A stomach ulcer (also referred to as a peptic ulcer or gastric ulcer) is a small erosion (sore) in the lining of your stomach. Less common, the peptic ulcer can also develop just above the stomach in the esophagus, which is the tube that connects the mouth to the stomach. The most common type is the duodenal ulcer, which affects the first 12 inches of the small intestine. People can have both a gastric and duodenal ulcer at the same time, and ulcers can re-occur. Duodenal ulcers are not cancerous nor are they contagious. Stomach ulcer disease is common, affecting millions of Americans yearly. The size of a stomach ulcer can range between 1/8 of an inch to 3-6 inches. Stomach (gastric) ulcers can become malignant. Ulcers can be diagnosed and treated by the GI Division of Premier Medical Group.
Years ago, it was common for doctors to think that ulcers were caused by stress or by eating food with too much acid in it. Today, we know that to be untrue. Ulcers are caused by infection from a bacteria (germ) called Helicobacter pylori, or H. pylori for short. Ulcers are also caused by an imbalance between digestive fluids in the stomach and duodenum. Another common cause of ulcers is the use of painkillers such as anti-inflammatory drugs such as aspirin, naproxen (Aleve, Anaprox, Naprosyn, and others), ibuprofen (Motrin, Advil, Midol, and others), and many others available by prescription. Even aspirin coated with a special substance can still cause ulcers.
If your body makes too much acid, this acid can certainly aggravate the symptoms by burning the lining of your digestive tract. While physical or emotional stress does not cause an ulcer, it can aggravate it. Eating spicy foods, smoking, and drinking alcohol can also worsen ulcers and prevent healing.
Peptic ulcers are not caused by stress or eating spicy food, but both can make ulcer symptoms worse. Smoking and drinking alcohol also can worsen ulcers and prevent healing.
An ulcer may or may not have symptoms. The most common symptom for both duodenal and gastric ulcers is abdominal discomfort, a gnawing or burning feeling. This discomfort is felt anywhere between the navel and the breastbone, and is usually a dull or burning pain. The symptoms tend to occur when the stomach is empty which explains pain during the night and between meals. The symptoms may be briefly relieved by eating some food, or antacids. Ulcer symptoms can come and go, and they can last for several days or even weeks.
Other symptoms may include:
More severe cases of ulcers, the symptoms can include:
If you have any of the following symptoms, call a doctor immediately! These symptoms could be a sign of a serious problem, such as internal bleeding, perforation of the ulcer through the stomach wall, or obstruction (when the peptic ulcer blocks the path of food into the stomach):
Your doctor will begin with a complete medical and physical history. Once he determines your symptoms, he may treat you with some medications to see if you feel better within a week or so. If the medications are helping, you may not need tests. If you do require diagnostic exams, they most likely will include:
Sometimes ulcers will heal on their own, but you should not ignore their warning signs. Left untreated, ulcers can lead to serious health problems. The most common treatments for ulcers are lifestyle changes (quitting smoking, not drinking alcohol), medications, and surgery. If the ulcer is caused by H. pylori, this would be treated with drugs that kill the bacteria, reduce stomach acid, and protect the stomach and duodenal lining. The correct antibiotic would be determined by where a person lived, because the strains of the bacteria are very different throughout the world.
Treatments for peptic ulcer can include:
If a patient does not react favorably to any of these treatments, the doctor may decide to repeat them with a second round of medications. Generally your doctor will choose a different course of antibiotics because the bacteria could be resistant to the medicine.
People used to believe drinking milk helped peptic ulcers heal, because it gave temporary relief. Today we know that milk actually increases stomach acid, which could make the ulcer worse. The best thing to do is discuss drinking milk with your doctor.
Antacids also help provide relief, but do not kill the H. pylori bacteria. Some antacids can impede the treatment of antibiotics. It’s best to check with your doctor before using any over-the-counter antacids.
No, neither spicy food nor stress causes ulcers, but they can trigger symptoms. Certain foods can make the pain worse. These foods include coffee, tea, chocolate, meat extracts, alcohol, black pepper, chili powder, mustard seeds, and nutmeg. If these bother you, it’s best to avoid them. Eat a balanced diet and also try eating small, frequent meals when you’re having pain. Smoking and drinking alcohol, however, can make ulcers worse and prevent healing.
Dull or burning pain, most often occurring when the stomach is empty.
With the H. pylori bacteria the usual course of antibiotics is from 2-4 weeks.
Taking antacids can provide temporary relief, but always check with your doctor before taking any medicines, even over-the-counter ones.
The two most common causes for ulcers are the H. pylori bacteria and painkillers known as anti-inflammatory drugs or NSAIDs. A very small percentage of people have ulcers from other causes like excess stomach acid secretion.
Be cautious when choosing over-the-counter pain relievers; don’t overdose on iron supplements if you are anemic, check with your doctor; learn to deal with stress by practicing relaxation techniques, such as deep breathing, Yoga and moderate exercise; eat properly prepared food; drink from clean safe sources; always wash hands after using the bathroom; don’t smoke; avoid caffeine and alcohol; avoid spicy foods if they cause heartburn.