Most people blame stomach ulcers on the stress of modern day life or unhealthy eating habits. But whatever may be the cause, stomach ulcers are common but painful medical conditions to deal with. Stomach ulcers can be seen as sores that are found in the lining of the stomach and in the small intestines. These sores can be quite painful to deal with and are often a sign of a bigger medical condition like the peptic ulcer disease. This disease is known to occur when a thick mucus layer protecting the stomach from the acidic digestive juices decreases. A decrease in the protective secretion causes the digestive acids to erode the tissues lining the stomach, thereby resulting in painful sores called stomach ulcers. A stomach ulcer is not a very critical condition and is easily curable. However, a delay in treatment can cause the condition to worsen.
Who is more prone to develop stomach ulcers?
The following individuals are more prone to developing stomach ulcers:
- People infected with Helicobacter pylori
- Those who have a family history of ulcers
- Individuals who regularly take NSAIDs such as aspirin or naproxen
- People with lung, liver, and kidney problems
- Elderly people (50 years and above)
- Individuals who regularly consume alcohol
What are the common causes of stomach ulcers?
Stomach ulcers are normally a result of a combination of factors rather than one single cause. The most common causes of stomach ulcers are attributed to the Helicobacter pylori bacterium and the frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs). Such drugs tend to weaken the defense mechanism of the stomach against the digestive juices, thereby resulting in a damage to the stomach lining.
1) Helicobacter pylori infection
This infection is an extremely common cause of stomach ulcers and anyone can acquire this infection without even realizing it. An H. pylori infection is hard to detect as it does not cause any symptoms. The bacterium tends to live in the stomach of most people without a problem. However, in some cases, they could cause an irritation in the lining of the stomach and increase the chances of stomach damage. There are no clear guidelines as to how this bacteria spreads. It could be transmitted from one individual to another by kissing or close contact. It is also said that this bacterium may travel through food or water.
2) Nonsteroidal anti-inflammatory drugs (NSAIDs)
These drugs are normally used to treat conditions such as pain, fever, and swelling. Most people can take these drugs without any side effects. However, its long-term use in high dosages can increase the risk of stomach ulcers in some people. Your doctor may ask you to stop consuming such medications, especially if you have suffered from previous stomach ulcers or are currently suffering from one. Paracetamol is considered to be a safer alternative to NSAIDs.
Certain lifestyle factors such as long gaps between meals, eating spicy foods, stress, and excessive consumption of alcohol are known to be contributing factors to the occurrence of stomach ulcers. Smoking can also lead to stomach ulcers and may also affect the effectiveness of stomach ulcer treatments.
What are the symptoms of stomach ulcers?
An individual may or may not experience any signs of stomach ulcers. However, when symptoms occur, they may include:
- An excruciating or burning pain in the upper stomach in between meals or at nighttime
- Vomiting or nausea
- Intolerance to certain fatty foods
If the ulcer is left untreated or ignored even after experiencing the symptoms, then the condition may get worse. In such worse conditions, the symptoms would include:
- Dark or black stools due to internal bleeding
- Sudden weight loss or loss of appetite
- Breathing difficulties
- Vomiting blood
- Severe pain from the middle to the upper part of the abdomen
Stomach ulcers usually heal on their own with certain lifestyle changes. However, one should not ignore the warning signs. There can be serious health problems if treatment is delayed. Stomach ulcer complications may include:
- Bleeding – internal bleeding can occur as a gradual blood loss that leads to anemia in an individual. Severe loss of blood would require hospitalization or blood transfusion. Individuals experiencing severe loss of blood may also vomit blood or pass darker stools.
- Perforation - is a hole in the stomach wall. Stomach ulcers can also perforate the stomach wall or the small intestine. It would increase the risk of developing a serious infection in the abdominal cavity.
- Swelling or scarring - because of swelling or scarring, there would be a gastric outlet obstruction that blocks the passageway, which leads from the stomach to the small intestine. Such blockage would lead to weight loss, bloating, or vomiting.
The elderly and those with a medical history of stomach ulcers are at a higher risk of developing the condition.
The doctor would first ask a few questions regarding the symptoms you are experiencing. However, certain tests may be requested to further confirm your condition. If you are experiencing symptoms of heartburn, then medication would be given to treat the discomfort. The doctor would also recommend for an upper endoscopy if needed.
1) Laboratory tests for H. pylori bacterium
To determine the presence of H. pylori bacteria, the doctor would take a sample of your blood and stool. You may also undergo a urea breath test (UBT), which is the most accurate test for detecting H. pylori. Blood tests can often be misleading. Hence, its accuracy level is not that reliable when it comes to H. pylori identification. Moreover, blood tests are not usually done on a routine basis.
For the breath test, you will be asked to eat or drink something that contains radioactive carbon. H. pylori breaks down the substance in the stomach. Later, you would be asked to blow into a bag, which is then tightly sealed. If you infected with the bacterium, the breath sample would contain the radioactive carbon in the form of carbon dioxide. Make sure to let your doctor know if you are taking any medicine prior to the test.
This procedure involves inserting an endoscope (a small, thin tube with a light) through the throat and into the stomach to check for any abnormalities. If the doctor detects an ulcer, he or she would remove small tissue samples for further examination in the lab. A biopsy can also help determine the presence of H. pylori in the stomach lining. This test is only done if the individual has severe or recurring symptoms of stomach ulcers. Doctors would also recommend this test if:
- You belong in the higher age bracket
- If you have any signs of bleeding
- If you have sudden weight loss
If the endoscopy test detects an ulcer, then the doctor would prescribe certain treatments. After the treatment, a follow-up endoscopy would be performed to check if the ulcer is healed or not.
3) Barium swallow
A series of X-rays of the upper digestive system creates images of one’s esophagus, stomach, and small intestine. The doctor would give you a white liquid containing barium to swallow. The liquid coats your digestive tract and makes the ulcer more visible for further diagnosis.
How are stomach ulcers treated?
The treatment suggested for a stomach ulcer largely depends on the factors that caused the ulcer. Most stomach ulcers can be treated using prescription medications recommended by the doctor, while surgery is suggested in some rare cases.
It is extremely critical to treat ulcers at the earliest before they become chronic. Speak with your doctor about the various treatment options. In case you have a bleeding ulcer, you may require immediate hospitalization for treatment using intravenous ulcer medicines. In some cases, blood transfusions may be required.
Symptoms of stomach ulcers are likely to subside soon after taking the medications. However, the entire course of treatment should be completed. The doctor may recommend certain restrictions on smoking, alcohol consumption, spicy foods, and others depending on your health condition. Side effects such as nausea, dizziness, headache, and diarrhea are normal during the course of treatment. Such side effects are usually temporary, but if you experience them for a prolonged period of time, inform your doctor immediately.
If the doctor finds the presence of H. pylori, then a combination of antibiotics to kill the bacteria is prescribed. These antibiotics would include tetracycline, metronidazole, amoxicillin, tinidazole, and clarithromycin. One would need to take the antibiotics for at least two weeks. In addition, the doctor would also give you certain medications such as a proton-pump inhibitor to reduce stomach acidity.
Aside from reducing stomach acid, proton pump inhibitors block the action of the parts of cells that produce the acid. It would include prescription and over-the-counter medications such as pantoprazole, esomeprazole, lansoprazole, and rabeprazole. However, if proton pump inhibitors are taken at a higher dose, the risk of spine, hip, and wrist fractures may increase. If needed, doctors may also recommend a calcium supplement.
Certain medications such as cytoprotective drugs can also help protect the tissues that line the small intestine and stomach.
Preventing stomach ulcers
Stomach ulcers can be prevented by:
- Avoiding excessive alcohol consumption
- Not smoking
- Not taking NSAIDs for a longer duration
- Contacting your nearest medical clinic before the symptoms get worse
Treating stomach ulcers using Carafate
The generic name of drug Carafate is sucralfate. This medicine is commonly prescribed for treating and preventing ulcers in the intestines. The drug covers the ulcers with a coating to prevent further injury and damage to the ulcer. It also speeds up the healing process.
This medication is also found to be extremely helpful in treating stomach ulcers caused by the use of NSAIDs such as ibuprofen and naproxen.
Usage directions for Carafate
This medication should be consumed orally, normally 2-4 times a day on an empty stomach. Take this medicine at least one hour before your meals otherwise instructed by your doctor. The doctor will adjust the dosage depending on your medical condition and how you respond to the treatment. This medicine should be consumed regularly as prescribed by the doctor for maximum results. Take the medicine at the same time every day. Do not attempt to suddenly stop the medication, even if the pain from the ulcers is not felt. Always seek medical advice before stopping the medication. The normal healing of stomach ulcers requires about 4-8 weeks.
Certain medications may lose their effectiveness when they are taken with sucralfate. In such cases, take them at different times of the day. Ask your doctor on how to schedule your medications to avoid contraindications. It is absolutely safe to have antacids with this medication. However, there should be a gap of at least 30 minutes between consuming the two medicines.
Consult your doctor if you see no significant improvements in your condition or find your condition worsening after consuming sucralfate for at least four weeks.
What are the side effects of Carafate?
Some of the common side effects associated with Carafate include constipation, mouth dryness, upset stomach, acidity, gas, and nausea. If you experience these side effects for a long period of time or if they begin to worsen, speak with your doctor immediately.
Inform your doctor if you also experience side effects such as severe nausea, fullness of the stomach, pain in the abdomen, and a difficulty in swallowing.
Normally, no serious allergic reactions are known to occur due to this medicine. However, certain allergic reactions could occur, which include skin rashes, itching, swelling, or dizziness.
What are the precautions to be considered?
Before starting this medicine, speak with your doctor to discuss your allergies or any of the ingredients of the medicine. The medicine can also contain certain inactive ingredients that could lead to allergic reactions and other associated problems.
Inform your doctor about your complete medical history before starting this medicine. Make sure to tell your doctor if you have other medical conditions such as kidney problems, difficulty in swallowing, stomach-related problems, and so on. This medicine is considered safe during pregnancy and breastfeeding. However, it is quite important to tell your doctor if you are pregnant or breastfeeding before taking the medication.