What You Should Know About Stomach Ulcers

Approximately 500K new ulcer diagnoses per annum take place in the United States of America, with an estimated 25 million people affected by this disorder throughout the course of their life, as reported by the Centers for Disease Control and Prevention (CDC). This health issue is not uncommon, however there is some optimistic news that ulcers can be healed for good. What are the signs that your abdominal discomfort is due to an ulcer? We wanted to talk to Will Bulsiewicz, MD, MSCI, a board certified digestive specialist with his own gut health Instagram page (@theguthealthmd), to clear up misunderstandings about stomach ulcers. He offered knowledgeable guidance concerning etiology, management, and avoidance of stomach ulcers. Below are some facts about them that everyone should familiarize themselves with.

Understanding the Condition

There is a lot of inaccuracies and false ideas that come up in conversations when people discuss stomach ulcers. Let us make sure our information is accurate, beginning with the label. Bulsiewicz asserts that people often call a peptic ulcer something else: a stomach ulcer. This medical issue involves lesions and lesions of the stomach and duodenum, which is the starting part of the small intestine. A peptic ulcer is an injury to the lining of the stomach or the initial section of the small intestine caused by an imbalance of inflammation and the body’s protective defense against it. To put it in simpler terms, it is a sore or opening in the lining of the stomach or small intestine. Ouch! So what causes stomach ulcers? It’s sometimes said that eating spicy food can damage your stomach lining or having a stressful life leads to ulcers, but that’s not correct. According to Bulsiewicz, the situation is quite intriguing. One reason the myth that stress causes stomach ulcers arose was due to the bombardment of England by Germany in World War II, which resulted in significantly higher rates of ulcers in the population. It is true that stress can lead to ulcers; however, most ulcers are caused by a bacterial infection instead. Nine times out of ten, an ulcer is caused by the Helicobacter pylori bacterium, more commonly known as H. pylori. A great deal of individuals may be in possession of H. pylori without exhibiting any signs. The idea is that, over time, we have developed a relationship with this bacteria and it acts as a form of protection, however, it can inhibit the body’s natural protective mechanisms in the stomach, thus leading to stomach ulcers or duodenal ulcers, Bulsiewicz explains. A main cause of stomach ulcers can be traced to medications found at home, like non-steroidal anti-inflammatory drugs like aspirin, ibuprofen, and naproxen. Dr. Bulsiewicz cautions that consistent use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) can damage the protective barriers of the stomach and small intestine, dismantling the lining over time. I’m not fond of these medications due to the fact that too much of them can create serious gastrointestinal bleeding in people who use them to treat diseases such as arthritis. Another cause of this issue could be Zollinger–Ellison syndrome, a rare medical condition in which the body produces excessive amounts of acid. Zollinger–Ellison syndrome is a very rare condition, afflicting only approximately one person out of every million. It is more prevalent among men in the 30 to 50 age range, per data provided by the National Institute of Diabetes and Digestive and Kidney Diseases. Your physician can conduct examinations to see if you are afflicted with Zollinger–Ellison syndrome.

What Causes Stomach Ulcers?

The two most common causes are:

H. pylori infection. This common bacterial infection affects up to half of people worldwide. It primarily lives in the stomach. In many people, it doesn’t seem to cause problems. Their gut immune systems keep it in check. But a portion of those infected have H. pylori overgrowth. The bacteria continue to multiply, eating into the stomach lining and causing chronic inflammation and peptic ulcer disease. H. pylori infection is associated with about 60% of duodenal ulcers and 40% of gastric ulcers.
Overuse of NSAIDs. NSAID stands for “non-steroidal anti-inflammatory drug.” These include common over-the-counter pain relief medications such as ibuprofen, naproxen and aspirin. NSAIDs contribute to ulcers in several ways. They irritate the stomach lining on contact and repress some of the chemicals that defend and repair the mucous lining. Up to 30% of people who take NSAIDs regularly develop peptic ulcers. Up to 50% of all peptic ulcers are caused by the overuse of NSAIDs.

Less common causes of stomach ulcers include:

Zollinger-Ellison Syndrome. This is a rare condition that causes your stomach to produce too much gastric acid.
Severe physiological stress. Severe illness, burns or injuries can produce stress ulcers in the stomach. Physiological stress changes your body’s PH balance, increasing stomach acid. Stress ulcers develop very quickly in response to stress, unlike normal stomach ulcers that develop gradually.

What Does a Stomach Ulcer Feel Like?

Peptic ulcer signs include abdominal discomfort and digestion problems. An ulcer can cause a sensation of burning or gnawing inside your stomach, somewhere between your chest and navel. It is potential that your condition will get better for a short time when you eat, drink, or take antacid medicine to reduce the amount of stomach acid. It might be more uncomfortable between meals and in the evenings when there is an accumulation of stomach acid since there is not anything to break down. It could make you feel disinclined to have any food.

How Do I Know If I Have an Ulcer or Gastritis?

Gastritis and stomach ulcers commonly exhibit similar signs and are frequently seen together. Gastritis can be an early warning sign of stomach ulcers, which are caused by things like the H. pylori bacterium and the wearing away of the protective mucus in the stomach. You may also have both.

Both inflammation of the stomach (gastritis) and sores in the lining of the stomach (stomach ulcers) can lead to abdominal discomfort and signs of indigestion. Generally, a sore from an ulcer will be more directed – similar to it is coming from a certain area. But since there are some ulcers that don’t present any symptoms, it is possible that you could have one and not even realize it.

If you are suffering from indicators of either gastritis or an ulcer in the stomach, you should get medical attention. Gastritis can lead to ulcers if it hasn’t already. It can be a sign that there is an infection or another issue that requires medical attention. Medical exams can rapidly figure out the source of your abdominal discomfort.

How Can I Tell If I Have Ulcer Pain or Heartburn?

Pain from an ulcer in the stomach area can be comparable to the sensation of heartburn. It’s often described as a burning kind of pain. Typically, the pain caused by an ulcer will be focused at the exact location of the ulcer, either in the stomach or in the small intestine. Acid reflux goes beyond the midsection, and it tends to be more intense in the upper chest. Nevertheless, it is possible to experience both heartburn and ulcer pain concurrently.

Heartburn is generally due to acid regurgitation, which is a situation when stomach acid is forced up the esophagus. Heartburn can begin in the abdomen and radiate upwards from there. If the pain in your chest region is more severe than what is at the level of your breastbone, then the cause of this pain is likely to be heartburn. However, it does not rule out the potential for a peptic ulcer being present as well. Gastric ulcers may manifest themselves through acid reflux.

Signs You Might Have a Stomach Ulcer

The periodic experience of stomachache is not enjoyable but typically it ends in a couple of hours and there is no need to be overly worried. But what if the pain is recurring? Could it be an ulcer? What do stomach ulcers feel like? One way to tell if there is an issue is through feeling pain in the center of the abdomen, just above the stomach, but not actually in the chest. It’s the epigastric area,” says Bulsiewicz. The physician further expounds on how what you eat can affect the times that your symptoms are worse. The agony experienced with a stomach ulcer usually sets in shortly after eating. He noted that if the ulcer was located in the small intestine, then it would cause pain a few hours after eating food. However, pain isn’t the only sign of a problem. Additional manifestations of stomach ulcers include nausea, having the sensation of being full too soon (which is referred to as “early satiety”) and anaemia. Vomiting and having stools which have a bloody appearance or look like coffee grounds could be big red flags. Bulsiewicz advises that anyone who is experiencing serious abdominal discomfort or any other related indicators should schedule an appointment with their physician. Don’t procrastinate and put off seeking help for an ulcer; if it gets too severe, it could lead to grave consequences. A possible perforation could be caused by erosion all the way through the covering of your stomach or intestinal tract. You will acquire peritonitis, resulting in a sudden attack of intense stomach pain. Bulsiewicz states that a situation can arise in which the ulcer leads to a contortion of the lumen of the intestine, thus preventing food from moving through. If you think you might have a stomach ulcer or something wrong with your digestive system, contact your doctor right away. Getting treatment quickly can help you to stop the issue from becoming more severe and causing you discomfort in the future.

What Triggers Stomach Ulcer Symptoms?

Stomach ulcers are irritated by stomach acid. Some people perceive increased discomfort after eating, and others experience it more when they haven’t had anything to eat. Ulcer symptoms can be aggravated by certain triggers, which can prevent them from healing. Smoking and alcohol are the biggest ones.

How to Get a Diagnosis

When it comes to any medical condition, using the internet to research symptoms should only be used as a source of general knowledge. A definitive determination of whether you have a stomach ulcer can only be made by a physician. Typically, your health care provider will begin by looking for an H. pylori contamination, which could signal the presence of a stomach ulcer. They can search for the microorganism through a stool sample, blood sample, or breath test. Bulsiewicz suggests that an upper endoscopy is one of the most effective methods to diagnose a stomach ulcer. You will be given anesthesia before the doctor who specializes in diseases involving the digestive system pushes a narrow, pliable tube down your esophagus, connected to a light, video camera, and medical instruments to take a sample tissue for biopsy. Once it is identified as an ulcer, I can give a treatment for it if necessary during the medical examination. The endoscopy is the most direct test. He claims that it is highly unlikely to overlook an ulcer and it provides a chance for treatment. A barium swallow can also be utilized to a lesser degree to reveal if you suffer from a stomach ulcer. You will have to drink a liquid containing barium sulfate in this test, which will cover the top area of your stomach and intestines. The doctor will then take a series of X-ray images to observe the contrast, in order to possibly identify an ulcer. Your doctor will advise the best course of action in order to determine if you have a stomach ulcer.

How Are Stomach Ulcers Treated?

If ulcers are relieved from the conditions which caused them, they can recover. Medical staff address uncomplicated ulcers using a blend of medicines to decrease stomach acidity, provide a protective barrier for the ulcer as it heals and eradicate any bacteria that could be involved. Medicines may include:

Antibiotics. If H. pylori was found in your digestive tract, your healthcare provider will prescribe some combination of antibiotics to kill the bacteria, based on your medical history and condition. Commonly prescribed antibiotics include tetracycline, metronidazole, clarithromycin and amoxicillin.
Proton pump inhibitors (PPIs). These drugs help reduce stomach acid and protect your stomach lining. PPIs include esomeprazole, dexlansoprazole, lansoprazole, omeprazole, pantoprazole and rabeprazole.
Histamine receptor blockers (H2 blockers). These reduce stomach acid by blocking the chemical that tells your body to produce it (histamines). H2 blockers include famotidine, cimetidine and nizatidine.
Antacids. These common over-the-counter medicines help to neutralize stomach acid. They may bring some symptom relief, but they aren’t enough to heal your ulcer. They also might interfere with some antibiotics.
Cytoprotective agents. These medicines help to coat and protect your stomach lining. They include sucralfate and misoprostol.
Bismuth Subsalicylate. This over-the-counter medicine, commonly found as Pepto-Bismol, can help coat and protect your ulcer from stomach acid. (Note: Bismuth might turn your poop black, but this effect looks different from the sticky, tarry appearance of blood in your poop.)

How Soon After Treatment Will I Feel Better?

If you make sure to take your medications exactly as directed and do not use nonsteroidal anti-inflammatories, drink alcohol, or smoke, your ulcer should heal in the span of a few weeks. Surgical cases may take a few weeks more. Your doctor will check in on you after you take the medication to make sure that the ulcer is mended and any infection has been eradicated. They are likely to carry out additional tests such as an endoscopy of the part where the ulcer is located, as well as H. pylori tests in the event that you had it, so as to make sure the bug is gone.

How Can I Prevent a Stomach Ulcer from Occurring or Returning?

Reduce NSAID use, if possible. Consider whether acetaminophen (Tylenol®) might substitute. If you take NSAIDs for medical reasons, talk to your doctor about reducing your dosage or switching your medication. Your doctor may also prescribe another medicine to take with NSAIDs to protect your stomach lining.
Reduce other irritants that may contribute to too much stomach acid or erode your stomach lining, including smoking and alcohol use.
Take an H. pylori breath test to find out if you have an overgrowth of the bacteria.