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Stomach ulcers

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Professor Lovat
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An ulcer is a breaking in the lining of the wall of an anatomical structure, such as the stomach wall. In the stomach, ulcers develop when the protective mucus layer that lines it is reduced. As a result, the digestive chemicals, such as hydrochloric acid, attack the stomach lining.

Signs and symptoms

Individuals with stomach ulcers may feel a painful, burning sensation in their abdominal region, between the belly button and chest. The pain is worse when the stomach is empty, and so will typically manifest a couple of hours after a meal.

Other signs/symptoms associated with stomach ulcers include:

  • Weight loss and reduced appetite
  • Nausea and vomiting (blood may appear in the vomit)
  • Heart-burn
  • Bloating or burping
  • Indigestion
  • Stools that smell like tar (melena)           

The symptoms will often go away if you eat or drink or take antacids.

If you experience any of the following, it is advised that you seek medical advice immediately:

  • A sudden extreme stabbing pain in your abdominal region
  • Blood in your stools or vomit
  • Tarry smelling stools (melena)

Causes

There are several causes of stomach ulcers, although an ulcer may be caused by several different factors. They include:

  • An infection with Helicobacter pylori (H-pylori) – this is the cause of over 50% of all stomach ulcers. H-pylori causes the stomach to increase the secretion of stomach acids. The acids damage the stomach wall, and can cause ulcers to develop
  • Non-steroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen and aspirin. The stomach normally produces a protective mucus layer to shield itself from the effects of stomach acid. NSAIDS prevent this protective layer from being produced.

Other less common causes (or contributors) of stomach ulcers include:

  • Stress
  • Smoking
  • Family history
  • Alcoholism
  • Spicy foods

 

 

Diagnosis and treatment

As H-pylori is a common cause of ulcers, your doctor will often carry out one of the following tests:

  • Stool antigen test
  • Blood test (this is no longer recommended as it is not very accurate and can stay positive for years after successful eradication of the bug)
  • Urea breath test

If your doctor detects an H-pylori infection, they will usually prescribe you antibiotics along with another drug such as a proton pump inhibitor (PPI) to try and minimise the damage caused by stomach acids.

Your doctor may also request that you have a gastroscopy. This involves passing an endoscope into your stomach and small bowel to allow your doctor to examine the wall of your gut for any evidence of an ulcer. A gastroscopy may also be performed to monitor the effectiveness of any treatment for stomach ulcers.

Will I ever need surgery for a stomach ulcer?

Very rarely, surgical interventions will be used to treat stomach ulcers. Surgery will only be offered if:

  • The ulcer does not heal
  • The ulcer bleeds
  • The lining of the stomach becomes torn

What else can I do?

  • Antibiotics, proton pump inhibitors and H2-receptor antagonists may all take time to work. If you want immediate relief, speak to your doctor or local pharmacist about taking antacids. Antacids neutralise stomach acids, and may also help produce a protective layer around the stomach lining
  • If you experience stomach pains, try to avoid taking NSAIDS such as ibuprofen or aspirin to treat the pain. Instead, take other medications such as paracetamol.
  • If you take ibuprofen / aspirin for headaches, fevers, migraines or other non-stomach related illnesses, be sure to eat either before or with the medication to minimise the risk of developing a stomach ulcer
  • Avoid eating spicy foods or alcohol if you know you have a stomach ulcer as these foods can make things worse
  • Avoid smoking as this can make stomach ulcers worse and slow the healing time

If you are concerned that you have a stomach ulcer, why not book an appointment with one of our consultants at the London Gastroenterology centre? Our world-class gastroenterologists perform endoscopy to the highest standards and would be happy to help you. Our office is open all day from Monday to Friday. Please call 020 7183 7965 to make an appointment.

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