Doctor's Notes on Peptic Ulcer Symptoms, Types, Causes, Diet, and Treatment
A peptic ulcer is an erosion of the lining of the esophagus, stomach or duodenum. The development of peptic ulcers is related to the presence of H. pylori bacteria in the stomach or taking nonsteroidal anti-inflammatory medications (NSAIDs) in about half of cases. Other possible causes of peptic ulcers can include smoking, severe psychological stress, or certain drugs. Sometimes, the exact cause is not known.
Symptoms of a peptic ulcer do not necessarily relate to the degree or severity of the ulceration. The most common symptom is pain in the upper abdomen, which can be felt as burning, sharp, stabbing, or dull. Associated symptoms can include feeling full when eating, and acid reflux (heartburn). The pain often occurs 1-3 hours after eating or during the night and is relieved by food or antacids that neutralize stomach acid.
Peptic Ulcer Symptoms, Types, Causes, Diet, and Treatment Causes
Ulcers do not always cause symptoms. Sometimes, a serious complication such as bleeding or a sudden, bad upper abdominal pain is the first sign of an ulcer.
The most common symptom of peptic ulcers is abdominal pain.
- The pain is usually in the upper middle part of the abdomen, above the belly button (navel) and below the breastbone.
- The ulcer pain can feel like burning, or gnawing, and it may go through to the back.
- Pain often comes several hours after a meal when the stomach is empty.
- The pain is often worse at night and early morning.
- It can last anywhere from a few minutes to several hours.
- The ulcer pain may be relieved by food, antacids, or vomiting.
Other symptoms of peptic ulcers include the following:
- Loss of appetite
- Loss of weight
Severe ulcers may cause bleeding in the stomach or duodenum. Bleeding is sometimes the only symptom of an ulcer. This bleeding can be fast or slow. Fast bleeding reveals itself in one of the following ways:
- Vomiting of blood or dark material that looks something like coffee grounds: This is an emergency and warrants an immediate visit to an emergency department.
- Blood in the stool or black, tarry, sticky-looking stools
Slow bleeding is often more difficult to detect, because it has no dramatic symptoms.
- The usual result is low blood cell count (anemia).
- The symptoms of anemia are tiredness (fatigue), lack of energy (lethargy), weakness, rapid heartbeat (tachycardia), and pale skin (pallor).
When you eat, your stomach produces hydrochloric acid and an enzyme called pepsin to digest the food.
- The food is partially digested in the stomach and then moves on to the duodenum to continue the process.
- Peptic ulcers occur when the acid and enzyme overcome the defense mechanisms of the gastrointestinal tract and erode the mucosal wall.
- Now it is understood that people with ulcers have an imbalance between acid and pepsin coupled with the digestive tract's inability to protect itself from these harsh substances.
- Research done in the 1980s showed that some ulcers are caused by infection with a bacterium named Helicobacter pylori, usually called H pylori.
- Not everyone who gets an ulcer is infected with H pylori. Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) can cause ulcers if taken regularly.
Some types of medical therapy can contribute to ulcer formation. The following factors can weaken the protective mucosal barrier of the stomach increasing the chances of getting an ulcer and slow the healing of existing ulcers.
- Aspirin, nonsteroidal anti-inflammatory drugs (such as ibuprofen and naproxen), and newer anti-inflammatory medications (such as celecoxib [Celebrex])
- Stress: physical (severe injuries or burns, major surgery)
- Cigarette smoking
- Radiation therapy:-used for diseases such as cancer
People who take aspirin or other anti-inflammatory medications are at an increased risk even if they do not have H pylori infection.
- Elderly people with conditions such as arthritis are especially vulnerable.
- People who have had prior ulcers or intestinal bleeding are at a higher-than-normal risk.
- If a person takes these medications regularly, alternatives should be discussed with a health-care professional. This is especially true if the affected individual has an upset stomach or heartburn after taking these medications.
H pylori bacteria is spread through the stools (feces) of an infected person.
- The stool contaminates food or water (usually through poor personal hygiene).
- The bacteria in the stool make their way into the digestive tracts of people who consume this food or water.
- This is called fecal-oral transmission and is a common way for infections to spread.
The bacteria are found in the stomach, where they are able to penetrate and damage the lining of the stomach and duodenum.
- Many people who are exposed to the bacteria never develop ulcers.
- People who are newly infected usually develop symptoms within a few weeks.
- Researchers are trying to discover what is different about the people who develop ulcers.
Infection with H pylori occurs in all ages, races, and socioeconomic classes.
- It is more common in older adults, although it is thought that many people are infected in childhood and carry the bacteria throughout their lifetimes.
- It is also more common in lower socioeconomic classes because these households tend to have more people living together, sharing bathrooms and kitchen facilities.
- African Americans and Hispanic Americans are more likely to have the bacteria than Caucasians and Asian Americans.
It is important to distinguish between ulcers caused by H pylori and those caused by medications because the treatment is completely different.
Ulcers can be linked with other medical conditions.
- People who worry excessively are usually thought to have a condition called generalized anxiety disorder. This disorder has been linked with peptic ulcers.
- A rare condition called Zollinger-Ellison syndrome causes peptic ulcers as well as tumors in the pancreas and duodenum.
The proper functioning of the digestive system is one of the foundations of health, but many myths surround digestive disorders. In this slideshow we separate fact from fiction about digestive diseases.
Pancreatitis : Test Your Medical IQ QuizQuestion
Pancreatitis is inflammation of an organ in the abdomen called the pancreas.See Answer
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.