Ulcer

A stomach ulcer is the most common ulcer in the gastrointestinal tract. Stomach ulcers are acidic and very painful. Over 2/3 of stomach ulcers are associated with the helical-shaped bacterium Helicobacter pylori, which lives in the stomach’s acidic environment. Stomach ulcers can also be caused by over the counter pain relievers. There are three types of stomach ulcers: gastric ulcers, esophageal ulcers, and duodenal ulcers. Contrary to popular belief, a stressful job or constant stress does not cause a stomach ulcer.

Symptoms

The most common symptoms include a burning pain in the stomach. The pain is caused by the ulcer and aggravated by acid in the stomach contacting the ulcerated area. Pain can be felt anywhere from the breastbone down to the naval. It may flare at night, be worse when your stomach is empty, and can be relieved temporarily by taking an acid-reducing medication or eating specific foods. It may disappear but return for a few weeks or days. A stomach ulcer may cause heartburn or bloating, and can create a loss of appetite leading to weight loss. Sometimes stomach ulcers can cause severe symptoms such as appetite changes, stool that is tarry or full of dark blood, or vomiting of blood that appears black or red. In some rare cases, a stomach ulcer can lead to a duodenal or gastric perforation, which causes acute peritonitis. It is extremely painful and needs immediate surgery.

Causes

The number one cause is acid that is found in a person’s digestive tract. The acid eats away at the inside of the small intestine, stomach, esophagus. This acid causes an open sore that is painful and may bleed. A mucous layer covers the digestive tract, and it normally defends against acid. Sometimes however, the amount of mucus is decreased or the amount of acid is increased and an ulcer develops. The most common cause of ulcers is the bacterium Helicobacter pylori. It can be passed easily to another person by being close to another person and contacting them. It can also be transmitted through contaminated water and food. Another cause is the regular and over use of pain relievers. Some prescription medications for pain or over-the-counter pills can inflame or irritate your small intestine and stomach. This is more frequent in older adults and seniors who take pain medications more frequently.

Prevention

It is important to practice good hygiene. Stomach ulcers can be caused by an infection, and following strong hygienic practice decreases your chance of becoming infected. This includes washing your hands regularly and cleaning commonly used surfaces like the kitchen counter often. You also want to quit smoking. Smoking causes developed stomach ulcers to heal at a slower rate than normal, making them harder to get rid of. Decreasing your use of alcohol (or stopping completely) also helps decrease the risk of ulcers. Because pain relievers are a known cause of stomach ulcers, it is important to use caution and take them appropriately. You may want to take any required medications with meals, and talk to your doctor about finding the lowest possible dose while still providing sufficient pain relief. You should avoid taking your medication while drinking alcohol. Reducing your intake of acidic foods and caffeine can also help prevent stomach ulcers, as they can cause stomach acid, increasing your exposure to H. pylori.

Treatment

Stomach ulcer treatment usually starts by using antibiotics. The goal is to eliminate the H. pylori while other medications are given to relieve pain and reduce the acid in your digestive system.

You will typically be on antibiotics for a couple of weeks. Taking the acid reduction medication goes on for longer. This is usually a few months. If H. pylori are not the reason behind your stomach ulcer, your doctor can recommend treatments as opposed to antibiotics. These treatments include changing a pain reliever medication or using a different dose, or allowing your ulcer to heal with acid-reducing medications. Johns Hopkins Medicine provides more information about stomach ulcers and how to treat them.