Stomach ulcers occur when the lining of the stomach becomes damaged by stomach acid, as the protective layer breaks down.
- A bacterial infection – Helicobacter pylori, also known as H. pylori
- Taking non-steroidal anti-inflammatory drugs (NSAIDs), particularly if taken in high doses and long term. These may include:
Certain foods and stress were thought to cause stomach ulcers, however there is no concrete evidence of this.
Smoking though may increase the risk of stomach ulcers, or may make treatment less effective.
Consultation with a specialist that can conduct the necessary diagnosis tests is the first step.
The pain of a peptic ulcer is often determined by these factors:
- Pain in the abdomen, which may travel up to your neck or down to your belly button from the middle of your tummy.
- It may also cause pain in your back.
- The duration of the pain may last up to a few hours, or be just minutes
- Pain typically starts shortly after eating, within a couple of hours
- The pain may cause you to wake up during the night
- Antacids may offer temporary pain relief, but the pain keeps returning
Other symptoms of a duodenum ulcer include:
- Indigestion or heartburn
- Loss of appetite
- Feeling sick or vomiting
- Weight loss
The most common complication with peptic ulcers is for them to bleed.
Bleeding may be slow and long-term, which may lead to anaemia or breathlessness. Or, bleeding may be severe and rapid, which causes you to vomit blood, and have black, sticky stools.
Peritonitis is a rare complication of stomach ulcers, which causes the stomach lining to perforate.
This means bacteria that live in your stomach, can escape into the lining of your abdomen, causing infection.
From here, the bacteria can travel in the blood and to other organs so this is potentially a fatal complication.
If an ulcer becomes swollen, inflamed, or scars it can obstruct the passageway of food. Symptoms may include:
- Repeated vomiting of undigested food
- Bloating or feeling of fullness
- Unexplained weight loss
Urea breath test
This tests for H. pylori infection via a special drink containing a chemical that gets broken down by the H. pylori bacteria. A simple breath test shows any existing infection.
Stool antigen test
A stool sample can also show signs of the H. pylori bacteria.
A blood test can detect antibodies of H. pylori bacteria. However, the stool test is more widely used these days as a test for H. pylori.
A gastroscopy uses an endoscope, which is a thin, flexible tube with a camera on one end that allows a doctor to see inside the stomach and the entrance to the small intestine. Images are projected onto a screen and the doctor can see if there are any signs of ulceration.
A gastroscopy uses a sedative, which means you are awake during the procedure but won’t feel any pain. Typically, you will be able to go home the same day, as you will visit the outpatient unit of the hospital.
Some treatment options include:
- Antibiotics – can clear up a bacterial infection caused by H. pylori
- Proton pump inhibitors (PPI) – PPIs reduces the amount of acid the stomach produces, which can help the ulcer to heal naturally. This may be relevant if the cause of the stomach ulcer is from using NSAIDs.
- H2-receptor antagonists – like PPIs these reduce the level of stomach acid, with Ranitidine being the most commonly used
- Antacids – short term relief from antacids may be recommended by a doctor, whilst other treatment options start to work
With more complicated peptic ulcers, procedures carried out under X-ray guidance may be used to attempt to stop bleeding ulcers. Surgery is also an option to repair affected blood vessels.