Ulcer, Peptic

Peptic ulcers are sore spots that develop in the lining of your stomach or the upper part of your small intestine. They occur when the protective mucus layer weakens, allowing stomach acid to irritate the gut. If you’ve ever experienced a sharp, burning pain in your stomach or upper small intestine, you might have encountered a peptic ulcer. While some people experience no symptoms, others feel a burning pain in the upper abdomen. Left untreated, ulcers can lead to complications like bleeding. In severe cases, peptic ulcers can lead to internal bleeding, necessitating hospitalization and even blood transfusions.

There are two primary types of peptic ulcer disease:

1. Gastric ulcer: This type occurs on the lining of the stomach.
2. Duodenal ulcer: found at the upper end of the small intestine, responsible for digesting and absorbing food.

While peptic ulcers can develop at any age, the likelihood increases with age.

The Culprits Behind Ulcers:

Peptic ulcers are typically the result of damage inflicted by digestive juices on the walls of the stomach or small intestine. This damage can occur due to two major causes:

1. Bacteria: Helicobacter pylori (H. pylori) is a bacterium found in approximately half of the population. While most individuals infected with H. pylori don’t develop ulcers, in some cases, the bacteria can elevate acid levels, compromise the protective mucus layer, and irritate the digestive tract. Transmission of H. pylori may occur through close contact or contaminated food and water.
2. Certain Pain Relievers: Prolonged use of aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can increase the risk of peptic ulcers. NSAIDs inhibit the production of a chemical that protects the inner walls of the stomach and small intestine from stomach acid. Unlike NSAIDs, acetaminophen does not pose a risk of peptic ulcers.

Other factors that may worsen ulcers, though they do not directly cause them, include:

• Smoking
• Heavy alcohol consumption
• Stress

Signs and symptoms of Peptic Ulcers

The most common symptom of a peptic ulcer is a burning pain in the upper abdomen, between your breastbone and belly button. This pain often occurs on an empty stomach and may improve with eating or taking antacids but then return. Other signs include:

• Bloating
• Burping
• Feeling full easily
• Nausea
• Vomiting
• Bloody or dark stools

Diagnosing and Treating Peptic Ulcers

To diagnose a peptic ulcer, your doctor will inquire about your symptoms, medication usage, and medical history. Physical examinations may be conducted to assess for bloating and pain in the abdomen. However, a definitive diagnosis often requires further investigation, which may include:

• Endoscopy: A thin, flexible tube equipped with a camera is inserted through the throat into the stomach and small intestine to visually inspect the lining for ulcers. Additionally, a small tissue sample may be taken for H. pylori testing.
• Imaging Tests: X-rays or other imaging techniques may be employed to visualize the presence of ulcers.
• Laboratory Tests: Blood, breath, and stool samples can be analyzed to screen for the presence of H. pylori bacteria.

Early detection and treatment of peptic ulcers are essential to prevent complications and promote healing. If you suspect you have a peptic ulcer, seeking medical attention promptly is crucial for proper diagnosis and management.

How to Treat Peptic Ulcers

Peptic ulcers can sometimes heal without intervention, but leaving them untreated increases the likelihood of recurrence and potential complications. These ulcers can erode blood vessel walls, perforate the lining, or cause swelling, leading to blockages in the digestive tract. Here’s how you can manage peptic ulcers:

1. Medication:

• Antibiotics: If Helicobacter pylori (H. pylori) bacteria are responsible for the ulcer, a combination of antibiotics may be prescribed to eradicate the infection.
• Pain Relievers: If aspirin or other NSAIDs are the cause, reducing or discontinuing their use may be necessary. Doctors may recommend Alternative pain relievers .
• Antacids: These medications neutralize stomach acid, providing relief from symptoms.
• Acid Reducers: Prescription drugs like proton pump inhibitors (PPIs) or H2 blockers can lower the production of stomach acid, promoting healing.
• Cytoprotective Agents: These drugs protect the stomach or small intestine lining, facilitating ulcer healing.

2. Lifestyle Modifications:

• Avoiding Irritants: Limiting smoking, alcohol consumption, and spicy foods can reduce irritation to the digestive tract.
• Stress Management: Stress doesn’t directly cause ulcers but can exacerbate symptoms. Techniques such as adequate sleep and stress reduction strategies can be beneficial.
• Dietary Adjustments: Probiotics, found in fermented foods like yogurt and kimchi, may help improve gut health and potentially aid in ulcer management.
• Prevention of H. pylori Infection: Practicing good hygiene, ensuring food and water safety, and thorough cooking of meats can reduce the risk of H. pylori infection.

3. Medical Intervention:

• Regular Monitoring: Patients with peptic ulcers may require periodic monitoring to assess healing progress and prevent complications.

Preventing Ulcers

• Limit NSAID Use: Take the lowest possible dose for the shortest duration necessary. Discuss alternatives with your doctor.
• Manage stress: Chronic stress can worsen symptoms. Relaxation techniques like deep breathing or meditation may be beneficial.
• Quit smoking and limit alcohol. These habits irritate the stomach lining.
• Maintain a Healthy Diet: While spicy foods don’t cause ulcers, they can irritate existing ones. Listen to your body and avoid foods that trigger discomfort.
• Practice good hygiene: Wash your hands regularly to reduce the risk of H. pylori infection.

Additional Tips:

• Consider probiotics, which are beneficial bacteria that may help with ulcers. You can find them in yogurt, kefir, kimchi, and other fermented foods.
• Talk to your doctor about the safety of alcohol consumption for you.

By following these tips and seeking medical attention if you experience symptoms, you can manage peptic ulcers and maintain a healthy digestive system.

Sources:

• UpToDate: “Patient education: Peptic ulcer disease (Beyond the Basics)”
• American College of Gastroenterology: “Peptic Ulcer Disease”
• Medical University of South Carolina Digestive Disease Center
• Mayo Clinic: “Peptic Ulcer”
• CDC: “Helicobacter pylori”
• National Institute of Diabetes and Digestive and Kidney Diseases: “Peptic Ulcers”
• American Academy of Family Physicians: “Peptic Ulcer Disease”