Do you sometimes experience a strange burning or pain in your stomach? Does it feel like your stomach is coming from somewhere in your chest? Or do you feel uncomfortable with a full stomach when you eat? Maybe this is due to a stomach ulcer, that is, a stomach ulcer . Don't worry, this is a condition that affects many people and can be treated. Let's talk about this in detail and simply.
What is a stomach ulcer?
Simply put, a stomach ulcer is a small tear in the lining of your stomach. It's like a sore on our skin. This is what causes a sharp pain in your stomach, often accompanied by a burning or stinging sensation . However, not all stomach ulcers cause major symptoms, and some can be silent.
This stomach ulcer is one type of ulcer that belongs to the larger category called `peptic ulcer disease`.
How common are these injuries?
In fact, these stomach ulcers are more common than you think. Do you know what? There are two main causes of this, both of which are very common in our society. One is some of the over-the-counter pain medications that we often buy from the pharmacy. The other is a bacterial infection called `H. pylori` (Helicobacter pylori) . These two are responsible for about ninety-nine percent of stomach ulcers.
What are the symptoms of stomach ulcers?
The main symptom of a stomach ulcer is stomach pain. This is usually felt in the area between your breastbone and your ribcage, slightly to the left.
This pain can be felt in different ways:
- It's like a burning sensation , like acid burning inside the stomach .
- It feels like something is eating away at your stomach .
This feeling is not just a feeling. What is actually happening is that the stomach acids and enzymes in the stomach are making the wound worse.
Many people experience indigestion at the same time. This means a feeling of fullness along with a burning sensation in the stomach. You may feel full as soon as you start eating, or you may feel full for a long time after eating.
Symptoms that others report are:
- Acid reflux and heartburn.
- Nausea and vomiting.
- Bloating, belching, and gas pain.
These symptoms are often related to the conditions that caused your stomach ulcer.
Silent injuries and dangerous symptoms
But, surprisingly, some people don't even realize they have these stomach ulcers. We call these 'silent ulcers'. You may not have any symptoms at all and only find out about them when you suddenly have a serious complication, such as bleeding or perforation .
In severe cases like this, keep an eye out for these symptoms:
- Pale skin color (pallor).
- Dizziness, weakness, or fainting.
- If you have black blood in your stool (this may look like tar).
- If the vomit looks like coffee grounds.
- A sudden, severe, persistent stomach ache.
Important: If you have any of these symptoms, you should see a doctor immediately, okay? These could be signs of a serious condition.
How serious are the complications caused by stomach ulcers?
If left untreated, stomach ulcers can cause serious problems.
- Bleeding ulcers: Bleeding from an ulcer can be mild or severe. If it continues to bleed for a long time, anemia can develop. If it bleeds a lot at once, it can lead to shock and be life-threatening.
- Perforated ulcers: This is a very rare condition, but it is a medical emergency! If the stomach wall is damaged and a hole is formed, stomach acid and bacteria can leak out and cause an infection in the abdominal cavity. If this infection spreads to the bloodstream, it can lead to a very dangerous, life-threatening condition called `sepsis` .
What are the main causes of stomach ulcers?
As we said before, there are two main reasons:
1. `H. pylori` bacterial infection:
H. pylori (Helicobacter pylori) is a very common bacteria. About half of the world's population has this bacteria in their stomachs. For most people, it doesn't cause any problems. But sometimes, this bacteria grows too much in the stomach and starts to eat away at the stomach lining. This is when chronic inflammation occurs, eventually leading to gastric ulcers.
2. Excessive use of painkillers (NSAIDs):
`NSAIDs` (Nonsteroidal anti-inflammatory drugs) are painkillers that we can buy over the counter at the pharmacy. Examples include `ibuprofen` (Ibuprofen), `naproxen` (Naproxen) and `aspirin` (Aspirin) . These drugs directly affect the lining of the stomach, which means they irritate it. They also block the production of some important chemicals that protect and repair the stomach lining.
Normally, our stomach lining is designed to protect against these minor injuries and heal quickly. But if you take too many NSAIDs, the stomach eventually becomes unable to repair itself. As the protective layer wears away, it becomes less able to repair itself, and ulcers form.
Other, less common reasons:
- Other infections: Rarely, other bacterial, viral, or fungal infections can also cause stomach inflammation (erosive gastritis) and ulcers.
- Zollinger-Ellison syndrome: This is a very rare condition. In this condition, the stomach produces too much gastric acid. This excess acid wears away the stomach lining and causes ulcers.
- Severe physiological stress: When your body is struggling to recover from a life-threatening illness or injury, meaning it is under a lot of stress, a 'stress ulcer' can develop. During times like these, the body's pH changes and the stomach's acidity increases.
Does our lifestyle affect stomach ulcers?
The day-to-day stress levels we face in our daily lives, and what we eat and drink, do not directly cause stomach ulcers. That is, eating too much or being a little stressed will not cause stomach ulcers.
However, if you already have an ulcer, these things can make the symptoms worse. Because anything that increases stomach acid is bad for the ulcer and will make it worse.
It's best to be careful of things like this:
- Smoking
- Alcohol
- Spicy and acidic foods
How do you know if you have a stomach ulcer?
When you see a doctor, he or she will first ask you about your symptoms and your medical history. They will try to find out things like whether you regularly use NSAIDs and whether you have had a previous H. pylori infection. If there is any suspicion that you may have an ulcer, the next step is to look inside your stomach.
Tests to diagnose stomach ulcers
The doctor will first need to check for an H. pylori infection, and then look for ulcers inside the stomach. There are several ways to do this.
- Upper Endoscopy / EGD test:
This is the most common and most accurate method. This involves inserting a small camera (an `endoscope`) at the end of a thin, flexible tube through your mouth and down your esophagus into your stomach and the first part of your small intestine (duodenum). You will be given medication to make you feel sleepy or light-headed during this procedure, so you will not feel any discomfort.
This camera allows the doctor to see inside the stomach. If there is an ulcer, it can be seen. Also, small instruments can be passed through this tube and a small piece of tissue (biopsy) can be taken from the lining of the stomach and tested for H. pylori. Sometimes, if there is bleeding from the ulcer, it can be treated right there.
- Other tests:
Although endoscopy is the best method, sometimes an imaging test such as an upper GI X-ray series can also detect a stomach ulcer. However, this is not as accurate as endoscopy.
There are specific tests to check for H. pylori infection:
- Urea Breath Test: This is a very simple, painless test.
- Blood test: This tests for antibodies produced in the body against H. pylori.
- Stool antigen test: A stool sample is tested for the presence of H. pylori bacteria.
Even if you think it's a stomach ulcer, what else could it be?
If your symptoms are not caused by a stomach ulcer, other conditions may be the cause, such as:
- Gastroesophageal reflux disease (GERD): If acid continues to flow up into the throat, it can cause heartburn, indigestion, and nausea.
- Functional dyspepsia: This is persistent indigestion without any obvious physical cause (such as an ulcer or gastritis). The symptoms are similar to those of a stomach ulcer, but it is not caused by acid, and there is no visible ulcer in the stomach lining.
- Stomach cancer (`Stomach cancer` / `Gastric cancer`): Although this is rare, it can sometimes cause symptoms similar to stomach ulcers (stomach pain, weight loss, loss of appetite). That is why it is important to get a proper diagnosis.
How to heal a stomach ulcer quickly?
The best part is, once the cause of the ulcer is gone, your stomach lining will start to heal.
Imagine that if the cause of your injury was the continued use of NSAIDs (painkillers), there is a good chance that the injury will heal without any other special treatment once you stop taking the medication.
However, if you have an H. pylori infection, you will definitely need to take antibiotics from a doctor to get rid of it .
In addition, the doctor can prescribe other medications to reduce stomach acid and protect the stomach lining, which will help the wound heal faster and better.
What are the treatments for stomach ulcers?
Doctors often treat ulcers with a combination of medications. These include medications that reduce stomach acid, cover and protect the ulcer until it heals, and kill any infections, such as H. pylori. Rarely, a minor procedure may be performed to stop bleeding or close a hole in the stomach.
Medications
The main types of medications given for stomach ulcers are:
- Antibiotics: If you have an H. pylori or other bacterial infection, your doctor will prescribe one or more antibiotics to kill the bacteria, usually for 7 to 14 days. The most commonly used antibiotics are:
- `Amoxicillin`
- `Clarithromycin`
- `Metronidazole`
- `Tetracycline`
- Proton Pump Inhibitors (PPIs): These medications significantly reduce the production of stomach acid. They also protect the stomach lining and speed up wound healing. The most commonly prescribed PPIs are:
- `Omeprazole`
- `Lansoprazole`
- `Pantoprazole`
- `Esomeprazole`
- `Rabeprazole`
- `Dexlansoprazole`
- Histamine (H2) blockers: These medications also reduce stomach acid production, but are not as strong as PPIs. Examples:
- `Famotidine`
- `Cimetidine`
- `Nizatidine`
- Cytoprotective agents: These medications coat the lining of the stomach, protecting it from acids and other harmful substances. They help the wound heal. They are given to treat and prevent ulcers caused by NSAID use. Examples:
- `Sucralfate`
- `Misoprostol`
- Bismuth subsalicylate (found in medications like Pepto-Bismol)
Medical procedures
If you have a complicated ulcer, meaning it is bleeding or has a hole, your doctor will need to treat it directly. This can often be done during an endoscopy. Bleeding ulcers can be treated by cauterizing (thermal therapy), injecting medication, or clipping the ulcer. If there is a hole in the stomach, a surgeon may need to stitch it up or repair it in another way.
Rarely, some people have ulcers that do not heal with treatment and keep coming back. This can cause ongoing pain and scarring. This scarring can also block the lower stomach outlet (gastric outlet). If this happens, surgery may be necessary:
- Remove scar tissue or open the outlet (pyloroplasty).
- Cut (vagotomy) the nerve that stimulates the production of stomach acid (vagus nerve).
How can you prevent a stomach ulcer from forming or recurring?
You can do these things to avoid stomach ulcers:
1. Get rid of H. pylori infection: Many people are unaware that they have H. pylori infection. You can find out if you have it with a simple breath test or stool test. If you have it, even if you don't have symptoms, getting it treated as directed by your doctor can help prevent future ulcers.
2. Use NSAIDs (painkillers) as directed and with caution: If you are used to taking NSAIDs (e.g., ibuprofen, diclofenac, aspirin) for minor everyday aches and pains, be sure to take them only for the shortest amount of time possible and only for the shortest possible time. If you must continue to take NSAIDs for a medical reason, talk to your doctor about using the lowest dose, switching to a safer medication, or taking another medication, such as a PPI, to protect your stomach lining.
3. Reduce or stop other harmful habits: Smoking and excessive alcohol consumption increase the risk of stomach ulcers, especially if you have an H. pylori infection or are taking NSAIDs. So it is best to stay away from these habits.
How long does it take for a stomach ulcer to heal?
If you take your medication as prescribed and avoid things that irritate the ulcer (such as eating junk food, smoking, and drinking alcohol), your ulcer should heal completely in a few weeks (usually 4-8 weeks). Your doctor may recommend another endoscopy or other test to make sure the ulcer is completely healed and that the H. pylori infection (if present) has been completely eliminated.
Most people get better with short-term treatment. However, people with conditions that cause stomach acid to continue to be produced, such as Zollinger-Ellison syndrome, may need to take medication long-term.
What to do if you think you have a stomach ulcer?
Most importantly: If you have even the slightest suspicion that you have a stomach ulcer, definitely seek medical advice.
You may be able to temporarily control symptoms with over-the-counter antacids (e.g. Digene, Gelusil). However, they will not heal the ulcer. You will need to treat the underlying cause.
An untreated ulcer, even if you don't have any major symptoms, can lead to serious complications (such as bleeding or perforation) over time. Also, keep in mind that H. pylori infection, a major cause of stomach ulcers, increases the risk of developing stomach cancer over time if left untreated.
When should you go to an Emergency Treatment Unit (ETU) ?
If you have any of these symptoms, go to a hospital emergency room immediately:
- A constant, unbearable stomach pain.
- If the stool is black (like tar) with blood, or if the blood is red.
- If you vomit blood (either like coffee grounds or fresh blood).
- Signs of severe blood loss (e.g., extreme paleness, excessive sweating, difficulty breathing, fainting, loss of consciousness).
So, what did we learn from this story? (Take-Home Message)
Stomach ulcers are common, but they should not be taken lightly. They can be dangerous if not treated properly. Sometimes ulcers can be present without symptoms, so if you have any doubts, it is wise to see a doctor for a checkup.
Remember: You may find relief with healthy lifestyle changes (such as diet, quitting smoking), but the key is to find the underlying cause (such as H. pylori, NSAID use) and treat it appropriately.
A stomach ulcer is when your stomach's natural acids damage the protective lining of your stomach. If this condition is not treated, it will only get worse. Your doctor can prescribe the right treatment for your condition and help you heal quickly. So, don't be afraid and seek medical advice without delay.
` Stomach ulcers, stomach ulcers, gastritis, H. pylori, NSAIDs, stomach inflammation, endoscopy
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