Peptic ulcers describe sores that occur in the lining of the esophagus, stomach or small intestine. According to the National Institute of Diabetes and Digestive and Kidney diseases, roughly 500 million Americans develop an ulcer yearly.
Ulcers that occur in the stomach are also known as gastric ulcers.
Symptoms & Causes
Typically, individuals with a stomach ulcer feel a burning pain that may be present anywhere in the abdominal region. An empty stomach may aggravate the pain, and it may be more intense during nighttime. The burning sensation may last for hours at a time.
Other symptoms associated with stomach ulcers include gas, nausea and loss of appetite.
A bacterium called H. pylori—not spicy cuisine or stress—is most often the cause of stomach ulcers. The curly-Q-shaped bacteria get into the protective mucosal lining in the stomach, creating holes that expose more sensitive tissue to stomach acid.
H. pylori is a common infection, and it is possible that the bacteria is spread between people through contact with infected stool, vomit or saliva. It also may be contracted from contaminated water or food. According to the Mayo Clinic, one in five young adults is actually infected with the bacteria. Still, for unknown reasons it does not result in ulcers in everyone.
A study published in the journal PLoS Pathogens last fall indicates that some people may have a genetic advantage. In their report, the team of researchers from Australia and Sweden illustrated how shorter versions of a protein called MUC1, which sticks out of the stomach lining and binds with H. pylori preventing it from coming into contact, are less adept at blocking H. pylori.
Cigarettes, alcohol, medications like aspirin and stress can exacerbate symptoms by further irritating the stomach lining.
If left untreated, stomach ulcers can cause bleeding from the ulcer that can lead to a condition called anemia. A blood transfusion may be needed in extreme cases.
Infections may develop at the site of the ulcer. Scar tissue may also build up that can affect digestion.
Diagnosis & Tests
Several tests exist for the diagnosis of stomach ulcers. A physician may use a blood, stool, or breath test to detect the presence of H. pylori or antibodies to H. pylori. According to the Mayo Clinic, blood testing has limitations: It cannot distinguish between a past and current infection, and it may result in a false negative if an individual happens to be taking certain medications.
Breath and stool tests are more accurate. A breath test consists of drinking a glass of liquid that contains a radioactive substance. This substance reacts with H. pylori so that when an individual with stomach ulcers blows into a bag, the radioactive substance will be present as carbon dioxide.
An X-ray exam may be performed to visualize the ulcer. A liquid containing a metal element called barium is ingested for this procedure. If an ulcer is found, the physician may then do an endoscopy in which a flexible tube with a camera attached at the end is inserted down the throat and into the stomach.
In a procedure called a biopsy, the physician may take a small piece of tissue from an area near the ulcer to confirm that H. pylori are present, or to make sure there is no cancer.
Treatment & Medications
Treatment of stomach ulcers consists of killing H. pylori and decreasing the amount of acid in the stomach. This requires several types of medications.
Physicians may prescribe several antibiotics at once, or use a combination drug such as Helidac to kill H. pylori. Helidac contains two antibiotics along with an acid-reducing drug and a medication that protects stomach tissue.
Drugs called acid blockers (for example, Pepcid) and antacids may be recommended to decrease the levels of stomach acid. Another option are so so-called proton pump inhibitors. These work by blocking cellular pumps that release acid into the stomach.
To aid healing of stomach ulcers, individuals should replace aspirin with acetaminophen for pain relief, limit alcohol use, and avoid cigarettes.