Stomach ulcers, also known as peptic ulcers, are open defects that develop on the lining of the stomach. They can also occur in other parts of the digestive tract (e.g. duodenum).
These ulcers can cause discomfort and pain and, if left untreated, may lead to complications such as bleeding, perforation, or obstruction. Some ulcers are also cancerous.
Causes and Risk Factors
The primary cause of stomach ulcers is the imbalance between stomach acid, digestive enzymes, and the protective mucosal lining of the stomach and intestines. Common causes and risk factors for stomach ulcers include:
- Helicobacter pylori Infection: The bacterium Helicobacter pylori (H. pylori) is a common cause of stomach ulcers. H. pylori infection can weaken the protective mucosal lining of the stomach and increase the risk of ulcer formation.
- Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, or naproxen can irritate the stomach lining and contribute to the development of ulcers.
- Excessive Alcohol Consumption: Heavy alcohol consumption can irritate the stomach lining and increase the risk of developing stomach ulcers.
- Smoking: Cigarette smoking can weaken the mucosal lining of the stomach and impair the healing of existing ulcers.
- Stress: While stress is not a direct cause of stomach ulcers, it can exacerbate existing symptoms and delay the healing process.
- Age and Genetics: Older adults and individuals with a family history of stomach ulcers may have an increased risk of developing ulcers.
Symptoms
The symptoms of stomach ulcers can vary depending on the location and severity of the ulcer. Common symptoms may include:
- Abdominal Pain: Persistent or intermittent pain in the upper abdomen, often described as a burning or gnawing sensation.
- Nausea and Vomiting: Nausea, vomiting, and bloating may occur, particularly after meals or when lying down.
- Loss of Appetite: Decreased appetite and unintended weight loss may occur due to discomfort associated with eating.
- Indigestion: Symptoms of indigestion, such as belching, bloating, and feelings of fullness, may be present.
- Bloody or Dark Stools: In cases of bleeding ulcers, blood may be present in the stool, appearing dark or tarry in color.
Diagnosis
Diagnosing stomach ulcers typically involves a combination of medical history assessment, physical examination, and diagnostic tests. Common diagnostic tests may include:
- Upper Endoscopy: A procedure in which a thin, flexible tube with a camera (endoscope) is passed through the mouth and into the oesophagus, stomach, and duodenum to visualize the lining of the digestive tract and identify ulcers.
- Laboratory Tests: Blood tests may be performed to check for the presence of H. pylori infection or signs of anemia or bleeding associated with stomach ulcers.
Treatment
Treatment for stomach ulcers aims to relieve symptoms, promote ulcer healing, and prevent complications. Treatment options may include:
- Medications: Medications such as proton pump inhibitors (PPIs), histamine H2-receptor antagonists and antibiotics may be prescribed to reduce stomach acid production, neutralize acid, eradicate H. pylori infection, and promote ulcer healing.
- Antacids: Over-the-counter antacids may be used to provide temporary relief from symptoms of indigestion and heartburn associated with stomach ulcers.
- Lifestyle Modifications: Making changes to diet and lifestyle habits, such as avoiding NSAIDs, reducing alcohol consumption, quitting smoking, and managing stress, can help prevent ulcer recurrence and promote healing.
- Surgery: In rare cases of severe or complicated stomach ulcers, surgical intervention may be necessary to repair the ulcer, remove damaged tissue, or control bleeding. Cancerous ulcers are treated as per the principles of treatment of stomach cancer.