PEPTIC ULCER – SYMPTOMS, CAUSES & TREATMENT

Stomachaches come and go, often blamed on something we ate or just stress. But when that gnawing pain keeps coming back, especially after meals or when you’re hungry, it could be something more than just indigestion. It could be a peptic ulcer.

Peptic ulcers are more common than many realize, affecting millions of people worldwide. Though they’re treatable, if left unchecked, they can lead to serious complications. 

In this blog, we’ll uncover everything you need to know about peptic ulcers, what they are, what causes them, how they’re diagnosed and treated, and how to prevent them in the first place.

Peptic ulcers are open sores that develop on the stomach’s inner lining and the small intestine’s upper portion. They are a common health issue, affecting millions worldwide. Understanding their causes, recognizing the symptoms, and knowing the available treatments are crucial for effective management and recovery.

What Are Peptic Ulcers?

Peptic ulcers form when the protective mucus layer that shields the digestive tract is eroded, allowing stomach acid to damage the underlying tissue. There are two main types:

• Gastric ulcers: Occur on the inside of the stomach.
• Duodenal ulcers: Occur on the inside of the upper portion of the small intestine (duodenum).

Causes of Peptic Ulcers

The development of peptic ulcers is primarily associated with:

• Helicobacter pylori (H. pylori) infection: This spiral-shaped bacterium is found in the stomach lining and is responsible for most peptic ulcers. It damages the mucous coating that protects the stomach and duodenum, making them vulnerable to acid.
• Long-term use of NSAIDs: Medications like aspirin, ibuprofen, and naproxen can irritate or inflame the lining of your stomach, especially when taken frequently or over a long period.

Other contributing factors include:

• Smoking: Increases stomach acid production and slows healing of any existing ulcers or erosions.
• Excessive alcohol consumption: Can erode the mucous lining of the stomach which protect the stomach from being digested by stomach strong acids.

Symptoms of Peptic Ulcers

Symptoms can vary, and some individuals may not experience any symptoms. Common signs include:

• Burning stomach pain
• Nausea
• Vomiting blood: Which may appear red or black.
• Black stool or having blood in stool
• Decreased appetite and weight loss

Complications of Untreated Peptic Ulcers

If not properly treated, peptic ulcers can lead to serious complications:

Perforation occurs when the ulcer causes a hole in the stomach or duodenal wall, which results in severe inflammation inside the abdomen, and can present as acute severe abdominal pain that needs immediate medical attention. 

Obstruction occurs when scar tissue forms as a result of repeated healing of ulcers with scar tissue. 

Diagnosis of Peptic Ulcers

To diagnose a peptic ulcer, your gastroenterologist will obtain your medical history and perform a physical examination. 

Then, he may request one or more of the following investigations:

• Endoscopy: A procedure using a thin, flexible tube with a camera. This scope is passed through your mouth into the stomach to visually examine the lining and possibly take a biopsy to recognize any abnormal cells under specialized microscopy.
• Barium swallow: X-ray series taken after drinking a barium solution to highlight any narrowing that the peptic ulcer has precipitated.
• Tests for H. pylori: Including blood, stool, or urea breath tests to detect H. pylori infection, as it’s the most common underlying cause of peptic ulcer.

Peptic Ulcer Treatment Options

Treating a peptic ulcer depends on its cause. Here’s how it typically breaks down:

• Treatment for H. pylori infection: If the ulcer is caused by H. pylori, your gastroenterologist will prescribe a combination of antibiotics to kill the bacteria. These are usually taken for 10 to 14 days, as indicated by your doctor.
• Proton pump inhibitors (PPIs): Drugs like omeprazole, lansoprazole, and esomeprazole reduce stomach acid production, allowing the ulcer to heal.
• H2-receptor antagonists: These include ranitidine (withdrawn in many countries), famotidine, and cimetidine. They work similarly to PPIs but may be more potent.
• Antacids: Neutralize existing stomach acid.
• Cytoprotective agents: Protect the stomach lining.

In severe cases, surgery may be necessary, especially if complications like bleeding or perforation occur

Can Peptic Ulcers Come Back?

Yes, they can, especially if the root cause isn’t fully addressed. H. pylori can recur if not completely eradicated, and continued use of NSAIDs or smoking increases the risk of recurrence. Follow-up testing is often recommended to confirm the infection is gone.

Lifestyle and Dietary Modifications: How to prevent Peptic ulcer?

Managing peptic ulcers also involves lifestyle changes:

• Testing for and treating H. Pylori infection as medically indicated 
• Avoid NSAIDs when possible or take them under medical supervision. Discuss alternatives such as acetaminophen with your doctor.
• Limit alcohol and quit smoking: Both can hinder healing.

Conclusion

Peptic ulcers can cause serious discomfort, but with the right knowledge and timely treatment, they are highly manageable and often fully treatable. Whether your symptoms include burning stomach pain, bloating, nausea, or changes in appetite, recognizing the early signs of a peptic ulcer is the first step toward healing.

Remember, most ulcers are caused by H. pylori infection or long-term use of NSAIDs, both of which are treatable. The good news is that with proper peptic ulcer treatment, you can find lasting relief and protect your digestive health.

If you’re struggling with persistent stomach pain or suspect an ulcer, don’t wait. Speak with one of our Top-notch gastroenterologists in Abu Dhabi now at Reem Hospital to get a proper diagnosis and start a plan that works for you.