This post was written by Rhonda Sharp, MD, FAAFP, PPG – Family Medicine, chief medical officer, Parkview Noble Hospital , Parkview LaGrange Hospital, Parkview Wabash Hospital and Parkview Huntington Hospital.
An ulcer is an open sore on any part of the body. In the case of a gastric ulcer, it is a break in the stomach lining. While this condition was long thought to be predominantly caused by stress and eating spicy foods, we now know that those factors can aggravate the symptoms but are seldom the source of an ulcer.
Causes
One potential cause of an ulcer is a bacterium called Helicobacter pylori or also known as H. pylori. H. pylori can live in the stomach and, in some people, can irritate or damage the stomach lining.
In other cases, certain medications can induce an ulcer. For example, prolonged use or high dosages of nonsteroidal anti-inflammatory drugs (NSAIDs) can lead to changes in the stomach lining that increase the risk of developing holes or breaks in the lining.
Ulcers can also be caused by anything that creates an increase in stomach acid, including these lifestyle factors:
-
Alcohol
Symptoms
Ulcers don't always show up right away. Often, before it forms, a person may have inflammation of the stomach lining or gastritis. This can cause what many call a "gnawing" pain and a burning sensation just below the breastbone. If this persists, it can lead to an ulcer, and the symptoms may include:
-
Loss of appetite
-
Weight loss
-
Nausea
Some people will notice these symptoms shortly after eating, while others may only notice them when they haven't eaten recently.
Black and tarry (sticky) stools, which can indicate blood in the stool coming from the upper gut, are a less common sign of an ulcer.
Diagnosis
Your healthcare provider can check for an ulcer in several ways. They can be diagnosed visually through endoscopy, in which a thin, flexible tube with a camera is gently guided down your throat to allow the doctor to look directly at the lining of your stomach.
If a less invasive method is preferred, your provider might order an upper gastrointestinal (upper GI) series. This involves drinking a barium liquid that coats the esophagus and stomach lining, making it easier to see ulcers on an X-ray.
Lab tests can also confirm the presence of H. pylori, which, along with those common symptoms, can indicate an ulcer is present. A lab test can detect H. pylori in blood, stool and breath samples.
Treatment
Sometimes ulcers can be prevented by making simple lifestyle changes, such as minimizing the use of NSAIDs, quitting smoking, reducing stress, alcohol consumption and the intake of foods that can increase stomach acid production.
Antacids or H2 blockers available over the counter can offer some relief from epigastric burning and pain. However, if the pain, bloating or discomfort worsens or later symptoms occur (nausea, vomiting and blood in stool), it's time to see a doctor for evaluation and treatment.
Treatment generally requires multiple medications to heal the ulcer and eradicate H. pylori if present. The medication regimen may include:
-
A proton pump inhibitor (PPI) or H2 blocker for an extended period of time to decrease stomach acid production
-
A medication to coat the stomach like Pepto Bismol®
-
One or two antibiotics when H. pylori is present
Final thoughts
While some small ulcers might heal on their own, a full-blown ulcer, especially one caused by H. pylori or NSAID use, will require the assistance of your physician to treat. Without intervention, ulcers can lead to further complications such as internal bleeding, stomach perforation and, in rare instances, an increased risk of stomach cancer.
If you're experiencing persistent ulcer symptoms, don't wait to get checked out. Learn more about our Primary Care options here. If you need help scheduling an appointment or establishing care with a provider, our Access Center can help. Call any time, at 877-PPG-TODAY or 877-774-8632 for assistance.
