What are Peptic ulcers?
A peptic ulcer is the burning abdominal pain spreading from the navel to the chest. In today’s article let’s discuss in detail peptic ulcer its symptoms, treatment, tests required and prevention.
Overview:
Peptic ulcers are sores that form in the lining of the stomach, lower oesophagus and small intestine. They formed as a result of inflammation. Firstly peptic ulcers are a common health concern. The symptoms may vary some may feel discomfort or burning pain. On the other hand, others might not show any symptoms.
The three types of peptic ulcers are:
- gastric ulcers: form inside the stomach
- oesophagal ulcers: develop inside the oesophagus
- duodenal ulcers: forming in the upper section of the small intestines, called the duodenum
Causes of peptic ulcers
Different facets cause inflammation. These include:
-
- Helicobacter pylori is a bacteria that causes a stomach infection and inflammation. Most people who’re infected do not get ulcers. In contrast, in others, can raise the amount of acid, break down the protective mucus layer, and irritate the digestive tract. Experts think it may transmit through close contact or from unclean food and water.
- Certain pain relievers. Prolonged aspirin intake increases the odds to get a peptic ulcer. Similarly the same applies to other nonsteroidal anti-inflammatory drugs (NSAIDs). They include ibuprofen and naproxen.
- Smoking cigarettes & drinking alcohol also can cause ulcers.
- radiation therapy
- stomach cancer
Stress and eating plenty of spicy food don’t cause ulcers. But they can make ulcers more harmful and difficult to treat.
Symptoms
The most common symptom is burning abdominal ache that extends from the navel to the chest, which can range from mild to severe. In a few cases, the pain may disrupt sleep by waking you up at night. Small peptic ulcers may not show any symptoms in the early stages.
Other common signs of a peptic ulcer include:
- changes in appetite
- nausea
- bloody or dark stools
- unexplained weight loss
- indigestion
- vomiting
- chest pain
Ulcers form when digestive juices damage the walls of the stomach or small intestine. If the mucus layer gets too thin or your stomach makes too much acid, your gut will feel it.
Diagnosis
The doctor will ask about the symptoms, intake of NSAIDs and other drugs, and the medical history. They’ll also check for bloating in the belly and pain. That may be enough to make a diagnosis. The only way your doctor can tell for sure if you have an ulcer is to look. They may use a series of X-rays or tests.
Tests required
The two types of tests available to diagnose a peptic ulcer are,
1. Upper endoscopy
In this procedure, the doctor inserts a long tube with a camera down the throat and into the stomach & small intestine to examine the area for ulcers. This instrument also aids in removing tissue samples for examination.
Not all cases require an upper endoscopy. However, this procedure is recommended for people with a higher risk of stomach cancer. This includes people over the age of 45, as well as people who experience:
- anaemia
- weight loss
- gastrointestinal bleeding
- difficulty swallowing
2. Upper GI
For this procedure, a thick liquid called barium is given to drink. Then a technician will take an X-ray of the stomach, oesophagus, and small intestine. The liquid will make it possible for your doctor to view and treat the ulcer. Since H. pylori is a cause of peptic ulcers, your doctor will also run a test to check for this infection in your stomach.
Treatment
Treatment depends on the cause of your ulcer. If tests turn up positive for H. pylori infection, the physician will prescribe a combination of medications. The medications comprise antibiotics and proton pump inhibitors (PPIs). If these medications cause any side effects that are hard to bear, consult the doctor. If it’s not due to H. pylori infection, a prescription or over-the-counter PPI is given. This helps reduce stomach acid and heal ulcers. Acid blockers like famotidine reduce stomach acid and ulcer pain.
Some ulcers, called refractory ulcers, don’t heal with treatment. If the ulcer doesn’t heal with the initial treatment, this can indicate:
- excessive production of stomach acid
- presence of bacteria other than pylori in the stomach
- another disease, such as stomach cancer/ Crohn’s disease
The doctor may offer a different method of treatment or run additional tests. This is to rule out stomach cancer and other gastrointestinal diseases.
Medications
Medications are usually used to treat mild-to-moderate ulcers.
- Antibiotics. If an ulcer is caused by pylori bacteria, antibiotics can cure the ulcer. Usually, the doctor will prescribe triple/quadruple therapy (combines several antibiotics with heartburn drugs).
- Proton pump inhibitors. PPIs are acid reducers. These medications include esomeprazole (Nexium) and omeprazole (Prilosec).
- H2 blockers. These are also known as histamine receptor blockers (H2-receptor antagonists). They block a natural chemical called histamine, which tells your stomach to make acid. H2 blockers include cimetidine (Tagamet), famotidine (Pepcid), and nizatidine (Axid).
- Bismuth. This medication covers the ulcer and shields it from stomach acid. It also helps kill pylori infections.
- Antacids. They may ease your symptoms for a short period. But they don’t treat ulcers. Taking antacid keeps antibiotics from working. Talk to your doctor before taking an antacid for peptic ulcer disease.
Complications
If left untreated, ulcers worsen over time. As a result leading to more serious health complications like:
- Perforation: A hole forms in the lining of the stomach/small intestine causing an infection. Symptom – sudden, severe abdominal pain.
- Internal bleeding: Bleeding ulcers can result in notable blood loss and requires hospitalization. Symptom – lightheadedness, dizziness, & black stools.
- Scar tissue: This is a thick tissue that forms after a wound. This tissue makes it hard for food to pass through the digestive tract. Symptom – vomiting & weight loss.
All three complications are severe and may require surgery. Seek urgent medical care if you experience the following symptoms:
- sudden, sharp abdominal pain
- fainting, extreme sweating, or confusion(signs of shock)
- blood in vomit or stool
- abdomen that’s hard to the touch
- abdominal pain that aggravates with motion but improves while lying completely still
Prevention
Certain lifestyle preferences reduce your risk of developing peptic ulcers. These comprise:
- not surpassing two alcoholic beverages per day
- not combining alcohol with medication
- To avoid infections, wash your hands frequently.
- limiting the use of ibuprofen, aspirin, and naproxen
- Quitting smoking cigarettes and other tobacco use and
- eating a balanced diet rich in fruits, vegetables, and whole grains
Pain relievers. Some people with chronic pain conditions take nonsteroidal anti-inflammatory drugs (NSAIDs) for weeks/months. These medications can have an effect on the mucus that protects the stomach from acid. In addition, increasing the risk of developing peptic ulcers.
These pain relievers include:
You’re more likely to get an ulcer while taking one of these if you:
- Are you over age 65
- Are infected with pylori bacteria
- Take more than one NSAID at a time
- Have had a peptic ulcer in the past
- Also, take a steroid drug or selective serotonin reuptake inhibitor (SSRI)
To lower your chances for peptic ulcers while you take NSAIDs:
- Use the lowest possible dose and stop taking them as soon as you no longer need them.
- Take your medicine with food.
While you’re on NSAIDs, you can take medicine to lower the amount of acid your stomach makes. Drugs that can do that include:
- Proton pump inhibitors (PPIs) like esomeprazole, omeprazole (Prilosec OTC), and pantoprazole (Protonix)
- H2 blockers such as cimetidine, famotidine, and nizatidine
But you can also take the drug misoprostol to boost the amount of protective mucus your stomach makes. But that can cause side effects like diarrhoea and stomach cramps.
Conclusion
Most peptic ulcers heal with proper treatment. However, if users stop taking medication too soon or continue to use tobacco, alcohol, or nonsteroidal pain relievers during treatment, it may not heal. In conclusion, take your meds properly & follow the lifestyle preferences suitable for this condition.
