Peptic Ulcer: Symptoms, Causes & More

31/08/2021

Peptic Ulcer: Overview

Peptic ulcers are open sores or ulcers formed in the lining of your stomach and upper region of the small intestine. They most commonly develop due to stomach acid erosion and infection with a bacteria known as ‘Helicobacter pylori’ (H. Pylori).

The different types of ulcers include:

  • Gastric ulcers: These are ulcers which are formed inside the stomach.
  • Duodenal ulcers: These ulcers develop in the upper region of the small intestine known as the duodenum.

Symptoms of peptic ulcers

Peptic ulcer is characterised by burning sensation and mild or severe pain in the stomach. Other common symptoms include:

  • Significant appetite changes
  • Nausea and vomiting
  • Increasing pain in upper region of stomach in between meals
  • Heartburn
  • Bloating
  • Unexplained weight loss
  • Blood in stools
  • Dark stools
  • Difficulty in breathing and feeling faint
  • Vomiting blood

Causes of peptic ulcers

There are two main causative factors associated with peptic ulcers. They include:

  • Helicobacter pylori (H. Pylori) bacteria: It is a common bacteria that causes stomach infections. The bacteria can firmly adhere to the lining of the stomach (mucosa), causing inflammation and irritation, leading to damage of the protective layer of the stomach. When this protective layer breaks down, the stomach acids tend to enter into the surrounding tissues, causing ulcers.
  • Pain relieving medications: Prolonged/regular usage of pain relief medications such as non-steroid anti-inflammatory drugs (NSAIDS) including aspirin, ibuprofen, naproxen, etc. can disrupt the protective lining of the stomach, causing ulcers.

In rare cases, peptic ulcers may develop as a result of prolonged infectious diseases, surgeries, medications such as steroids and specific medical conditions such as Zollinger-Ellison syndrome, which causes a tumour with cells producing acids in the digestive tract.

Diagnosis of peptic ulcers

Medical history and physical examination: Your doctor takes a thorough history of your medications, signs, symptoms and physically examines the area around your stomach to locate the exact area of pain and identify the factors intensifying the pain.

Diagnostic tests

Endoscopy: An upper endoscopy is performed to inspect your gastrointestinal tract by insertion of an endoscope (a small, thin tube attached with a tiny light and camera) through your mouth and throat to detect abnormalities in your stomach.

H. Pylori tests: These tests are performed to identify the presence of H. pylori bacteria in your stomach. They may include breath tests, blood/stool tests or examination of samples taken during endoscopy.

Treatment and prevention of peptic ulcers

Your ulcer is treated based on the underlying causes. Your doctor may prescribe a combination of medications including:

Antibiotics: To treat stomach infection caused by H. pylori bacteria.

Proton pump inhibitors: To reduce the production of stomach acids and promote healing of the ulcer.

Acid blockers: To reduce stomach acids and pain caused by the ulcer.

Protective medications: To form a protective layer around the ulcer to prevent further damage from stomach acids and other enzymes.

Preventive measures for peptic ulcers include:

Protection from infections: Frequently wash your hands with soap and water and consume foods which are fresh and thoroughly cooked.

Cautious use of pain killers: Avoid regular usage of pain relieving medications. Confirm with your doctor to find low dose pain medications and take them along with meals. You may also take antacids along with pain medications to reduce your risk of peptic ulcers.

Lifestyle habits: Avoid smoking, excessive alcohol intake and combination of alcohol with medications. Maintaining a healthy balanced diet including fresh fruits, vegetables and fibre-rich foods can help to prevent peptic ulcers.

Complications of peptic ulcers

Peptic ulcers which are left untreated can lead to complications over time, including:

Perforation: A hole is developed in the stomach lining or small intestine, causing serious infections in the abdominal cavity.

Internal bleeding: It can lead to gradual loss of blood causing anaemia or severe blood loss which may require hospitalisation.

Formation of scar tissue: It can lead to development of thick tissue, obstructing the passage of food through the digestive tract, which may result in vomiting and weight loss.

Frequently asked questions (FAQs)

Can ulcers be cured?

Ulcers can be cured with a combination of medications and certain lifestyle changes. Medications may include antibiotics, acid blockers and protective medicines. Lifestyle changes include reduction of alcohol consumption, smoking, cautious use of pain relieving medications and consumption of a healthy balanced diet.

What does ulcer pain feel like?

Ulcer pain may feel like a dull, burning and gnawing sensation in the upper region of the abdomen and stomach.

What causes stomach ulcers?

Stomach ulcers may be caused by H. Pylori bacterial infections and regular usage of pain relieving medications. In some rare cases, they may be caused as a result of prolonged infectious diseases, surgeries, steroid medications and specific medical conditions.

How long does it take for peptic ulcers to heal?

The symptoms of peptic ulcers are generally relieved within a few days to few weeks after appropriate treatment. However, complete healing of the ulcers may take a few more additional weeks.

Dr Mahadevan B
HOD & Senior Consultant – Department of & Endosonography

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