A stomach ulcer, also known as a gastric ulcer, is a break or defect in the mucosal lining of the stomach.
The stomach contains strong acid, which is necessary for digestion. Any breach in the tissue lining can cause great pain (usually felt in the upper abdomen, just below the ribcage) as well as bleeding.
Other symptoms typical of a stomach ulcer would include indigestion, nausea, poor appetite, vomiting (sometimes containing either bright red fresh blood – called haematemesis – or old denatured blood, which typically may have the appearance of coffee grounds), weight loss, black bowel motions (this black colour is caused by the bleeding from the upper gastrointestinal tract changing the colour of the stools and is called 'melaena stool') and symptoms of anaemia like fatigue, weakness or light-headedness (as a result of recurrent blood loss from the bleeding ulcer).
Ulcers can also occur in the duodenum, which is the first part of the small intestine leading out from the stomach. These are called duodenal ulcers. Gastric ulcers and duodenal ulcers can be referred to collectively as 'peptic ulcers'. Peptic ulcers are caused primarily by infection of bacteria known as 'Helicobacter pylori' which is responsible for an estimated 60 per cent of gastric ulcers and at least 90 per cent of duodenal ulcers.
Another common cause of peptic ulcers is certain medications such as aspirin and other non-steroidal anti-inflammatory drugs (commonly known as NSAIDs). Stomach cancer can also start as an ulcer in the stomach lining so in every case of gastric ulcer, the possibility of malignancy must be excluded.
Ulcers can be diagnosed by endoscopy, where the specialist puts a thin, flexible microscope down the oesophagus into the stomach to look inside and sample tissue from the ulcer. This tissue can be examined by the pathologist and checked for cancerous change as well as for the presence of infection.
Another test to detect Helicobacter pylori infection is a C14 breath test where you swallow a small amount of radioactive carbon (C14) and air exhaled from your lungs is then tested to detect the presence of the bacteria.
In terms of treatment, if Helicobacter pylori is identified your doctor will prescribe antibiotics to eradicate the infection. Usually a combination of antibiotics will be required and the entire course needs to be completed for successful clearance of infection.
The C14 breath test can be repeated to follow up and ensure the infection has been fully eradicated.
It may also be necessary to change certain medications you are taking that may have caused or exacerbated the ulcer, such as aspirin or other NSAIDs.
There are a number of drugs available which can decrease acid production in your stomach and your doctor may prescribe one of these in order to assist with ulcer healing and decrease the chances of ulcer recurrence.
Stopping smoking and minimising alcohol intake are also beneficial.
In severe cases where an advanced, untreated ulcer perforates or burns right through the stomach wall, the highly acidic digestive juices and partly digested food can escape into the abdominal cavity. A perforated ulcer is obviously a medical emergency which requires urgent medical intervention and surgical treatment.
To prevent a stomach ulcer from reoccurring:
The stomach contains strong acid, which is necessary for digestion. Any breach in the tissue lining can cause great pain (usually felt in the upper abdomen, just below the ribcage) as well as bleeding.
Other symptoms typical of a stomach ulcer would include indigestion, nausea, poor appetite, vomiting (sometimes containing either bright red fresh blood – called haematemesis – or old denatured blood, which typically may have the appearance of coffee grounds), weight loss, black bowel motions (this black colour is caused by the bleeding from the upper gastrointestinal tract changing the colour of the stools and is called 'melaena stool') and symptoms of anaemia like fatigue, weakness or light-headedness (as a result of recurrent blood loss from the bleeding ulcer).
Ulcers can also occur in the duodenum, which is the first part of the small intestine leading out from the stomach. These are called duodenal ulcers. Gastric ulcers and duodenal ulcers can be referred to collectively as 'peptic ulcers'. Peptic ulcers are caused primarily by infection of bacteria known as 'Helicobacter pylori' which is responsible for an estimated 60 per cent of gastric ulcers and at least 90 per cent of duodenal ulcers.
Another common cause of peptic ulcers is certain medications such as aspirin and other non-steroidal anti-inflammatory drugs (commonly known as NSAIDs). Stomach cancer can also start as an ulcer in the stomach lining so in every case of gastric ulcer, the possibility of malignancy must be excluded.
Ulcers can be diagnosed by endoscopy, where the specialist puts a thin, flexible microscope down the oesophagus into the stomach to look inside and sample tissue from the ulcer. This tissue can be examined by the pathologist and checked for cancerous change as well as for the presence of infection.
Another test to detect Helicobacter pylori infection is a C14 breath test where you swallow a small amount of radioactive carbon (C14) and air exhaled from your lungs is then tested to detect the presence of the bacteria.
In terms of treatment, if Helicobacter pylori is identified your doctor will prescribe antibiotics to eradicate the infection. Usually a combination of antibiotics will be required and the entire course needs to be completed for successful clearance of infection.
The C14 breath test can be repeated to follow up and ensure the infection has been fully eradicated.
It may also be necessary to change certain medications you are taking that may have caused or exacerbated the ulcer, such as aspirin or other NSAIDs.
There are a number of drugs available which can decrease acid production in your stomach and your doctor may prescribe one of these in order to assist with ulcer healing and decrease the chances of ulcer recurrence.
Stopping smoking and minimising alcohol intake are also beneficial.
In severe cases where an advanced, untreated ulcer perforates or burns right through the stomach wall, the highly acidic digestive juices and partly digested food can escape into the abdominal cavity. A perforated ulcer is obviously a medical emergency which requires urgent medical intervention and surgical treatment.
To prevent a stomach ulcer from reoccurring:
- Avoid potential exacerbating factors such as taking aspirin or NSAIDs
- Quit smoking or consuming excessive amounts of alcohol excess
- Take prescribed medication precisely according to your doctor's instructions
- Follow up with your specialist or doctor, especially if you have any recurrence of symptoms.