What To Expect At Home
You have peptic ulcer disease . You may have had tests to help diagnose your ulcer. One of these tests may have been to look for bacteria in your stomach called Helicobacter pylori . This type of infection is a common cause of ulcers.
Most peptic ulcers will heal within about 4 to 6 weeks after treatment begins. Do not stop taking the medicines you have been prescribed, even if symptoms go away quickly.
What Are Its Symptoms
The most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of the abdomen. This is caused by the ulcer and is aggravated by stomach acid coming in contact with the ulcerated area. The pain typically may:
- Be felt anywhere from your navel up to your breastbone
- Be worse when your stomach is empty
- Flare up at night
- Often be temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication
- Disappear and then return for a few days or weeks.
Less often, ulcers may cause severe signs or symptoms such as:
- The vomiting of blood
- Dark blood in stools or stools that are black or tarry
- Nausea or throwing up blood
- Unexplained weight loss
- Appetite changes.
People who have stomach ulcers generally continue to function quite comfortably and some ulcers heal spontaneously without medication.
However, left untreated, stomach ulcers can cause complications, including bleeding, perforation and obstruction of the gastric system.
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 is usually done if you have a stomach ulcer. The H. pylori bacterium can be detected in a sample of stool , 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 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 . The doctor will then be able to see any inflammation or ulcers in your stomach.
- Small samples 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.
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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.
Orange Juice Good For Ulcer
Ingredients: Orange juice 150 ml. .
Method: Take 2 oranges, extract juice, it will make 150 ml. Now drink of the remedy in the morning after breakfast, same dose in the evening after dinner.
It will fulfill your internal wound fastly. Above process twice daily and up to 4 to 6 months to get well soon completely.
Drink orange juice to cure both of stomach ulcers peptic and gastric, it will relief your pain gradually.
Advice: Do not consume any types of spices and alcohol. To prevent constipation, eat only boil foods.
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What Is The Treatment For Ulcers
If you have ulcer symptoms, see your doctor. Prompt treatment can prevent excessive bleeding and other complications.
Ulcers are usually diagnosed after an upper GI endoscopy . An endoscope is a long flexible tube with a light and camera on the end. The tube is inserted into your throat, then to the esophagus, stomach, and upper part of the small intestine. Learn how to prepare for an endoscopy here.
Generally performed as an outpatient procedure, it allows the doctor to locate and identify problems in the stomach and upper intestine.
Bleeding ulcers must be addressed quickly, and treatment can start during the initial endoscopy. If bleeding from ulcers is found during the endoscopy, the doctor can:
- inject medication directly
- cauterize the ulcer to stop the bleeding
- clamp off the bleeding vessel
If you have an ulcer, youll be tested for H. pylori. This can be done using a tissue sample taken during the endoscopy. It can also be accomplished with noninvasive tests such as a stool sample or breath test.
If you have the infection, antibiotics and other drugs can help fight the bacteria and ease symptoms. To be certain you get rid of it, you must finish taking the medication as directed, even if your symptoms stop.
If your ulcers are the result of taking too many NSAIDs, work with your doctor to find another medication to treat pain.
Over-the-counter antacids sometimes relieve symptoms. Ask your doctor if its okay to take antacids.
What Happens After Treatment
A repeat gastroscopy 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 âulcerâ 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.
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What Is The Treatment For Peptic Ulcers
The choice of treatment depends on whether or not the ulcer is caused by infection with H pylori. Correct diagnosis is key to whether a treatment works or not. If the bacteria are the cause, treatment focuses on killing the infection. Regardless of whether the bacteria are the cause, reducing acid in the stomach is another important focus of treatment.
The following treatments are recommended for ulcers:
- Lifestyle changes: Quit smoking, avoid alcohol, aspirin, and NSAIDs
- Acid-blocking medications
- Medications that protect the lining of the stomach and duodenum
- Triple-therapy or dual-therapy regimens for ulcers caused by H pylori
No single medication works to get rid of H pylori infection. Two combinations have been found that work well in most people.
These treatments are generally given for two weeks.
Once H pylori bacteria are eradicated from a persons digestive tract, usually it will not come back. The ulcers usually heal completely and do not return.
Treatment for bleeding ulcers depends on the severity of blood loss and includes:
It is important to remember that treatment may not work if the diagnosis is not correct. If the doctor diagnoses an ulcer, it is important to determine whether the ulcer is caused by infection with H pylori.
Peptic Ulcer Disease Complications
The three major complications of peptic ulcer disease treatment are:
- Perforation/penetration, due to the ulcer burning through the stomach wall
- Gastric outlet obstruction, or pyloric stenosis, occurs when the pylorus narrows. The pylorus is the opening from the stomach into the small intestine.
There are a number of options available to treat these complications, including endoscopic therapy.
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What Are The Risks For People With Ulcers
Why do painkillers increase the risk of gastrointestinal problems? The same chemicals that amplify pain which some pain medicines block also help maintain the protective lining of the stomach and intestines. When a painkiller stops these chemicals from working, the digestive tract becomes more vulnerable to damage from gastric acids.
For people with ulcers, the risky pain relievers are nonsteroidal anti-inflammatory drugs, or NSAIDs. They include aspirin, ibuprofen, naproxen sodium, and ketoprofen, the active ingredients in medicines such as Bufferin, Advil, and Aleve.
Other pain relievers may be less dangerous. Acetaminophen the active ingredient in Tylenol works differently and poses a much lower risk of GI problems. However, like any drug, it does have side effects of its own. You shouldnt take any over-the-counter painkiller for more than 10 days without your health care providers approval.
The risks from NSAIDs are quite serious. Studies show that people who use NSAIDs are about three times as likely to have gastrointestinal bleeding. Even at low doses, NSAIDs can make mild ulcers much worse.
Aspirin has additional risks. Aspirin can help prevent blood clotting, which is why it helps people at risk of heart attacks and strokes, says Cryer. But in people with ulcers, it can lead to more serious gastrointestinal bleeding.
How Is An Ulcer Diagnosed
Your doctor will ask you about your symptoms. They may do an endoscopy. This procedure involves inserting a thin, flexible tube attached to a camera down your throat and into your stomach. Your doctor will test your blood, breath or stool for H. pylori. They also can test a sample of your stomach lining. Your doctor also will ask you if you regularly take aspirin or anti-inflammatory medicines.
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When To See A Doctor
Anyone who thinks they may have an ulcer in their stomach should consult their doctor. Any stomach symptoms that last for more than a few days or keep happening need evaluation and treatment.
A slow-bleeding ulcer can be signaled by symptoms of anemia, such as being tired and breathless. More serious bleeding is an urgent medical problem and can be signaled if blood is vomited up, or stools are black and sticky.
Perforation, or a hole in the stomach, is also an emergency. Without quick treatment, the wall of the stomach can become infected. Sudden stomach pain that gets worse can indicate perforation, and any signs of being very unwell with infection need treatment as soon as possible.
What Are The Common Side Effects Of Ulcer Medication
All medications may produce side effects, and side effects will vary depending on the type of medication. This is not a complete list of possible side effects, so consult with a healthcare professional about any concerns or questions you may have regarding your specific situation.
Proton pump inhibitors and H2 blockers are relatively safe medications available in prescription and over-the-counter formulations. The most commonly experienced side effects are digestive system problems such as abdominal pain, nausea, vomiting, diarrhea, and constipation. H2 blockers can also affect the central nervous system, so headaches, drowsiness, and dizziness are often experienced.
Proton pump inhibitors can reduce the absorption of calcium in the body, which can lead to an increased risk of osteoporosis and bone fractures. Patients will often be prescribed or recommended calcium supplements to take along with proton pump inhibitors. Other serious side effects of proton pump inhibitors may include kidney disease, vitamin B12 deficiency, and diarrhea caused by Clostridium difficile infection.
The most serious side effects of H2 blockers are related to their effects on the central nervous system. These side effects may include delirium, hallucinations, extreme drowsiness, and slurred speech.
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What Tests Will Be Done To Diagnose A Peptic Ulcer
Endoscopy. An upper endoscopy exam is expedient because allows healthcare providers to see inside your digestive tract and also take a tissue sample to analyze in the lab. The test is done by passing a thin tube with a tiny camera attached down your throat and into your stomach and duodenum. Youll have medication to numb your throat and help you relax during the test. Your healthcare provider may use the endoscope to take a tissue sample to test for signs of mucous damage, anemia, H. pylori infection or malignancy. If they take a sample, you wont feel it.
Imaging tests. Imaging tests to look inside the stomach and small intestine include:
- Upper GI series. An upper GI X-ray exam examines the stomach and duodenum through X-rays. Its less invasive than an endoscopy. For the X-ray, youll swallow a chalky fluid called barium, which will coat your esophagus, stomach and duodenum. The barium helps your digestive organs show up better in black and white images.
- CT scan. Your healthcare provider might recommend a CT scan if they need to see your organs in more detail. A CT scan can show complications such as a perforation in the stomach or intestinal wall. For the test, youll lie on a table inside a scanner machine while X-rays are taken. You may drink or have an injection with contrast fluid to make your organs show up better in images.
Tests for H. pylori. Your healthcare provider might want to test you separately for H. pylori infection. Tests may include:
What Are The Complications Of Peptic Ulcers
Ulcers can cause serious problems if you dont 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 . 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 .
- Narrowing and blockage . 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 cant leave your stomach and go into your small intestine. This causes vomiting. You cant eat properly.
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How Do Nsaids Cause A Peptic Ulcer
To understand how NSAIDs cause peptic ulcer disease, it is important to understand how NSAIDs work. Nonsteroidal anti-inflammatory drugs reduce pain, fever, and inflammation, or swelling.
Everyone has two enzymes that produce chemicals in your bodys cells that promote pain, inflammation, and fever. NSAIDs work by blocking or reducing the amount of these enzymes that your body makes. However, one of the enzymes also produces another type of chemical that protects the stomach lining from stomach acid and helps control bleeding. When NSAIDs block or reduce the amount of this enzyme in your body, they also increase your chance of developing a peptic ulcer.
When To Call A Healthcare Provider
If the ulcer is large or deep, growing in size, incredibly painful, or if you have any signs of infection , you notice a bad smell coming from your ulcer, or youre running a fever, call your healthcare provider right away.
Youll also want to call your healthcare provider if your ulcer, no matter how minor, isnt showing signs healing after a week to 10 days.
In most cases, the ulcer will be dressed to protect the wound. However, if your ulcer is draining considerably, your healthcare provider may recommend leaving the wound uncovered. Dressing the ulcer if its draining considerably can impede healing.
If your ulcer is painful, pain medication can be prescribed. Antibiotics may also be prescribed either prophylactically to prevent infection or to treat an already infected wound.
Debridement is done to remove dead tissue from more serious ulcers. For deep ulcers or those that arent healing after a long period of time, skin grafts may be needed. In the most severe cases, part of the foot, leg, or other appendage may have to be amputated.
Restoring good circulation is key in treating and preventing ulcers. This includes elevating the legs, wearing compression stockings, reducing pressure on ulcer-prone areas, superficial vein surgery. Leg ulcers, in particular, are incredibly likely to reoccur, so compression stockings are often needed to be worn for life.
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What Triggers Stomach Ulcer Symptoms
Stomach ulcers are irritated by stomach acid. Some people notice this irritation more after they eat, and some people notice it more on an empty stomach. There are also certain irritants that seem to make ulcer symptoms worse and make them more difficult to heal. Smoking and alcohol are the biggest ones.
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