What is an ulcer?
An ulcer is the result of an imbalance in digestive fluids. It occurs when the linings of the stomach or the small intestines become deeply eroded.
Ulcers range from quite small to an inch or more in size.
Stomach ulcers are also known as gastric ulcers. Just as peptic ulcers are any ulcers that affect both the stomach and small intestines.
The stomach produces a strong acid to help digest food and protect against microbes. To protect the tissues of the body from this acid, it also secretes a thick layer of mucus. If the mucus layer is worn away and stops functioning effectively, the acid can damage the stomach tissue causing an ulcer.
In some cases, the body produces too much stomach acid. As a result, the mucous lining becomes damaged or worn away. When this happens, the acid may damage the lining of the digestive tract and cause an ulcer sore.
Peptic ulcer remains a common problem in the United States. Around 10% of people will have peptic ulcer disease at some point in their life.
What are the causes?
Contrary to popular belief, stress and spicy foods do not cause stomach ulcers. They may aggravate an already existing ulcer but definitely not be the cause for one.
To clarify, ulcers are typically caused by an infection with a bacterium called Helicobacter pylori (H. pylori).
Another cause of stomach ulcers is the long-term use of pain medications known as NSAIDs (nonsteroidal anti-inflammatory drugs). NSAIDs can weaken the stomach lining’s ability to resist acid made in the stomach.
Aspirin, ibuprofen, or naproxen are some examples of NSAID medications.
How is it diagnosed?
Stomach ulcers are diagnosed through a review of medical history along with the symptoms experienced by the patient. Doctors would also want to know if there are any other prescriptions or over-the-counter medications involved.
Doctors would also do a physical examination. They will check for bloating in the belly and pain.
To determine if H. pylori are involved, a blood, stool or breath test may be conducted. A breath test involves drinking a clear liquid and breathing into a bag that will be then sealed after. If the breath sample contains high levels of carbon dioxide, H. pylori are present.
X-rays or a test called endoscopy can also be conducted. These tests can accurately determine the presence of an ulcer. An endoscopy involves a thin, bendy tube that is moved down the throat and into the stomach and small intestine. The tube has a camera at the end that can check the lining for ulcers.
What are the types of ulcers?
- Gastric ulcers are sores in the lining of the stomach.
- Duodenal ulcers are those in the duodenum or the first part of the small intestine.
What are the complications of ulcers?
- Bleeding – This can range from a trickle to a life-threatening bleed
- Perforation – This is the term used to describe the ulcer having gone all the way through the wall of the stomach. It may cause severe pain and makes a patient feel very unwell.
- Stomach blockage – This is a rare occurrence. An ulcer at the end of the stomach can cause the part of the stomach that goes into the duodenum to narrow and cause an obstruction. This can cause frequent severe vomiting.
- Fistula – This occurs when a perforated ulcer can establish a connection with an adjacent abdominal organ or structure. Exchange of material and fluids may happen between the adjacent structures resulting in vomiting these materials or hemorrhages.
How are ulcers treated?
Some mild cases of ulcers may not need medical attention as they will heal on their own. However, not seeking proper medical treatment may result in these ulcers coming back.
Antibiotics are normally prescribed to eliminate the infection, and sometimes an acid reducer. They may be prescribed to be taken twice a day for 1 to 2 weeks.
If NSAIDs are causing the ulcers, a doctor may prescribe a protective medication to take along with it.
What are the symptoms?
The symptoms of an ulcer may vary from person to person. Some may not experience any whereas, some may have a few or several of the symptoms.
1. Dull pain in the stomach
Dull and burning pain is the most common symptom of an ulcer. The pain is felt anywhere between the belly button and the breastbone. It can also travel out from the middle of the stomach up to the neck, down to the belly button, or through to the back.
Stomach acid helps break down and absorb the food consumed. Excess stomach acid makes the pain worse because it creates painful sores within the stomach.
This kind of pain is often more severe whenever the stomach is empty such as between meals or at night. Sometimes it can also start a few hours after eating. This pain can last for several minutes to several hours. The burning pain is sometimes made better by eating or aggravated between one and three hours after a meal. This occurs when food can no longer neutralize the acid produced by the stomach.
Taking antacids may help relieve some of the pain but it doesn’t help cure the ulcer. The pain will just keep coming back. Eating certain foods can help buffer stomach acid.
2. Weight loss
Unintended weight loss is one of the key symptoms of peptic ulcer. It should not be ignored.
Unexplained weight loss is a noticeable drop in body weight that occurs even if a person is not actively trying to lose weight. The weight loss does not come about because of diet, exercise or lifestyle changes.
Cachexia is the clinical term for weight loss.
Since ulcer makes eating painful, hence many patients with ulcers avoid meals. This decrease in appetite consequently leads to weight loss.
Peptic ulcers can definitely have a large effect on eating patterns and how the body can absorb essential vitamins and nutrients, therefore causing weight loss.
3. Loss of appetite
Intense and sudden pain from ulcers can sometimes make a person too sick to eat.
Loss of appetite can be physical or psychological. It’s often temporary. Factors like infections or digestive issues (like ulcers) can make a person stay away from eating. In many cases, appetite returns when the patient has been given medical help and is recovering.
Signs of decreased appetite include not wanting to eat, unintentional weight loss, and not feeling hungry.
Loss of appetite can also be brought about by lowered immune system functions and feeling generally unwell.
The medical term for a complete loss of appetite over a more extended period of time is anorexia.
Bloating is described as a swollen feeling in the stomach right after eating. It can often cause discomfort or pain and a stuffed, tight or full feeling in the abdominal region. This also makes the stomach distended, hard and painful.
It should be noted that it is not the same as water retention. The two terms are often used interchangeably. To simplify, bloating involves excessive amounts of solids, liquids or gas in the digestive system.
If the ulcer is located at the end of the stomach where it attaches to the duodenum, the scarring it causes may eventually narrow the opening to the duodenum. The duodenum is located between the stomach and the middle part of the small intestine, or jejunum.
This will prevent food from leaving your stomach and moving into the small intestine.
A person with an ulcer often feels heavy after eating a small meal. It can also become physically uncomfortable.
This is also known as early satiety. Early satiety is the inability to eat a full meal or feeling full very fast after only a small amount of food or before finishing a normal-sized meal.
In general, anything that impairs the emptying of the stomach can make a person feel full quicker. This includes scarring or compression of the small intestine. Ulcers are one of the main causes of these.
Ulcers can block the passage of food through the digestive tract, causing early satiety.
Treating this symptom depends on the underlying condition that is causing it. For early satiety due to ulcers, doctors would recommend a diet that is low in fats and/or prokinetic medications.
6. Acid reflux or heartburn
Acid reflux happens when contents from the stomach move up into the esophagus. It is also called acid regurgitation or gastroesophageal reflux. This occurs when the lower esophageal sphincter is weakened or relaxes at the wrong time. This may cause stomach acid to back up into the esophagus.
The esophageal sphincter is the muscle that tightens to prevent food in the stomach from going back up. Ulcer sores cause disruption with how this muscle functions.
Heartburn is experienced when excessive amounts of acid reflux get into the esophagus. It is described as a feeling of burning discomfort behind the breastbone. The burning then moves up toward the neck and throat. A bitter or sour taste in the back of the throat is reported to be experienced by some people. The pain and pressure brought by heartburn can last for several hours and may worsen after eating.
Indigestion, or dyspepsia, is one of the most common symptoms of a peptic ulcer.
Dyspepsia is a term used to describe an unpleasant or sometimes painful sensation at the top of the abdomen or in the lower part of the chest. It usually occurs after eating or drinking due to the body having problems with digesting food.
Indigestion is a symptom, not a disease and is so common that virtually everyone will experience it at some time.
Symptoms of indigestion can vary greatly from one person to another and greatly depends on the underlying problem causing indigestion. Most indigestion sufferers have their own pattern of symptoms, which range from mild discomfort in the upper part of the abdomen to quite severe pain, which sometimes might go through into the back.
Furthermore, indigestion can feel like a stomachache. It can occur by itself or may be accompanied by other symptoms such as nausea, retching or vomiting.
Anemia is a surprising symptom of an ulcer.
The stomach’s protective lining prevents digestive enzymes from eating away the stomach. When the linings become damaged, inflammation and pain may occur. If inflammation gets worse, it can cause the lining of the stomach or the duodenum (the first part of the small intestine) to bleed.
These are the instances that peptic ulcers can bleed. These are also known as bleeding ulcers. Minor bleeding is usually not serious and may go unnoticed. However, it still requires treatment.
More severe bleeding or hemorrhaging, however, can be life-threatening and needs immediate medical attention.
A slow-bleeding ulcer may gradually cause anemia. Anemia means the body does not have enough red blood cells and hemoglobin, which means the body’s organs cannot get enough oxygen. This, in turn, causes some breathing problems, fatigue, and fainting spells.
This bleeding causes the anemia.
9. Fatty food intolerance
Fat intolerance is a condition that arises when the body is unable to properly digest food. Fatty food, in general, take longer to digest.
In addition, a fat intolerance can make eating this kind of food uncomfortable and even painful. Since it takes longer to digest them,
This intolerance can lead to belly pain and bloating. Food that is high in fat may worsen inflammation in the lining of the stomach.
It’s still quite unclear what is the exact reason for this sensitivity to fatty food. Researchers speculate, however, that it may be related to hormones that are released in the gastrointestinal tract.
It may also be due to the slowed digestion in which food does not move quickly from the stomach to the small intestine.
10. Dark stools
A dark stool may be a sign of gastrointestinal tract bleeding.
A bleeding ulcer is the most common cause of dark stools.
Black stool that is tarry in texture and foul-smelling is often a symptom of upper gastrointestinal bleeding from the esophagus, stomach or small intestine. This is called melena.
The black color of the stool indicates that the bleeding may have come from the upper part of the gastrointestinal tract. This includes the esophagus, stomach or the first part of the small intestine.
The blood is darker because it has been digested as it made its way through the gastrointestinal tract.
11. Nausea or vomiting
These are two uncommon symptoms of an ulcer.
The urge to vomit is present in nausea. Vomiting is the forceful ejection of stomach contents through the mouth. Nausea may occur with or without vomiting and vomiting can occur without nausea. These symptoms may be accompanied by a sensation of flushing, sweating, salivation, lightheadedness and upper abdominal discomfort.
Most often nausea occurs early in the morning. It will most likely subside once the vomiting episodes begin.
People with bleeding ulcers may also vomit. This vomit may look like “coffee grounds” meaning that it will likely be dark brown in color and not the bright red most people expect. The “coffee ground” appearance occurs due to the presence of coagulated blood in the vomit.
The blood’s color may vary depending on how long the blood was in the gastrointestinal tract. If there is a delay in vomiting, the blood will appear dark red, brown or black,
Vomiting blood is a very serious symptom and requires immediate medical help.