Healthy Living

Stomach Ulcers: What are the Causes, Symptoms, Diagnosis, and Treatment?

Stomach Ulcers: What are the Causes, Symptoms, Diagnosis, and Treatment?

Stomach ulcers are painful lesions that are found in the lining of your stomach or small intestine. They are the most visible sign of peptic ulcer disease. Your stomach and small intestine are lined by a layer of mucus-producing cells. The mucus produced by these cells protect the lining of your stomach wall from the acidic environment. But in some people, due to various reasons, the protective mucus layer is reduced, allowing digestive acids to eat the lining of your stomach which leads to stomach ulcers. 

What is a stomach ulcer?

A stomach ulcer is a painful sore that is present in the lining of your stomach or small intestine. It indicates that you are having peptic ulcer disease. The reason for the development of stomach ulcers is the reduced protective mucus layer of your stomach wall. This mucus layer protects your stomach lining from the digestive, acidic environment. But when the mucus layer is reduced, the protection is lost and thus allows the digestive acids to eat away the lining of the stomach wall, eventually leading to the development of stomach ulcers.  

Stomach ulcers can be cured, but if you do not get proper treatment, it can become severe.

What are the causes of stomach ulcers?

Stomach ulcers can be caused by several factors, and it is often hard to isolate one single cause. The main reason for the development of stomach ulcers is the thinning of the protective mucus layer of the stomach, and this thinning is usually caused by one of the following:

  • A common bacterial infection called helicobacter pylori infection (H. Pylori) 
  • Using non-steroidal anti-inflammatory drugs (NSAIDS) such as aspirin and ibuprofen for a long period of time
  • Excessive acid production in the stomach, which may be due to a number of factors including genetic factors, lifestyle factors such as stress and smoking and certain food types
  • Zollinger-Ellison syndrome, which is a rare disease that causes your body to produce excessive stomach acid 


Who is at risk of developing stomach ulcers?

Various factors can put you at risk of developing stomach ulcers. Some of these include:

  • Smoking
  • The frequent use of steroids, including the use of steroids to treat asthma
  • Increased calcium levels in the blood (hypercalcemia)
  • If you have a family history of stomach ulcers
  • People above the age of 50 years old
  • Those who consume excessive amounts of alcohol

What are the symptoms of stomach ulcers?

There are several symptoms produced by stomach ulcers. The severity of the signs and symptoms you may experience will depend on the severity of the stomach ulcer.

The common signs and symptoms of stomach ulcers include:

  • Burning sensation in the epigastric region of the stomach or the area between your chest and belly button
  • Pain in the epigastric area, which tends to be more severe when your stomach is empty 
  • Weight loss
  • Reduced appetite due to the severe pain
  • Nausea or vomiting
  • Bloated stomach
  • Heartburn or a burning sensation in the chest
  • Burping or acid reflux

The pain you may experience from stomach ulcers may last from a few minutes to several hours, and this pain usually improves with eating, drinking or after taking antacids.

If you have any of the above symptoms, it is important that you consult your health care professional for further evaluation. Even though the symptoms may be mild, the ulcers in the stomach can worsen over time.

How are stomach ulcers diagnosed?

The diagnosis and treatment of stomach ulcers depend on the symptoms and the severity of the condition. At your initial visit with the doctor he or she will take a detailed medical history from you, asking about your symptoms and the drugs that you are taking. The doctor will then do a complete physical examination to locate where the pain is exactly coming from.

First, your doctor would want to rule out the possibility of a helicobacter pylori infection. To rule this out, he or she will order a blood, stool or breath test. During the breath test, you will be instructed to drink a clear liquid and then breathe into a bag which is then sealed. If you are infected with helicobacter pylori, then the breath sample will have a higher than normal level of carbon dioxide.

Other useful investigations that may be carried out to diagnose stomach ulcers include:

  • Barium enema – During this test, you will be asked to drink a thick white liquid known as the enema. This liquid helps the stomach and the small intestine to be shown up clearly on the X-ray film.
  • Endoscopy – This procedure includes the insertion of a thin tube with an attached camera to visualize the stomach to look for the presence of ulcers in the lining of your stomach wall.
  • Endoscopic biopsy – Here, a small piece of your stomach wall is removed during the endoscopy procedure so that it can be analyzed.


How are stomach ulcers treated?

The type of treatment will depend on the underlying cause of your stomach ulcers. Most ulcers can be easily treated with prescribed drugs and surgical intervention is rarely needed. 

Drug treatment

If your stomach ulcer is due to a helicobacter pylori infection, then you will be prescribed antibiotics. The following medicines will be prescribed to you:

  • H2 blockers – This is to prevent your stomach from producing too much acid. 
  • Proton pump inhibitors – These drugs will inhibit the cells that are responsible for acid production in the stomach. 
  • Antacids – These drugs can be purchased over the counter and they will neutralize the stomach acid.
  • Cytoprotective agents – These drugs will protect the lining of the stomach and the small intestine.

Your symptoms will quickly subside with treatment, but it is important that you continue to take the drugs prescribed by your doctor until the treatment schedule is complete. This is particularly important when taking drugs for H. pylori infections to make sure that all of the bacteria are destroyed.

Along with drug therapy, it is important that you avoid any triggering factors that may aggravate stomach ulcers such as certain foods, smoking, alcohol and any drugs.

Surgical treatment

Surgical treatment is necessary in very rare cases. Surgical treatment may be needed in cases where the ulcers:

  • Continue to recur
  • Do not heal with drug therapy
  • Bleed
  • Tear the stomach wall or small intestine wall
  • Prevent food from passing out of the stomach and into the small intestine

Surgical treatment will do the following:  

  • Remove the entire ulcer
  • Take a small piece of tissue from a site away from the ulcer and sew it over the site where the ulcer occurred
  • Tie off the bleeding artery
  • Cut the nerve supply to the stomach to reduce the synthesis of stomach acid

Ulcers can be uncomfortable, painful and potentially dangerous. So if you are experiencing any of the symptoms, it is highly recommending to see a doctor for diagnosis and treatment.