Stomach Ulcers
What Is a Stomach Ulcer?
A stomach ulcer is a defect in the outermost protective layer of the stomach or duodenal wall (first portion of the small intestine). An estimated 70% of stomach ulcers don’t present with symptoms. However, late presentations of ulcer-related complications like bleeding or perforation can lead to hospitalization.
In this article, we will discuss the symptoms, causes, and treatments of ulcers so you can be better equipped to prevent complications from this common medical condition.
What Do Stomach Ulcers Feel Like?
The most common symptom of stomach ulcers is upper abdominal pain (the area just below the sternum). The pain is usually described as sharp or burning, and it can radiate to different areas of the abdomen. Stomach ulcer pain usually worsens on an empty stomach. Duodenal ulcer pain usually occurs at night or 2 to 5 hours after a meal when stomach acid is secreted.
Some other associated symptoms include bloating, abdominal fullness, nausea, and early satiety. Gastroesophageal reflux disease (GERD) may coexist with ulcers. This can feel like stomach acid is traveling up the esophagus, a burning feeling in the chest, or a bitter taste in the mouth.
What Causes Stomach Ulcers?
Two major factors contribute to stomach ulcer formation: nonsteroidal anti-inflammatory drugs (NSAIDs) and a bacterial infection by Helicobacter pylori.
NSAIDs, including aspirin, are associated with a four-fold increase in the risk of developing a stomach ulcer. This is because NSAIDs inhibit the production of prostaglandin, which helps protect the stomach lining. Therefore, chronic and excessive NSAIDs use can damage the normal protective lining of the stomach, creating a high risk for ulcer formation.
Another risk factor for stomach ulcers are H. pylori infections. This bacteria infects the stomach lining and is prevalent in developing countries. The prevalence ranges from 65-70% in Western Asia, South America, and Africa. However, in North America the prevalence is still estimated to be around 37.1 %. H. pylori causes increased gastric acid secretion and disturbance of normal stomach defense mechanisms.
How Do You Treat Stomach Ulcers?
Stomach ulcer treatment depends on the initial cause. If the patient had been taking NSAIDs, their first step in treatment should be to avoid all NSAIDs use, including aspirin.
Acid-reducing medications can give the stomach lining a chance to heal. These medications include proton pump inhibitors such as omeprazole (Prilosec), esomeprazole (Nexium), and pantoprazole (Protonix). These medications are available over the counter, but dosage, frequency, and duration of treatment should be individualized based on the patient’s risks and severity of symptoms.
Another class of medications called the histamine 2 receptor antagonists are considered to be acid reducers. Such medications include famotidine (Pepcid) and cimetidine (Tagamet). These are available over the counter but are less effective because they have weaker suppression of stomach acid secretion compared to proton pump inhibitors.
If H. pylori infection is identified as the cause of stomach ulcers, treatment includes triple therapy with two antibiotics and a proton pump inhibitor given twice daily for 14 days. Various treatment regimens can be discussed with your doctor. Note that antibiotics are important in eradicating the infection, as there is evidence to suggest that H. pylori infection is a risk factor for gastric cancer.
Dr. Kingsley's Dietary Recommendations for Patients With Stomach Ulcers
Since the mainstay of stomach ulcer treatment is acid suppression, it is recommended to avoid highly acidic foods. For this reason, Dr. Kingsley recommends avoiding or at least limiting the following foods:
- Alcohol
- Caffeinated drinks, including coffee
- Red meat
- Tomato-based products
- Citrus fruits
What Are the Complications of Stomach Ulcers?
If ulcers are left untreated, serious complications like bleeding can result. This can involve vomiting bright red blood or coffee-ground material (clotted blood), or passing black, tarry stool. If you experience these symptoms, please seek medical attention as soon as possible.
These serious complications should be monitored closely in the hospital as significant blood loss can happen quickly when an ulcer is actively bleeding. Typically, an endoscopy or colonoscopy is recommended as soon as possible to identify and treat the source of the bleeding. To say it again, if you are having signs or symptoms of GI bleeding do not wait, seek medical care right away to prevent a catastrophic bleed.
If you believe you are experiencing stomach ulcer symptoms, it’s important to be treated by a board-certified physician. Schedule your appointment with The Kingsley Clinic today.