Stomach Ulcers

What Are Stomach Ulcers?

Stomach ulcers are uncomfortable, painful sores that develop in the stomach. They are also referred to as gastric ulcers and are a type of peptic ulcer disease. Peptic ulcers occur in the stomach and the small intestine. 

Sores occur when the mucosal lining of the stomach is compromised and degenerative. This allows digestive juices to eat away at the lining, which causes ulcers. Once diagnosed, ulcers are very treatable but require proper treatment so that the condition does not worsen. 

What Causes Stomach Ulcers:

Stomach ulcers have two leading primary causes, and with rare exception, it is one of the two:

  • A Helicobacter pylori (H. pylori) infection
  • Overuse of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, and naproxen

In approximately 1 percent of stomach ulcer cases, the cause is Zollinger-Ellison syndrome, which causes the body to produce more stomach acid than necessary. 

What Are the Symptoms of Stomach Ulcers?

Some patients only feel mild discomfort, while others may be in more pain. This depends on the severity of the ulcer. The most common symptom of stomach ulcers is a burning or painful sensation between your chest and navel. It is typically more painful when the stomach is empty. Other common symptoms include:

  • Unintentional weight loss
  • Refusal to eat because of pain
  • Acid reflux
  • Belching 
  • Heartburn 
  • Blood in vomit or vomit that looks like coffee grounds
  • Dark, tarry stools 
  • Anemia (which can cause shortness of breath and pale skin)
  • Dull pain in the stomach
  • A feeling of being full
  • Noticing that symptoms subside after eating or taking antacids

There are many different types of gastrointestinal disorders that share the same symptoms, so if you’re feeling uncomfortable and experiencing these types of symptoms for more than a day or so, you should consult your gastroenterologist. They can rule out other problems and provide you with a diagnosis of stomach ulcers if they are present, so you get the proper treatment. 

How Are Stomach Ulcers Diagnosed?

If you suspect you have stomach ulcers, let your physician know. There are several tests you can take to confirm the diagnosis. 

Because many stomach ulcers are caused by H. pylori infection, you may be asked to take a lab test to detect the infection. The test can be performed by obtaining a breath, stool or blood sample.

You may also have a barium swallow. You’ll drink a white liquid and wait one hour for this. The barium lights up your stomach and small intestine on an X-ray. 

Upper endoscopy is considered the gold standard test to discover gastric ulcers. During an upper endoscopy, you are put under sedation, and a thin tube with a small camera at the end is inserted into your mouth, through your throat, and down to the esophagus and then into the stomach and duodenum (first part of the small intestine). This can give your gastroenterologist a bird’s eye view of those organs to inspect for ulcers or other problems. Your doctor may also want to take a biopsy (small piece of tissue) during the endoscopy to be evaluated. 

How Are Stomach Ulcers Treated?

The treatment of peptic ulcer disease depends on the root cause. If you have an H. pylori infection, this is typically treated with antibiotics and proton pump inhibitors (PPIs), which help block cells responsible for acid production. If the cause is from NSAIDs, antibiotics are not needed, but PPIs are still first-line treatment. 

Your doctor may also recommend stopping NSAIDs completely. Instead, you can use other analgesics for pain, such as acetaminophen. You may also schedule a follow-up endoscopy in some cases.

In rare cases, surgery is needed to treat stomach ulcers. This is necessary for instances when ulcers are bleeding, continue to return despite treatment, or cause a hole (perforation) in the stomach. The surgeon may remove the entire ulcer, patch it with fatty tissue, may cut off the nerve supply to the stomach or may remove part of the stomach to reduce acid production,. 

What Happens if Stomach Ulcers Are Not Treated?

If you suspect stomach ulcers, contact your gastroenterologist as soon as possible. Many ulcers can be mild and cause mild discomfort, but any ulcer caused by H. pylori infection that goes untreated may face potential complications. H. pylori infection is associated with other digestive diseases that are much more serious, such as:

  • Obstruction in the digestive tract
  • Stomach cancer
  • Internal bleeding 
  • Penetration of the ulcer into the pancreas
  • Perforation of the digestive tract 

If you experience blood in the stool or in vomit, trouble breathing, weakness, and sharp abdominal pain that isn’t relieved with any treatment, those symptoms may be associated with the conditions above. It’s always best to be safe and visit your doctor when you have noticeable gastrointestinal symptoms for more than a day or so.