ulcers don’t experience any symptoms. But signs of an ulcer can include:

• Gnawing or burning pain in your middle or upper stomach between meals or at night.
• Pain that temporarily disappears if you eat something or take an antacid.
• Bloating.
• Heartburn.
• Nausea or vomiting.

In severe cases, symptoms can include:

• Dark or black stool (due to bleeding).
• Vomiting.
• Weight loss.
• Severe pain in your mid- to upper abdomen.

Diagnosis and Tests

How are ulcers diagnosed?

Your healthcare provider may be able to make the diagnosis just by talking with you about your symptoms. If you develop an ulcer and you’re not taking NSAIDs, the cause is likely an H. pylori infection. To confirm the diagnosis, you’ll need one of these tests:

Endoscopy

If you have severe symptoms, your provider may recommend an upper endoscopy to determine if you have an ulcer. In this procedure, the doctor inserts an endoscope (a small, lighted tube with a tiny camera) through your throat and into your stomach to look for abnormalities.

H. Pylori tests

Tests for H. pylori are now widely used and your provider will tailor treatment to reduce your symptoms and kill the bacteria. A breath test is the easiest way to discover H. pylori. Your provider can also look for it with a blood or stool test, or by taking a sample during an upper endoscopy.

Imaging tests

Less frequently, imaging tests such as X-rays and CT scans are used to detect ulcers. You have to drink a specific liquid that coats the digestive tract and makes ulcers more visible to the imaging machines.

Management and Treatment

Will ulcers heal on their own?

Though ulcers can sometimes heal on their own, you shouldn’t ignore the warning signs. Without the right treatment, ulcers can lead to serious health problems, including:

• Bleeding.
• Perforation (a hole through the wall of the stomach).
• Gastric outlet obstruction (from swelling or scarring) that blocks the passageway from the stomach to the small intestine.

What ulcer treatments are available?

If your ulcer is bleeding, your doctor may treat it during an endoscopy procedure by injecting medications into it. Your doctor could also use a clamp or cauterization (burning tissue) to seal it off and stop the bleeding.

For most people, doctors treat ulcers with medications, including:

• Proton pump inhibitors (PPI): These drugs reduce acid, which allows the ulcer to heal. PPIs include Prilosec®, Prevacid®, Aciphex®, Protonix® and Nexium®.
• Histamine receptor blockers (h3 blockers): These drugs also reduce acid production and include Tagamet®, Pepcid®, Zantac® and Axid®.
• Antibiotics: These medications kill bacteria. Doctors use them to treat H. pylori.
• Protective medications: Like a liquid bandage, these medications cover the ulcer in a protective layer to prevent further damage from digestive acids and enzymes. Doctors commonly recommend Carafate® or Pepto-Bismol®.

Prevention

How can I prevent ulcers?

You may be able to prevent ulcers from forming if you:

• Talk to your doctor about alternatives to NSAID medications (like acetaminophen) to relieve pain.
• Discuss protective measures with your doctor, if you can’t stop taking an NSAID.
• Opt for the lowest effective dose of NSAID and take it with a meal.
• Quit smoking.
• Drink alcohol in moderation, if at all.

Outlook / Prognosis

Are ulcers curable?

For most people, treatment that targets the underlying cause (usually H. pylori bacterial infection or NSAID use) is effective at eliminating peptic ulcer disease. Ulcers can reoccur, though, especially if H. pylori isn’t fully cleared from your system or you continue to smoke or use NSAIDs.

How long does it take an ulcer to heal?

It generally takes several weeks of treatment for an ulcer to heal.

Living With

Will drinking milk help an ulcer?

No. Milk may temporarily soothe ulcer pain because it coats the stomach lining. But milk also causes your stomach to produce more acid and digestive juices, which can make ulcers worse.

Is it safe to take antacids?

Antacids temporarily relieve ulcer symptoms. However, they can interfere with the effectiveness of prescribed medications. Check with your doctor to find out if antacids are safe to take while undergoing treatment.

What should ulcer patients eat?

No foods have been proven to negatively or positively impact ulcers. However, eating a nutritious diet and getting enough exercise and sleep is good for your overall health.

What questions should I ask my doctor?

If you have stomach ulcers, you may want to ask your doctor:

• What pain reliever can I use instead of an NSAID?
• How will I know if the H. pylori infection is gone?
• How do we find out if the ulcer has healed?
• What can I do relieve symptoms at home during treatment?

A note from Cleveland Clinic

Contrary to commonly held beliefs, ulcers aren’t caused by stress or foods you eat. Most of time, bacteria causes them. Doctors can treat the bacteria with antibiotics and other medications.

If you’ve been popping a lot of antacids lately, you’re constantly snacking to get rid of a gnawing pain in your stomach or you have any other signs of an ulcer, the best thing you can do for your health is talk to your provider. Treatment can heal an ulcer in a matter of weeks.

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.

Ulcer Disease | Gastrointestinal Society

Click here to download a PDF of this information.

A peptic ulcer is a sore or break in the lining of any part within the digestive tract that contains concentrated gastric juice. The main components of gastric juice are water, mucus, hydrochloric acid, enzymes, and electrolytes. Ulcers most commonly occur in the first part of the small intestine below the stomach (duodenum) and can also occur at the lower end of the esophagus or in the stomach.

Most ulcers result from infection with Helicobacter pylori (H. pylori) bacteria. Contrary to old beliefs, neither eating spicy food nor living a stressful life cause ulcers. H. pylori bacteria weaken the protective mucous coating of the esophagus, stomach, or duodenum, which then allows acid to get through to the sensitive lining beneath. Once the protective coat is weakened, then both acid and H. pylori irritate this lining and cause a sore (ulcer) to form.

It is unclear how these bacteria spread from person to person and why only a small percentage of those who have H. pylori within the stomach develop peptic ulcers. Just because you have H. pylori bacteria populating your stomach does not mean you will get an ulcer, although most diagnosed with ulcers also have an H. pylori infection.

Another cause of ulcers is the regular use of pain medications called non-steroidal anti-inflammatory drugs (NSAIDs), which include aspirin, ibuprofen, and naproxen. Frequent or long-time use of NSAIDs, especially among the elderly population, can increase the risk of developing an ulcer.

About 10% of Canadians will experience peptic ulcers at some point throughout their lives.

Ulcer Disease Symptoms

The most common symptom of an ulcer is a burning pain in the upper abdomen, somewhere between the breastbone and the navel. The pain can last anywhere from a few minutes to several hours, often occurs between meals, and can awaken you from sleep. Food or antacids might temporarily relieve the discomfort. Less common symptoms of an ulcer include nausea, vomiting, lack of appetite, and weight loss.

There are three main complications of peptic ulcers: bleeding, perforation, and obstruction.

Bleeding may be the first and only symptom of an ulcer. Bleeding ulcers can cause vomiting of acidified blood that looks like ‘old coffee grounds’ and/or bowel movements that appear black. When an ulcer bleeds and continues to bleed without treatment, a person might become anemic.

Perforation can occur when ulcers go untreated, as gastric juices can make a hole through (perforate) the stomach and/or duodenal lining, requiring surgery to close the opening.

Obstruction is a complication that can occur when chronic inflammation from the ulcer causes swelling and scarring. Over time, this scarring may close (obstruct) the outlet of the stomach, preventing the passage of food and causing vomiting and weight loss. Surgery is required to repair obstructions.

It is important to contact a physician immediately if your ulcer symptoms worsen.

Diagnosing Ulcer Disease

The most common tests used to check for the presence of an ulcer are:

Upper GI series: You will swallow a liquid that contains barium and then a technician will take X-rays. Barium coats the esophagus, stomach, and upper part of the small intestine, which makes their outline visible on the X-ray images.

Gastroscopy: A physician passes a long flexible tube with a tiny video camera on the end (endoscope) through the mouth and down the esophagus to the stomach to look for the presence of inflammation or ulcers. If necessary, the physician removes a small sample of tissue (biopsy) for further testing.

Tests for H. pylori: There are several tests available to detect Helicobacter pylori infection. These include a simple breath test, checking the blood for antibodies to the bacteria, or examination of stomach biopsies.

Management of Ulcer Disease

Dietary and Lifestyle Modifications

Physicians often recommend lifestyle and dietary changes for those with ulcers in addition to medications until the ulcers completely heal. It is best to avoid certain foods and beverages such as chocolate, coffee, alcohol, fatty foods, peppermint, citrus fruits and juices, tomato products, pepper, mustard, and vinegar during healing. Eating smaller meals more frequently may also control symptoms better. Smoking cessation is important, as smoking inhibits ulcer healing. You should also not take NSAIDs, such as aspirin, ibuprofen, or naproxen because they can cause further damage to stomach tissue. Your physician will probably lift any dietary restrictions once your ulcers have healed.

Medications

The cause of your ulcer will determine the type of medical treatment that your physician recommends. If caused by NSAID use, then your doctor may discontinue prescribing NSAID medication, suggest a different pain medication, or continue NSAID use and add another medication to protect your stomach and duodenum, such as a proton pump inhibitor (PPI), which reduces stomach acid production.

If H. pylori infection is the cause, then your doctor may prescribe a treatment plan to kill the infection while reducing the acid in your stomach. Usually, this is a combination of one or more antibiotics (to kill the bacteria) plus a PPI. It is important to follow the treatment plan exactly as your doctor prescribes. This treatment can permanently cure 80-90% of peptic ulcers.

Some of the common antibiotic medications prescribed for treatment of ulcers caused by H. pylori infection include amoxicillin, clarithromycin, tetracycline, and metronidazole. It is important to take antibiotic prescriptions until they are complete. This helps prevent the growth of superbugs (more resistant bacteria) that might make subsequent infections more difficult to treat.

Along with the antibiotic, your physician will likely prescribe a PPI. PPIs work by blocking an enzyme necessary for acid secretion. These include omeprazole (Losec®), lansoprazole (Prevacid®), pantoprazole sodium (Pantoloc®), esomeprazole (Nexium®), rabeprazole (Pariet®), pantoprazole magnesium (Tecta®), and dexlansoprazole (Dexilant®).

Ulcer Disease Outlook

Acquiring H. pylori infection during childhood is common and individuals carry it throughout their lives, often without consequence. Transmission within a family is very rare, so indiscriminate screening for H. pylori is unnecessary.

To help ensure that you remain ulcer-free, it is important to take all of your medication exactly as your physician prescribes, even if you begin to feel better part way through treatment. Re-infection after successful eradication of H. pylori is uncommon.

Want to learn more about ulcer disease?

We have several related articles that may be helpful:

Image Credit: © bigstockphoto.com/GeorgeRudy

List of 40 Stomach Ulcer (Gastric Ulcer) Medications Compared

Stomach ulcers are small holes or erosions that occur in the lining of your stomach. They may also be called gastric ulcers.

Ulcers can also form in your duodenum which is the first part of your small intestine, immediately beyond your stomach. A peptic ulcer is a term used to describe either a stomach or duodenal ulcer.

What Causes a Stomach Ulcer and Who is More at Risk?

Our stomach is lined with a mucus-producing inner layer known as the mucosa. This layer is delicate and its integrity depends on a careful balance of protective factors (such as the production of mucus) and destructive factors (such as acid production).

Disruption of this balance can result in a break in this protective layer, causing a stomach ulcer. Disruptions may occur as a result of:

• Excessive acid production
• Excessive alcohol consumption (stimulates acid production)
• Infection, particularly with a common stomach bacterium known as Helicobacter Pylori
• Medications NSAIDs  (eg, aspirin, ibuprofen, diclofenac, ketoprofen)
• Other conditions, such as liver disease, Crohn’s disease, or Zollinger-Ellison syndrome
• Physical stress, such as major surgery or burns.

Although everyday stress (emotional stress) doesn’t appear to cause ulcers, it may make the pain worse.

The risk of getting an ulcer is also increased in people who smoke and coffee has been known to stimulate acid production in the stomach and make ulcers worse. 

What are the Symptoms of a Stomach Ulcer?

Symptoms vary from person to person, and some people may have no symptoms at all. Abdominal pain is common, and that associated with stomach ulcers tends to worsen after food. Other common symptoms include:

• Bloating or belching
• Blood in the vomit or stools or dark tarry stools
• Chest pain
• Heartburn or indigestion
• Nausea or vomiting
• Tiredness
• Weight loss.

Symptoms such as vomiting, severe pain or blood in the stools are rare with stomach ulcers and should be reported to your doctor.

Most ulcers occur in the first layer of the inner lining. A hole that goes all the way through is called a perforation and will cause severe pain and bleeding. It is a medical emergency.

How is a Stomach Ulcer Diagnosed?

To help diagnose a stomach ulcer, your doctor will ask you what medications you take or have been taking, and if you have had a peptic ulcer or any other relevant condition in the past. Make sure you mention all the medications you are taking, especially NSAIDs such as aspirin, ibuprofen, diclofenac, or ketorolac.

Your doctor will also conduct a physical examination, to check for bloating or lumps within your abdomen, and to listen for bowel sounds. Make sure you mention any areas of pain or tenderness.

Blood may also be taken to test for infection or anemia and testing may also be conducted for Helicobacter pylori, a bacteria commonly associated with stomach ulcers. Testing usually involves either a breath test, stool sample, or biopsy. To get a clear picture of the inside of your stomach and small intestines, doctors may use an endoscope (a small thin tube with a camera on the end), a series of X-rays (called an upper GI series) and/or a CT scan.

How is a Stomach Ulcer Treated?

Treatment for stomach ulcers usually involves a combination of medications which reduce acid secretion, protect the mucosa, and kill H. pylori bacteria (if present).

This allows ulcers to heal and reduces the chance of them will come back. All medications should be taken exactly as prescribed.

Examples of medications that may be considered to treat stomach ulcers include:

• Antibiotics to kill H. pylori (usually two or three different antibiotics are taken in combination for one to two weeks)
• h3 receptor blockers that reduce stomach acid production (like cimetidine, ranitidine, or famotidine)
• Proton pump inhibitors to block stomach acid production (such as esomeprazole, lansoprazole, omeprazole, or pantoprazole)
• Protectants that coat the ulcer and protect it against acid and enzymes, enhancing healing (like sucralfate)
• Bismuth (may help protect the lining and kill the bacteria).

Rarely, surgery may be needed.

If NSAIDs have caused your stomach ulcer, your doctor may advise you to stop taking them, reduce their dosage, or switch to an alternative medicine. Follow his/her advice. Talk to your doctor before taking antacids as these may reduce the absorption of some other medications.

How Can I Prevent a Stomach Ulcer From Developing?

• Don’t smoke or chew tobacco.
• Limit alcohol.
• Avoid all NSAIDs, such as aspirin, diclofenac, ibuprofen, and naproxen. Try acetaminophen instead.
• Eat a well-balanced, healthy diet. Avoid late-night snacks or overeating.
• Reduce stress.

The following list of medications are in some way related to, or used in the treatment of this condition.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Peptic ulcer / Diseases / Clinic EXPERT

Peptic ulcer is a group of chronic diseases that are manifested by a change in periods of exacerbation and remission. There is an inflammatory process and the formation of ulcerative defects in the mucous membrane of the stomach and / or duodenum (Duodenum). As a rule, peptic ulcer disease is seasonal in nature, the period of exacerbation of the disease is noted in the spring and autumn seasons.

Peptic ulcer disease is quite common in the modern world.In industrialized countries, there are 8-10% of the population who suffer from this ailment. In Russia, over the past 10 years, the incidence of peptic ulcer disease has increased by 38%. It is important to note that gastric ulcer is observed in the population over 40 years old, and duodenal ulcer is most often detected before the age of 40. As for gender, men are more likely to get sick than women. The ratio between women and men for stomach ulcers is 1: 2, and for duodenal ulcers 1: 4.

The causes of peptic ulcer disease

The causal factors causing the formation of ulcers are:

• infection Helicobacter pylori
• thermally, mechanically, chemically “rough food”, irregular, dry food
• heredity
• smoking drugs, alcohol, various
• taking ulcerogenic drugs
• stresses

Peptic ulcer disease is based on the imbalance of protective and damaging factors in the stomach and duodenum.

Protective factors:

• protective barrier of mucus
• adequate blood circulation
• regenerative capacity of stomach cells
• synthesis of substances that suppress and inhibit damaging factors

Damaging factors:

• overproduction of hydrochloric acid and enzyme-pepsin
• infection of the mucous membrane Helicobacter pylori
• effects on the mucous membrane of the stomach and duodenum of bile, pancreatic juice
• tobacco smoking, alcohol
• some medications
• heredity

Symptoms of peptic ulcer disease

7 stomach – pain appears 1 / 2h-1h after eating, lasts 1-2 hours, and then subsides.Pain occurs in the epigastric (epigastric) region and on the left.
• Ulcers of the antrum, the pylorus of the stomach, as well as the duodenal bulb – hungry, nighttime, late pains appear. Late pains appear 2-3 hours after eating. “Hungry” pains – occur on an empty stomach, subside after eating a small amount of food. Night pains occur in the early morning hours (2-4 hours). More often, pain occurs in the epigastric (epigastric) region, on the right.
• Ulcers of the cardiac stomach – pain occurs in 10-15 minutes or immediately after eating and bothers directly in the epigastric region.

Stomach dyspepsia

• For stomach ulcers: heartburn, sour belching, nausea, refusal to eat.
• For duodenal ulcers (duodenal ulcers): belching, heartburn, nausea, less often, sour vomiting.

Intestinal dyspepsia

• with stomach ulcers: a tendency to diarrhea
• with duodenal ulcers: a tendency to constipation

Astheno-vegetative manifestations

• Appears in any localization of ulcers: decreased performance, fatigue, irritability, fatigue.

Peptic Ulcer Risk Test

Take a few minutes to answer the questions below. Try to be honest. Answer the questions: “yes” or “no”.

1. Do you and / or your relatives have any diseases of the gastrointestinal tract?
2. Have any of your relatives been diagnosed with Helicobacter pylori?
3. Do you smoke?
4. Do you follow your diet?
5. Are you worried about heartburn, sour belching, aversion to food?
6. Have you noticed a decrease in body weight recently?
7. Are you concerned about stomach discomfort or pain?
8. Have you ever noticed that you wake up at night with a stomach ache?
9. Do you have blood group I?
10. Do you often take painkillers?
11. Do you often find yourself in stressful situations?
12. Do you often visit common food places (fast food, canteen, cafe, restaurant)?

Test Results: If you answered “YES” to at least 2-3 questions, you are at risk of peptic ulcer disease.If you want to prevent the progression of the disease and reduce the risk of complications and disability, you should consult a gastroenterologist. Remember that peptic ulcer disease can be asymptomatic for both you and your loved ones. Listen to your body, try to analyze your life, habits, nutrition, as well as the level of health in the family. A specialist of the EXPERT Clinic will be able to answer all your questions.

Diagnosis of peptic ulcer disease

At the first stage of diagnosis, the doctor collects complaints and a thorough objective examination.Then, taking into account all the risks of the disease, concomitant pathology, the doctor draws up an individual diagnosis plan, which includes laboratory and instrumental examination methods. Today, there are many biochemical indicators that help not only in the diagnosis of diseases of the gastrointestinal tract, but also in the timely identification of possible complications.

You can also start the examination with a basic screening for stomach diseases.

Forecast

In case of timely diagnosis and adequate complex treatment and the absence of complications, the prognosis is favorable.

Unfortunately, with an untimely appeal to an expert gastroenterologist, in some cases the condition progresses with the emergence of life-threatening complications leading to disability and sometimes death.

If peptic ulcer disease is not detected in time, the following serious complications may develop:

• Bleeding is a fairly common complication of peptic ulcer disease (10-15%). Duodenal ulcers bleed more often than stomach ulcers.Vivid symptoms of bleeding are manifested in the period of exacerbation of peptic ulcer disease and are very diverse. Typical signs: bloody vomiting, black – tarry stools, constant weakness, dizziness, decreased blood pressure, increased heart rate. It is necessary to urgently consult a doctor, since this condition harbors a person’s life.
• Perforation (perforation) of the ulcer occurs in 5-20% of cases. It occurs in men 10-20 times more often than in women. The patient feels a “dagger”, sharp pain in the stomach, takes a forced position (on the right side or back, knees are brought to the stomach).The state of health gradually worsens, pallor of the skin and mucous membranes appears, a decrease in the pulse rate (bradycardia). It is also important to note that in elderly patients, perforation can occur without visible symptoms and without severe pain.
• Penetration – a condition when an ulcer spreads beyond the boundaries of the stomach and duodenum. It is observed in 15% of cases. With this condition, pain in the stomach appears when eating. Also, the pain can be given to the back, to the right hypochondrium, it can be shingles in nature.The localization of pain is determined by the depth of the injury and the organ that is involved in the process.
• Pyloric stenosis – in 6-15% of patients with peptic ulcer disease. The clinical picture depends on the severity of the narrowing of the pylorus. There is heaviness in the stomach after eating, vomiting, which brings relief, periodically there is sour belching. When the condition worsens, discomfort and a feeling of fullness in the stomach appear after eating a small amount of food, belching with a rotten egg. Only the correct antiulcer treatment can improve the condition.
• Malignancy – a stomach ulcer can transform into a malignant tumor. The frequency of malignancy ranges from 1 to 38%. In people over 60 years of age, the risk of the transition of peptic ulcer disease to stomach cancer is 1.4-2 times more often than in young people. Clinical manifestations range from latent (latent) course to vivid symptoms of the disease. That is why if you suspect that you have even minimal signs of stomach disease, consult an expert doctor in order to timely identify the risks of complications, improve the quality of life and avoid deaths.

Treatment

Treatment of peptic ulcer should be comprehensive, taking into account the etiological factor of the disease. Depending on the area, the depth of the lesion and associated complications, conservative (drug) and surgical treatment are distinguished.

Drug treatment is selected individually, based on etiological factors and concomitant pathology. The doctor, starting the drug treatment of the patient, must also follow what drugs the patient uses in everyday life.Experts of the EXPERT Clinic always select an effective therapy, taking into account the individual sensitivity and characteristics of each patient, use drugs of a new level and generation.

Prevention and recommendations

It is necessary to exclude those factors that lead to the development of peptic ulcer and monitor the state of health in the presence of a hereditary predisposition, even if nothing bothers you.

Risk factors for the development of peptic ulcer:

• infection Helicobacter pylori
• hereditary predisposition
• blood group I (0)
• bad habits (tobacco smoking, alcohol and its substitutes)
• increased stomach acidity
• violation of working conditions and rest, frequent stress
• taking ulcerogenic drugs (hormones, ibuprofen, nise, nurofen, diclofenac and others)
• non-compliance with food intake
• diseases of the gastrointestinal tract (cholecystitis, pancreatitis, gastritis, gastroduodenitis)
• chronic obstructive Lungs, systemic diseases, chronic renal failure.

Frequently asked questions

Can peptic ulcer disease be inherited?

The ulcer itself cannot, but the risk factors for its development are certainly.

Can a peptic ulcer get infected?

In case of infection with Helicobacter, the risk of developing a peptic ulcer, mainly in the duodenum and antrum, is significantly higher.

Can an ulcer develop into cancer?

In the case of a long-term current inflammatory process, metaplasia may develop – a change in the typical structure of cells in the gastric mucosa and, less often, in the duodenum, which significantly increases the risk of malignancy.

Can an ulcer be cured?

An uncomplicated ulcer heals itself, and the disease “peptic ulcer” and the process of ulceration are cured when the cause (Helicobacter pylori, bile throwing, drug-induced effects, endocrine diseases, etc.) is identified and eliminated.

Can peptic ulcer disease be treated without antibiotics?

If the peptic ulcer is not caused by the HP bacterium – certainly, in the case of HP-associated disease – a course of antibiotic therapy is required.

Case histories

Case history No. 1

When contacting the EXPERT Clinic, patient E., 32 years old, complained of aching, cutting pains in the epigastric region 1.5 hours after eating, often at night, on an empty stomach, heartburn, belching sour, constipation, weakness, fatigue.

Within 5 years, in the fall, noted the appearance of aching pains in the epigastrium, heartburn. Takes maalox on his own. 4 years ago, a 7-day eradication therapy was carried out using amoxicillin and clarithromycin.Post-treatment controls were not carried out. From the anamnesis of life: eats irregularly, work is associated with frequent business trips, smokes.

The patient was assigned an examination (blood test; ultrasound of the logans of the abdominal cavity, FGDS + HP-test, etc.) as a result of which the diagnosis was made: Peptic ulcer disease. Duodenal ulcer, exacerbation. HP (+). Cicatricial deformity of the duodenal bulb. Additionally, a C13-carbon breath test for HP was prescribed, which showed a high contamination of HP.A complex treatment was prescribed, aimed at eliminating the active factor – NR. During the control examination and examination, the patient did not show any complaints, and during the endoxopic examination, a significant positive dynamics was revealed. HP – not found. In the future, the patient undergoes a preventive examination once every 6 months. Over the past 2 years after the treatment, exacerbations were not observed.

Story # 2.

Patient S., 49 years old, turned to the EXPERT Clinic with complaints of aching pains in the epigastric region (more on the left), after 20 minutes.after eating, sour eructation, heartburn, ameliorated after taking Almagel. A year ago, there were similar complaints after errors in the diet, independently took maalox, famotidine.

Laboratory and instrumental examination revealed an ulcer of the body of the stomach. The patient was prescribed treatment, including dietary advice and drug therapy, aimed at protecting, restoring and reducing inflammation of the gastric mucosa. Complaints were stopped. The patient continues treatment and observation at the EXPERT Clinic.

Peptic ulcer of the stomach and duodenum

Peptic ulcer is a disease in which defects (ulcers) form in the stomach and / or duodenum of a person.

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

Interestingly, duodenal ulcer disease occurs much more often than gastric ulcer.

Causes of stomach ulcer

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

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

• stress, anxiety, depression;
• bad heredity;
• unhealthy diet: consumption of rough and spicy food, alcohol abuse;

90,011 smoking;

• uncontrolled intake of certain medications (reserpine, corticosteroid hormones, aspirin).

What’s happening?

The microbe Helicobacter pylori is transmitted from person to person through close long-term contact, for example, through kissing, through shared dishes and towels, as well as by non-compliance with the rules of hygiene in toilets.

Once in the stomach, Helicobacter begins to actively multiply and conduct subversive activities. It produces special enzymes (urease, proteases) that damage the protective layer of the mucous membrane (inner) of the stomach and duodenum, disrupts cell functions, mucus production and metabolic processes and causes ulcers.

On the other hand, constant stress can alter the functioning of the nervous system, which leads to a spasm of the muscles and blood vessels of the stomach. As a result, it remains without food and loses its invulnerability: the walls begin to be digested by caustic gastric juice. An ulcer is formed.

How to recognize?

First of all, the onset and development of peptic ulcer disease is signaled to a person by pain in the upper abdomen.Troubled by night pains, in which a person needs to eat something to “extinguish” the pain.

Often worried about heartburn 2-3 hours after eating. Nausea, vomiting, “sour” belching, frequent constipation, all this indicates that it is time for you to see a gastroenterologist.

Keep in mind, in some cases, the ulcer may be asymptomatic!

Why is it dangerous?

If the disease is left untreated, the ulcer defect extends deep into the stomach wall.This process can end with life-threatening complications: perforation (perforation), in which a through hole forms in the wall of the stomach or intestine, and bleeding.

Diagnostics

To establish the diagnosis of peptic ulcer disease, it is necessary to conduct esophagogastroduodenoscopy (EGDS), ultrasound and radiography of the stomach will help to make the correct diagnosis, Helicobacter Pylori test

This pathology is treated in our medical center

gastroenterologist nutritionist

Korobova Irina Vladimirovna.

Registration is carried out by phone +7 (495) -745-65-03 +7 (495) -745-65-06 +7 (495) -745-65-07

Stomach and duodenal ulcer

Stomach and duodenal ulcer is a wound, ulceration, deep defect in the wall of the duodenum or stomach.

An ulcer can get to the deep layers (it can penetrate into the muscle layer and even deeper) of the duodenal wall and stomach, often complicated by bleeding, as well as perforation of the walls of the duodenum and stomach, which is fraught with serious consequences.In most cases, peptic ulcer disease occurs against the background of an existing gastritis (gastroduodenitis), which, like peptic ulcer disease, develops as a result of exposure to the bacteria Helicobacter pylori (Helicobacter pyloriosis). The thing is that cracks form on the surface of the mucous membrane of the stomach of a person with gastritis – erosion. And if you do not carry out the appropriate treatment, they deepen and get to the muscle layer of the stomach, turning into ulcers.

The main symptom of peptic ulcer disease is the same as in gastritis – pain in the epigastric region on the left side.In case of peptic ulcer disease, they differ in frequency – they can fade out and reappear (the so-called relapse, or exacerbation of peptic ulcer disease).

In most cases, the onset of symptoms of peptic ulcer disease depends on the season: exacerbation most often occurs in spring and autumn. This is the difference between it and gastritis, which is not seasonal in nature, and the occurrence of discomfort in the stomach is mainly associated with the quality of food and diet.

To find out what the patient is sick with – gastritis or peptic ulcer, as well as to make an accurate diagnosis, FGDS – fibrogastroduodenoscopy is performed.

Causes of peptic ulcer

The main role in the appearance of peptic ulcer disease is played by the bacteria Helicobacter pylori, as well as taking for a long time (30 days) in a standard dosage of nonspecific anti-inflammatory drugs (for example, aspirin), cytostatics and corticosteroids (prednisolone).

It is these factors that influence the appearance of damage to the mucous membrane of the duodenum and stomach, reducing the protection and increasing the content of hydrochloric acid, which leads to disorders of gastric motility.

Main symptoms and signs:

The main symptoms of the disease are painful sensations and dyspeptic syndrome (sour belching, heartburn, vomiting and nausea).

• Pain appears in the upper abdomen, in the navel, is bursting, paroxysmal, baking in nature. The patient experiences the so-called hunger pains – on an empty stomach, or 2-3 hours after eating (with a duodenal ulcer), although after eating the pain subsides.Patients often complain of pain at night
• Heartburn, which is characterized by a burning sensation behind the breastbone, occurs after eating – due to the fact that the contents of the stomach are thrown into the esophagus

• Constipation – most sufferers suffer from it
• Emotional lability, asthenia (insomnia, malaise, weakness) – develop if the illness lasts a long time. At the same time, body weight decreases, which is explained by the restriction in food intake, which the patient sets, fearing the appearance of pain
• Vomiting and nausea occur due to increased vagus tone, increased hypersecretion of hydrochloric acid and gastric motility.Vomiting occurs when the pain is most pronounced. After vomiting, a feeling of relief comes, the pains noticeably decrease or disappear altogether

When should you rush to the doctor?
The reason for an immediate appeal to a gastroenterologist at the Medline Medical Center is the appearance of:

• severe weakness
• diarrhea
• frequent vomiting
• Presence of blood impurities in feces

Peptic ulcer diagnostics
The detection of peptic ulcer disease in the Medline clinic is based on several basic studies that are aimed at determining the location, size and other characteristics of the ulcer, and also includes tests for intestinal acidity and Helictobacteriosis.

A special diagnostic method – FGDS (fibrogastroduodenoscopy) – consists in examining the gastric mucosa and duodenum by a doctor using a probe that is inserted into the stomach through the esophagus. This method helps to distinguish gastritis (or gastroduodenitis) from an ulcer, which, in appearance, is, as a rule, a rounded formation of small size (up to several centimeters in diameter), along the edges of which there is an elevation, indicating intense inflammation (inflammatory shaft).When conducting EGD, in many cases, tissue scraping is performed from suspicious areas, which are then checked under a microscope for the presence of the causative agent of peptic ulcer disease – Helicobacter pylori. It is necessary to diagnose helicobacteriosis in order to determine the composition of the treatment and monitor the success of the therapy.

During fibrogastroduodenoscopy, pH metry is performed – the acidity of the stomach is determined. These data are also needed in order to choose the right course of treatment.

Peptic ulcer treatment

Main components of peptic ulcer treatment :

• Treatment aimed at eliminating Helicobacter pylori infection
• Treatment aimed at lowering gastric acidity and stimulating ulcer healing
• diet

Treatment of peptic ulcer disease with drugs is carried out according to standard schemes, which include bismuth preparations, antibiotics, proton pump inhibitors (pantoprazole, omeprazole, esomeprazole, rabeprazole).

Pay attention!

Only a specialist gastroenterologist of the Medline Medical Center can make an accurate diagnosis, conduct a full examination, prescribe a treatment regimen, its duration and dosage of drugs!

Diet advice

In case of stomach ulcer it is necessary to exclude from the diet:

• coffee
• alcoholic beverages
• Too hot or cold food
• fried, spicy dishes \
• coarse, salty food (e.g. coarse meat, mushrooms)

Meals should be frequent – every 4 hours, in small portions.

Allowed to be eaten:

• vegetable soups and vegetable purees
• milk and dairy products
• yoghurts
• porridge
• egg

In addition, to speed up the healing process of ulcers, you need to eat foods that contain proteins and vitamins.

90,000 treatment, operation, removal of stomach ulcers in St. Petersburg

This is a chronic disease, the morphological substrate of which is recurrent damage to the gastric wall or the wall of the duodenum, which occurs as a result of a violation of the mechanisms of regulation of gastric secretion.

What is gastric ulcer and 12 duodenal ulcer?

A set of substances that are peptic aggressors regularly enter the stomach cavity: hydrochloric acid, enzymes. Their action is aimed at breaking down food. In order for these substances not to damage the wall of the stomach or duodenum 12, a special protective factor is produced in the stomach, which consists of mucus and bicarbonates.

• The predominance of aggressive factors in combination with the depletion of the protective layer leads to damage to the stomach wall.
• Erosion appears, followed by an ulcer.
• The acidic contents of the stomach enter the duodenum.
• Inflammation occurs – duodenitis; erosion and ulcers can also develop in its mucous membrane.
• Particular importance in the development of the problem is attached to the microbe – Helicobacter pylori, which aggravates and provokes damage to the mucous membrane of both the stomach and duodenum.

The chronic nature of the pathology provides for the alternation of exacerbations and remissions. Exacerbations occur against the background of physical and mental overload, diet disorders, bad habits. Peptic ulcer disease often affects men. The working age of the main group of patients with gastric ulcer indicates the social and economic significance of the problem.

Causes of stomach ulcers

Distinguish between etiological factors of the disease and risk factors that increase the likelihood of ulcers.Among the causes of peptic ulcer disease, the following are distinguished:

• the presence of Helicobacter pylori bacteria in the body,
• decrease in local immunity in the stomach,
• burdened heredity,
• imbalance between the protective factors of the gastric mucosa and its secretion,
• taking certain medications.

Among the drugs that destroy the gastric mucosa, non-steroidal anti-inflammatory drugs (NSAIDs) should be highlighted.Long-term treatment with their help, without proper protection of the mucous membrane, leads to the appearance of ulcers, bleeding from them.

Factors contributing to the appearance of ulcers:

• stresses,
• physical overvoltage,
• alcohol exposure,
• smoking,
• eating harmful products (spicy, smoked, fried),
• violation of the diet.

Symptoms of a peptic ulcer in the presence of an ulcer

• Symptoms of the disease usually appear quite brightly, which makes it possible to timely identify the disease and begin appropriate treatment.The main symptom is pain , depending on the nature of the pain, you can understand exactly where the ulcer is located. The timing of the onset of pain is also important. For peptic ulcer with localization of ulcers in the stomach, the so-called “hunger pains” are characteristic, which appear on an empty stomach, as well as a few hours after eating.

• If the cardiac part of the stomach is affected (it is adjacent to the esophagus), then pain occurs closer to the solar plexus 20 minutes after eating.It is not uncommon for the pain to spread to the chest in the region of the heart, which can be confusing and lead to misdiagnosis such as heart attack when trying to self-diagnose. Such localization of peptic ulcer disease is never accompanied by pain after exercise.

• The defeat of the pyloric stomach ulcer (closer to the duodenum 12) causes prolonged acute pain, manifested in attacks.Sometimes the duration of one attack can be more than 40 minutes. The pain develops an hour after eating. May occur at night. Dyspeptic symptoms often occur: nausea, bloating, vomiting. The ulcer of this localization 5-10% becomes malignant. Also, there are frequent complications, penetration, perforation, bleeding, pyloric stenosis due to cicatricial deformity.

• 10-15% of ulcers are localized in the antrum, located between the pyloric and cardiac.Moreover, if the defective formation is in the lesser curvature of the stomach, the patient will feel severe pain in the left hypochondrium 1-1.5 hours after eating. The stabilization of the state occurs after the contents of the stomach have been digested. Most of these patients experience pain in the evening.

• The ulcer defect localized in the greater curvature of the stomach is characterized by a less pronounced clinic, occurs less often, more often in the elderly, and in 50% of cases has a malignant character, moreover, it is quite difficult to detect such an ulcer.

• Incessant aching pain, experienced mainly in the evening and at night, may indicate the location of the defective formation in the antrum. In this case, the pain syndrome does not correlate with food intake.

• The nature of pain in duodenal ulcer is characterized by the fact that it appears 1.5-2 hours after eating, often at night. This localization of the ulcer is more common in men under 40.The genetic factor is more significant for this category of patients. Dyspeptic disorders are less common than with localization in the stomach, but quite often patients are concerned about constipation.

Other signs of gastric ulcer

In addition to painful sensations of the presence of peptic ulcer disease, the following symptoms may also indicate:

• Nausea, sometimes accompanied by vomiting. This is due to a violation of gastric motility.In the presence of an ulcer, vomiting may begin 2 hours after eating.
• Heartburn . Most patients suffer from this symptom, which manifests itself as a burning sensation in the epigastric region. With heartburn, the acidic contents of the stomach are in the lumen of the esophagus, which is accompanied by a rather unpleasant sensation.
• Feeling of heaviness in the abdomen . It is observed after eating, and, regardless of the amount eaten.
• Poor appetite. The symptom is associated with a fear of heartburn and vomiting, which torment the patient after eating. This is a psychological factor that explains the deterioration in appetite by the patient’s desire to avoid unpleasant sensations.
• Belching with air can also be accompanied by the throwing of stomach contents into the oral cavity, after which an unpleasant sour or bitter taste remains in the mouth.
• Increased gassing .

Patients often complain of constipation caused by impaired bowel function.Among the atypical symptoms, one can distinguish a white coating on the tongue, sweating of the palms, pain when pressing on the abdomen. Sometimes the ulcer does not manifest itself with any symptoms, in which case it can be found in a rather neglected state.

Complications of ulcers

If left untreated, complications can develop. There are 5 conditions that threaten the patient if the ulcer is not treated:

• Ulcer perforation – perforation of the stomach wall through and through.
• Bleeding – if the integrity of the blood vessel in the walls or at the bottom of the ulcer is compromised.
• Stenosis of the pyloric stomach – narrowing of the exit site from the stomach, accumulation of food there.
• Penetration of an ulcer – perforation of an ulcer into an adjacent organ.
• Malignant ulcer – the growth of a malignant tumor.

Methods for the diagnosis of stomach ulcers

In order to make the final diagnosis, it is necessary to undergo esophagogastroduodenoscopy (FGDS) , the more common name is gastroscopy.

The endoscope is inserted through the mouth and esophagus into the stomach. is a thin tube equipped with a special optical device. So, the doctor gets the opportunity to clearly see the inside of the gastrointestinal tract. Endoscopy allows you to assess the size of the ulcer, the number (with multiple process), localization, and the presence of complications. During the study, samples of gastric juice, mucosal biopsy for morphological examination and the presence of Helicobacter pylori are taken.If the patient does not tolerate the procedure of such a study, then it is recommended to use medication sleep. To clarify the depth of the ulcer, gastrointestinal motility, some complications of peptic ulcer, such as stenosis, penetration, etc., fluoroscopy and radiography with a contrast agent are used. Diagnostic procedures may also include Helicobacter pylori tests, laboratory tests of urine, blood, and feces. Ultrasound does not allow a diagnosis of peptic ulcer disease.

Methods for the treatment of stomach ulcers

It is important for patients to adhere to the established daily regimen, avoid stressful situations, if possible, do not resort to smoking and drinking alcoholic beverages, at least for the duration of treatment, follow the diet prescribed by the doctor, adhere to the correct daily regimen.As usual, the duration of an active course of treatment is about two weeks, and then supportive therapy is needed with the obligatory observance of proper nutrition.

For each patient, an individual treatment is selected taking into account such significant factors as age, physical condition, the presence or absence of concomitant chronic diseases. A stomach ulcer is characterized as a rather serious, deadly disease, therefore, at the slightest suspicion, you should immediately undergo a diagnosis by visiting a specialist doctor.

Drug therapy consists of the following drugs:

• antibacterial drugs – the action is aimed at eliminating Helicobacter pylori from the body;
• antacids – drugs that reduce the secretion of gastric juice;
• proton pump inhibitors – their action affects the chemical composition of hydrochloric acid, disrupts its structure;
• H2 ‑ histamine blockers – reduce the aggression of gastric secretions;
• antispasmodics – symptomatic drugs that relieve pain.

Medicines must be taken strictly on the advice of a doctor. Each of the medicines is indicated only in certain circumstances of the disease. Medication must be taken within the prescribed period. If the patient feels relief, this does not mean that the drugs can be canceled on their own. The process of drug treatment is controlled by the attending physician; only he can make all changes to the reception.

Surgical treatment (surgery to remove stomach ulcers)

The need for surgical intervention may arise only with long-term non-healing ulcers, or with the appearance of complications.Such an operation can be planned or carried out urgently. Emergency surgery is indicated for perforation of an ulcer, bleeding that cannot be stopped with conservative measures. The ulcer is sutured, bleeding is stopped, the narrowing of the digestive tube expands. The previously used planned operations to remove a section of the stomach in order to reduce its secretion are currently practically not used, since a properly selected modern drug treatment, as a rule, leads to remission.

In case of malignancy (malignancy) of an ulcer, surgical treatment is necessary, the volume of which depends on how early the tumor is detected – whether it has time to germinate all layers of the stomach, or has only struck the mucous and submucous layers, has it managed to spread to nearby organs or lymph nodes, or has it already gave metastases to distant organs. The earlier the malignancy of the ulcer is detected, the less will be the volume of surgical intervention. In this case, the operation to remove the ulcer can be performed endoscopically or laparoscopically.Otherwise, extended intervention is performed in the traditional way.

Prevention and prognosis

As a prophylaxis for gastric ulcer, you should:

• devote at least 6 to 8 hours of sleep a day;
• to minimize the consumption of smoked, fatty and fried foods, such food irritates the mucous membrane;
• to monitor the health of your teeth, so that you can always chew food well;
• avoid frequent stressful situations, as they lead to nervous tension and cause pain in the stomach;
• do not drink alcoholic beverages or smoke;
• undergo the necessary examinations for pain in the stomach;
• Increase the number of meals to 6 per day.Food should be chopped, jelly, porridge, steamed meat, omelet, vegetables are shown.

Important

• It should not be forgotten that a stomach ulcer affects the functioning of the whole organism, and therefore it is better to prevent this disease than to then adapt to it all your life, relieving the torment with medicines.

• Seizures can be prevented by following a diet and proper diet, avoiding alcohol and cigarettes.You should visit a doctor at least once a year. For prophylactic purposes, patients are prescribed antiulcer drugs in courses, in spring and summer. It was at this time that the disease makes itself felt as the most striking manifestation of symptoms.

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  It is also necessary to remember patients suffering from peptic ulcer disease about the annual endoscopic control, which must be performed even in the absence of pain after the ulcer has healed.The need for such control is associated with a high probability of malignancy of gastric ulcers.

90,000 Symptoms of peptic ulcer disease (ulcer) in children

Peptic ulcer is a chronic and recurrent disease prone to progression with involvement in the pathological process, along with the stomach and duodenum, digestive system organs, the development of complications that threaten the patient’s life.

Reasons

• Hereditary predisposition.
• Allergic inflammation of the gastric mucosa.
• Early transition to artificial feeding
• Lack of fresh fruits and vegetables; macro- and microelements; dietary fiber acting as enterosorbents.
• Excess in the diet of refined proteins and carbohydrates, as well as the consumption of large amounts of canned food fats.
• Irregular, unbalanced meals (for schoolchildren).
• Helminthiasis, parasitic diseases.
• Common infectious diseases: viral hepatitis, rotavirus infections, dysentery, salmonellosis.
• Neurovegetative and psychoemotional disorders in children, especially in adolescence.
• Disorder of the sphincters of the digestive system, manifested by refluxes, insufficiency of the sphincter apparatus.
• Helicobacter pylori bacterium (Hp).

Symptoms

• Intense, persistent, prolonged pain in the epigastric region, sometimes in the right hypochondrium, aggravated by palpation.
• Characterized by pains on an empty stomach, eliminated by eating, as well as late night.
• Dyspeptic symptoms (belching, heartburn, nausea, vomiting).
• Appetite is usually not disturbed, sometimes even increased.

With the long-term existence of peptic ulcer disease, pathological changes in the liver (its enlargement, impaired functional tests) and intestines (constipation) are noted.

The course of peptic ulcer disease in children is protracted and recurrent. Peptic ulcer disease in children is often complicated by periduodenitis (inflammation of the serous membrane of the duodenum), minor bleeding found in the study of feces for occult blood. Ulcer perforation (usually found in adolescence), heavy bleeding from it and stenosis (narrowing) of the pylorus are more rare complications.

When diagnosing, first, along with symptoms, the data of a fibrogastroscopic examination (fibrogastroscopy), an X-ray are considered.

Prevention

• Sleep 6 – 8 hours.
• Refusal from fatty, smoked, fried foods.
• Reception of mashed and easily digestible food at room temperature (5 – 6 times a day).
• Timely caries treatment.
• Quiet, homely atmosphere and at school.
• There are two types of disorders of the motility of the biliary tract: hyperkinetic, when the contractions of the gallbladder are enhanced, and hypokinetic, when the walls of the bladder and ducts are relaxed, and the outflow of bile is slowed down.

More about pediatric gastroenterology at the YugMed clinic

90,000 Memo for patients with gastric ulcer and duodenal ulcer

29 April 2016
What is a peptic ulcer?
Peptic ulcer (PUD) of the stomach and duodenum is a chronic recurrent disease occurring with alternating periods of exacerbation and remission (without exacerbation), the main morphological sign of which is the formation of ulcers in the stomach and / or duodenum.The difference between erosion and ulcers is that erosion does not penetrate the muscle plate of the mucous membrane.

How common is peptic ulcer disease?
The prevalence of peptic ulcer disease among the adult population is 7-10%. Duodenal ulcer localization is diagnosed more often than gastric (ratio 4: 1). Among patients with duodenal ulcers, men predominate over women, while among patients with stomach ulcers, the ratio of men and women is approximately the same.

When can peptic ulcer disease occur?
Peptic ulcer disease can occur at any age. The largest number of patients is observed at the age of 20 to 50 years (70-80%), and the maximum frequency of duodenal ulcers is observed at the age of 30-40 years, and stomach ulcers – at 50-60 years. Less commonly, it occurs in childhood and adolescence (5-12%), old and senile age.

What is the danger of peptic ulcer disease?
In recent years, there has been a trend towards an increase in the frequency of detection of ulcerative gastrointestinal bleeding (GIH).

What increases the risk of bleeding ulcers?
To date, the risk factors for ulcer bleeding have been identified, which include old age, male sex, smoking and alcohol abuse, large ulcer defect, painless course of the disease, high secretion of hydrochloric acid, stressful nature of the lesions, contamination of the gastric mucosa by Helicobacter pylori.

What is Helicobacter pylori infection?
Currently, Helicobacter pylori is recognized as the leading factor in the development of ulcer and one of the main factors determining its often recurrent course.The duration of persistence is associated with the peculiarities of the stomach – the “niche” that Helicobacter pylori chose for its habitat: it has no competitors for this microorganism, but this is also the reason for its extreme instability in the environment. Because of this, only the most sensitive to helicobacteriosis people become infected (mainly children in developed countries under the age of 5 years, and in developing countries, possibly up to 10-14 years old, and individuals in closed groups).

What is the risk of contracting Helicobacter pylori infection?
Helicobacter pylori is widespread throughout the world.Its prevalence is influenced by economic, social (education, profession, marriage and family composition, religious affiliation, isolation of the population), racial and age factors. The most significant reservoir of Helicobacter pylori is humans. Getting into the human body in childhood, Helicobacter pylori persists in it, causing clinically significant consequences of its life in less than 1% of those infected. A very high virulence of Helicobacter pylori was also noted, as a result of which spontaneous recovery is extremely rare.

Why is it important to identify and treat Helicobacter pylori infection in peptic ulcer disease?
If you determine the infection with Helicobacter pylori and then carry out its eradication, then the risk of recurrence of ulcer will decrease within a year after scarring of ulcers from 70 to 4-5%.

What is the treatment for Helicobacter pylori infection?
To treat Helicobacter pylori infection, an antisecretory drug and two antibiotics are prescribed.
During treatment, it is necessary to strictly adhere to the recommended scheme of H. pylori eradication therapy, since an arbitrarily changed regimen of frequency and dosage of drugs is the main reason for the persistence of H. pylori infection.

Other recommendations
If long-term use of NSAIDs is necessary (including analgesics in connection with various pain syndromes or acetylsalicylic acid for prophylactic purposes), the possibility of reducing the dose of the drug or replacing it with another drug that has less effect on the mucous membrane of the gastrointestinal tract should be considered.
It must be remembered that taking NSAIDs with food does not weaken their negative effects on the mucous membrane of the stomach and duodenum. Replacing NSAIDs with enteric-coated dosage forms also does not eliminate their unwanted effects.
If symptoms occur, indicating signs of recurrence of peptic ulcer disease and its complications (bleeding, perforation, pyloric stenosis), it is necessary to urgently consult a doctor.

The leaflet was developed on the basis of the Clinical Recommendations for the Diagnosis and Treatment of Peptic Ulcer Disease (Moscow, 2013), the Recommendations of the Russian Gastroenterological Association for the Diagnosis and Treatment of Helicobacter pylori Infection in Adults (Moscow, 2012), the results of the conciliation meeting of the European Working Group on the Study of Helicobacter pylori “Maastricht-4” (Florence, 2010).

90,000 Ulcer: diet, treatment, symptoms | Clinic “Alone”

An ulcer is a local defect in the lining of the stomach or duodenum. The first type of peptic ulcer disease is more common among the elderly, the second – in young people.

Reasons

The most common cause of peptic ulcer disease is infection with the bacterium Helicobacter pilory.It can be contracted through saliva through close contact with another person. In patients with a duodenal ulcer, helicobacter is found in 90% of cases, with a stomach ulcer, the figure is 50-60%.

In addition to bacteria, stress, improper diet and prolonged use of non-steroidal drugs can become a provoking factor. Many people believe that peptic ulcer is a complication of gastritis, but this is not so: these are different diseases and gastritis does not develop into peptic ulcer.

Symptoms

Symptoms of the disease are heartburn, pain and heaviness after eating, night pains. But in some cases, it is asymptomatic. For example, this happens if it was provoked by non-steroidal drugs. Patients taking such medications do not feel pain, so their disease manifests itself as complications: bleeding or perforation (a hole in the wall of the stomach).

Treatment

Treatment depends on whether a helicobacter is found in the patient’s body or not.In the first case, the doctor prescribes two types of antibiotics, because one does not kill her, as well as drugs that create unfavorable conditions for the life of bacteria. Sometimes, after the destruction of the bacteria, the ulcer itself does not heal, then the patient is prescribed drugs that reduce secretion and improve tissue trophism. If no helicobacter is found, antibiotics are not prescribed.

The course of treatment usually lasts 14 days, in certain cases it takes more time. So, a callous ulcer (large, neglected, more than 5 cm in diameter) can heal for 2-3 months.Usually, the defect grows to this size in older people who have been drinking non-steroidal drugs for years and do not have their stomach checked. First of all, for its healing, the doctor cancels medications that cause peptic ulcer disease.

Operation

Treatment of peptic ulcer disease rarely requires surgery. It is only necessary for complications. For example, a perforated (perforated) ulcer can be cured only with the help of surgical intervention.Also, the operation is performed with massive bleeding, when it cannot be stopped conservatively, and with spinosis (narrowing of the duodenum).

Power

To heal the defect, in addition to treatment with drugs, you must follow a diet. It consists in observing the diet: a person should eat in small portions 4-5 times a day, excluding spicy, salty, fried, smoked food. All food must be boiled or steamed.When an ulcer heals, it is no longer necessary to follow a diet, but you should not overuse spicy, fried, smoked and salty foods. It is also important to eat regularly without skipping meals to prevent flare-ups. Alcohol is contraindicated for any gastrointestinal disease. Products that it is better to refuse: baked goods, black bread, tomatoes, coffee, strong tea, lard, lamb fat, margarine, chocolate. The diet can include: dried wheat or yesterday’s bread, crackers, uncooked cookies, milk soups, beef, chicken, pike perch, pike, perch, porridge on water with the addition of milk (semolina, buckwheat, oatmeal, pearl barley, rice).

Diagnostics

To diagnose peptic ulcer disease, patients undergo fibrogastroscopy, during which a rapid urease test can be performed and a helicobacter examined. Somewhere in addition, a pH meter is carried out in order to find out the level of acidity in the stomach. During this examination, a probe is inserted into the stomach through the nose and the acidity is measured during the day.

Early diagnosis of diseases of the gastrointestinal tract allows you to timely identify and prevent the risk of developing infectious, inflammatory and tumor diseases of the gastrointestinal tract, to avoid the development of complications and the transition of the disease to a severe form.We care about the health of our patients and suggest using our programs for the prevention and treatment of diseases of the digestive system. These programs can be completed in 1 visit to the clinic.

You can sign up for a consultation with a gastroenterologist at the Clinic Alone by phone in Kirov: (8332) 32-7777
or through the form on the website

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