What Should I Do If I Think I Have A Stomach Ulcer
Always seek medical care for a stomach ulcer. While you may be able to manage symptoms temporarily with over-the-counter medications, these wont heal the ulcer. You need to identify and treat the underlying cause. An untreated ulcer can lead to serious complications, even if your symptoms are mild. The major cause of stomach ulcers, H. pylori infection, can also lead to other complications.
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.
When To Seek Medical Advice
You should visit your GP if you think you may have a stomach ulcer.
Seek urgent medical advice if you experience any of the following symptoms:
- vomiting blood the blood can appear bright red or have a dark brown, grainy appearance, similar to coffee grounds
- passing dark, sticky, tar-like stools
- a sudden, sharp pain in your tummy that gets steadily worse
These could be a sign of a serious complication, such as internal bleeding.
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You Have Pain Specifically In Your Upper Abdomen
One of the most common ulcer symptoms is a severe pain in the upper abdomen, according to Neil Sengupta, MD, a gastroenterology specialist at the University of Chicago. Ulcers can develop anywhere in the upper digestive track, but Dr. Sengupta says we often think about those occurring in the stomach or small intestine, where we feel pain. This pain usually occurs between the breastbone and belly button, and can bring on a burning, aching, or dull feeling. The sensation may begin as a light, mild pain but often progresses into something more serious as the ulcers develop.
You Have Heartburn At Most Meals
If you find yourself experiencing frequent heartburn, regardless of what you eat, an ulcer may be responsible. Many patients with ulcers describe feeling very intense chest pain, which often causes them to burp or hiccup more than usual after eating. In many cases, a simple over-the-counter antacid can be taken to temporarily alleviate some of the pain and gassiness, but if it persists day after day, its likely something more than a regular case of heartburn.
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Peptic Ulcer Facts And Picture
- Peptic ulcer are sores in the lining of the esophagus, stomach or duodenum.
- The main symptom of a stomach or duodenal ulcer is upper abdominal pain, which can be dull, sharp, or burning .
- Other associated symptoms may include:
- Acid reflux or heartburn
- Feeling satiated when eating
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What Tests Diagnose A Peptic Ulcer
To confirm a person has an ulcer a diagnostic imaging test will usually be ordered. The two most widely used tests are:
- Upper GI series : This is a type of X-ray. The patient is given a chalky liquid to drink that increases the contrast on the X-ray, making certain features easier to see. Because this liquid contains barium, this test is sometimes called a barium swallow.
- Endoscopy : An endoscope is a thin, flexible tube with a tiny camera at the end. The patient is given a mild sedative, and then the tube is passed through the mouth into the stomach. The doctor can see the lining of the stomach to diagnose a peptic ulcer. Tiny samples of the tissue will be taken , which are examined under a microscope.
If a diagnostic imaging test reveals an ulcer, the patient will most likely have a test to see if H pylori bacteria are present.
- It is important to be certain about this, because treatment of the H pylori is likely to heal the ulcer.
- Ulcers caused by H pylori are treated differently than ulcers caused by medications.
Three types of tests are available to detect H pylori.
What About Complicated Ulcers
While most ulcers are successfully treated with medication, some complicated ulcers may require surgery. Ulcers that are bleeding, or that have perforated your stomach or intestinal wall, will need to be surgically repaired. An ulcer that is malignant, or obstructing a passageway, will need to be surgically removed. In severe cases, an ulcer that keeps coming back may be treated by surgery to cut off some of the nerve supply to the stomach that produces stomach acid.
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What Are The Signs You Have A Stomach Ulcer
“The symptoms of a stomach ulcer are often similar to a regular upset stomach,” says Andrew Boxer, MD, a gastroenterologist at Jersey City Medical Center in New Jersey. “But usually, the symptoms of an ulcer will not go away.”
The symptoms can vary widely. “Some patients are completely asymptomatic, while some patients experience the worst pain of their life. There can also be anything in between,” says Boxer. “Some patients may see blood in their stool or even vomit blood. In rare instances, an ulcer can cause an obstruction, and the patient will have nausea and vomiting. Because ulcers can involve bleeding, some patients may show anemia or a lack of hemoglobin on a blood test.”
The most common symptom is upper abdominal pain, says Alex Spinoso, MD, of Genesis Lifestyle Medicine in Las Vegas, Nevada. “Occasionally the discomfort localizes to the right or left upper quadrants of the hypochondrium, the areas right below the chest on either flank where there are still ribs.”
Typically, pain associated with a stomach ulcer happens two to five hours after a meal, when the stomach secretes acid and is mostly empty, and at night when acid secretion normally increases, says Spinoso. Without treatment, ulcer pain may last a few weeks, followed by symptom-free periods of weeks or months.
What Are The Possible Complications Of Peptic Ulcer Disease
An ulcer left untreated may cause serious complications, including:
- Internal bleeding: While most people with ulcers wont have bleeding, this is the most common complication that can occur. A slow bleeding ulcer can cause anemia or even severe blood loss.
- Perforation: An ulcer that is continuously eroded by acid can eventually become a hole in the stomach or intestinal wall. This is intensely painful and also dangerous. It allows bacteria from the digestive tract to enter the abdominal cavity, which can lead to an infection of the abdominal cavity called peritonitis. From there, the infection is at risk of spreading to the rest of the body . This can lead to a life-threatening condition called .
- Obstruction: An ulcer in the pyloric channel, the narrow passageway that leads from the stomach into the duodenum, can become an obstruction that blocks the flow of food into the small intestine. This can happen after the ulcer has healed. Ulcers that have gone through a healing process may build up scar tissue that enlarges them. An ulcer that is big enough to obstruct the small intestine can stall the digestive process, with numerous side effects.
- Stomach cancer: Some gastric ulcers can become malignant over time. This is more likely when your ulcer is caused by H. pylori infection. H. pylori is a contributing cause of gastric cancer, though fortunately this is uncommon.
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Other Causes Of Peptic Ulcers
- Genetics: A significant number of individuals with peptic ulcers have close relatives with the same problem, suggesting that genetic factors may be involved.
- Smoking: People who regularly smoke tobacco are more likely to develop peptic ulcers when compared with non-smokers.
- Alcohol consumption: Regular heavy drinkers of alcohol have a higher risk of developing peptic ulcers.
- Corticosteroid use: People on large or chronic doses of corticosteroids are also at greater risk.
- Mental stress: This stress has not been linked to the development of new peptic ulcers, but symptoms appear to be more severe in people with ulcers who are experiencing ongoing mental stress.
A patientâs description of symptoms will normally cause a doctor to suspect a peptic ulcer.
Tests that can confirm a diagnosis include:
- a blood test to check for H. pylori, though a positive test does not always mean there is an active infection
- a breath test, using a radioactive carbon atom to detect H. pylori
- a stool antigen test to detect H. pylori in the feces
- an upper gastrointestinal X-ray to identify ulcers
An endoscopy may also be used. This involves a long, narrow tube with a camera attached to the end is threaded down the patientâs throat and into the stomach and duodenum. This is the best diagnostic test.
Black Or Dark Colored Stool
If you think you may have an ulcer, a good way to tell is to look at your stool. If you notice that when you use the restroom your stool is extremely dark in color, or even black, chances are you are right about what is ailing you. If this is the case, you should absolutely go to the hospital immediately.
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What Causes Peptic Ulcer Disease
The main cause is the bacterial infection, Helicobacter pylori . Another common cause is long-term use of nonsteroidal anti-inflammatory drugs . This includes aspirin, ibuprofen, and naproxen. In rare cases, the disease can be caused by cancerous and noncancerous tumors. A less common cause is a rare disorder called Zollinger-Ellison syndrome.
What Is A Stomach Ulcer
A stomach ulcer, also called a gastric ulcer, is an open sore that develops in your stomach lining. You can also get one in your duodenum, the first part of the small intestine that your stomach feeds into. Duodenal ulcers and stomach ulcers are both types of peptic ulcers. Theyre named for pepsin, one of the digestive juices that are found in the stomach and that sometimes leak into the duodenum. These juices are a contributing factor in peptic ulcer disease.
Peptic ulcers occur when the protective mucous lining in your stomach and duodenum has been eroded, allowing gastric acids and digestive enzymes to eat away at your stomach and duodenal walls. This eventually results in open sores that are continually irritated by the acid. If left untreated, they can begin to cause serious complications, such as internal bleeding. Over time, they can even wear a hole all the way through. This is a medical emergency.
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What Are The Symptoms Of A Peptic Ulcer Does It Cause Pain
Ulcers do not always cause symptoms. Sometimes, a serious complication such as bleeding or a sudden, bad upper abdominal pain is the first sign of an ulcer.
The most common symptom of peptic ulcers is abdominal pain.
- The pain is usually in the upper middle part of the abdomen, above the belly button and below the breastbone.
- The ulcer pain can feel like burning, or gnawing, and it may go through to the back.
- Pain often comes several hours after a meal when the stomach is empty.
- The pain is often worse at night and early morning.
- It can last anywhere from a few minutes to several hours.
- The ulcer pain may be relieved by food, antacids, or vomiting.
Other symptoms of peptic ulcers include the following:
- Nausea
- Loss of appetite
- Loss of weight
Severe ulcers may cause bleeding in the stomach or duodenum. Bleeding is sometimes the only symptom of an ulcer. This bleeding can be fast or slow. Fast bleeding reveals itself in one of the following ways:
- Vomiting of blood or dark material that looks something like coffee grounds: This is an emergency and warrants an immediate visit to an emergency department.
- Blood in the stool or black, tarry, sticky-looking stools
Slow bleeding is often more difficult to detect, because it has no dramatic symptoms.
- The usual result is low blood cell count .
- The symptoms of anemia are tiredness , lack of energy , weakness, rapid heartbeat , and pale skin .
How Can I Prevent A Stomach Ulcer From Occurring Or Returning
- Reduce NSAID use, if possible. Consider whether acetaminophen might substitute. If you take NSAIDs for medical reasons, talk to your doctor about reducing your dosage or switching your medication. Your doctor may also prescribe another medicine to take with NSAIDs to protect your stomach lining.
- Reduce other irritants that may contribute to too much stomach acid or erode your stomach lining, including smoking and alcohol use.
- Take an H. pylori breath test to find out if you have an overgrowth of the bacteria.
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Will Surgery Cure A Peptic Ulcer
Medical therapy works in most people with peptic ulcers. Sometimes, medical therapy does not work, or a person can’t take the therapy for some reason. Surgery is an alternative to medical therapy for these people.
Surgical operations often used in peptic ulcers include the following:
- Vagotomy: Cutting the vagus nerve, which transmits messages from the brain to the stomach, can reduce acid secretion. However, this can also interfere with other functions of the stomach. A newer operation cuts only the part of the nerve that affects acid secretion.
- Antrectomy: This is often done in conjunction with a vagotomy. It involves removing the lower part of the stomach . This part of the stomach produces a hormone that increases production of stomach acid. Adjacent parts of the stomach may also be removed.
- Pyloroplasty: This procedure also is sometimes done with vagotomy. It enlarges the opening between the stomach and duodenum to encourage passage of partially digested food. Once the food has passed, acid production normally stops.
- Tying off an artery: If bleeding is a problem, cutting off the blood supply to the ulcer can stop the bleeding.
You Bleed When You Use The Bathroom
Blood coming from the gastrointestinal tract can signal a variety of underlying health issues, but Dr. Sengupta says when this bleeding is combined with upper abdominal pain, hes highly suspicious that its one of the signs of an ulcer. Many patients notice this blood either when vomiting, or when using the bathroom, as their stools may appear black. If you notice youre suffering from a bleeding GI tract, along with nausea and pain in the stomach or chest, Dr. Sengupta says doctors will often perform a blood test or an upper endoscopywhere they use a camera to look into the stomach itselfto check if an ulcer is the culprit. Blood in your stool can also be due to hemorrhoids or a symptom of colon cancer, so its a good idea to get checked out by your doctor.
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Stages And Types Of Stomach Ulcers
If you dont get treatment for a stomach ulcer, it can develop into a more serious condition:
- Bleeding: Your ulcer can bleed, which may cause your stools to look dark and can lead to anemia.
- Perforation: The ulcer can become so severe that it creates a hole in the wall of the stomach out of which food can leak, which is a severe situation, but it is rare.
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 series or barium swallow. This test looks at the organs of the top part of your digestive system. It checks your food pipe , stomach, and the first part of the small intestine . 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 . 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 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:
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