Peptic ulcers are open sores on the lining of the stomach (gastric ulcers), or the beginning of the small intestine, the duodenum (duodenal ulcers).
The most common symptom of an ulcer is a burning pain, aggravated by contact with stomach acid. The pain may be anywhere from your navel to your breastbone, worse on an empty stomach and at night, and be relieved by antacids. Less common symptoms of severe ulcers include vomiting of blood, blood in stools, nausea, weight loss, and change in appetite.
See your WellStar physician if you have any these symptoms persistently.
Causes and Prevention
Normally, your digestive tract is coated with a layer of mucus that protects it from digestive acid. If the amount of mucus diminishes, or the amount of acid increases, an ulcer may result. At one time, they were thought to result mainly from diet and stress, but research indicates causes including:
- A corkscrew-shaped bacterium called Helicobacter pylori, which lives in the mucous layer in your digestive tract. Usually, it causes no problems, but it can disrupt the mucous layer, producing an ulcer. It is not clear how H. pylori spreads; perhaps through close contact, perhaps also through food and water. H. pylori was discovered in 1982. At the time, it was thought that no bacterium could survive the acids of a human stomach. For the discovery of this bacterium and its connection to gastric ulcers, the Nobel Prize in Medicine was awarded in 2005.
- Chronic use of pain relievers, like aspirin, ibuprofen (Advil®, Motrin®, etc.), and naproxen (e.g. Aleve®), especially among older adults. Acetaminophen (e.g. Tylenol®) does not cause ulcers.
Risk factors for peptic ulcers include:
- Smoking erodes the mucous lining and increases acid production
- Alcohol also erodes the mucous lining and increases acid production
- Uncontrolled stress is a contributing factor, not a cause.
Although it is not clear how H. pylori is transmitted, steps to reduce the transmission of infection, such as frequent hand washing, may help prevent ulcers. Avoid using alcohol with pain relievers, and, if you take pain relievers regularly, try to find the lowest dosage that provided relief.
If you exhibit symptoms of gastric ulcers, your WellStar physician may conduct such tests as:
- A test for H. pylori. This may be a blood test, a stool test, or a breath test.
- An endoscopy, passing a flexible tube down your throat to look for ulcers, and possibly taking a biopsy.
- X-ray of the upper digestive system, enhanced by a barium-containing liquid that coats your digestive tract making it more visible.
There are simple remedies for mild peptic ulcers, such as:
- A healthy, vitamin-rich diet
- If you use pain relievers regularly, asking your WellStar physician if you can use acetaminophen.
- Managing stress, for example, with exercise
- Not smoking
- Limiting alcohol
Treatments for peptic ulcer include:
- Antibiotics to kill H. pylori, if it has been found in your digestive tract
- Proton pump inhibitors, like Prilosec® and Previcid® to block acid production and encourage healing
- Acid blockers like Zantac®, Pepcid®, and Tagamet®, to reduce the amount of acid produced and promote healing
- Antacids that neutralize stomach acid to provide immediate relief
- Cytoprotective agents, like Pepto-Bismol®, that protect your stomach and small intestine
Some ulcers fail to heal. This may be due to:
- Not taking medications properly
- Antibiotic resistance of some H. pylori
- Using pain relievers that increase the risk of ulcer
Or, more rarely:
- Extreme overproduction of stomach acid
- Infection other than H. pylori
- Stomach cancer
- Other digestive diseases causing ulceration, like Crohn's disease