Ulcers: More Than Just a Stomach Ache

We all get stomach aches from time to time, but if you're having severe or regular stomach pain, check with your doctor about ruling out the possibility of an ulcer or other problem.

Ulcers are sores that can develop on the lining of your digestive tract — that is, in your esophagus, stomach, or duodenum (the first section of the small intestine). Ulcers are named depending on where they appear.

• Ulcers in the esophagus are called esophageal ulcers.
• Ulcers in the stomach are called gastric ulcers. They are also sometimes called peptic ulcers (peptic means having to do with digestion). 
• Ulcers in the duodenum are called duodenal ulcers. Duodenal ulcers, too, can sometimes be referred to as peptic ulcers. 

The good news is that most ulcers can be healed quickly with treatment.

What Are the Symptoms of an Ulcer?

Ulcer symptoms can vary from person to person, and sometimes there may be no symptoms at all. But typically, some of the following signs can occur:

• You might have a burning pain in your stomach that comes on between meals or overnight and can last for minutes or hours. It might make you feel better to eat or take an antacid, but the pain can come back worse a couple hours later. 
• Your pain may occur at meal time. And sometimes eating (or drinking) can make the pain feel worse, not better. 
• Less common symptoms can include feeling full after eating a small amount of food, burping, nausea, vomiting (sometimes vomiting blood), lack of hunger, unexpected weight loss, and black or bloody stool. 

If you have any of those symptoms, call your doctor and see if you should come in for an exam. An ulcer’s symptoms can sometimes look like other health problems, and your doctor can help figure out what's going on.

What Causes Ulcers?

For a long time, it was thought that ulcers were caused by too much stress or by eating too much acidic food. Today, doctors know that, while stomach acid and stress can sometimes aggravate an ulcer, most ulcers are actually the result of an infection — specifically an infection caused by a type of bacteria called Helicobacter pylori, or H. pylori for short.

Long-term use of nonsteroidal anti-inflammatory medications (NSAIDs) such as aspirin and ibuprofen can sometimes cause ulcers. And ulcers can also arise due to rare tumors in the stomach, duodenum, or pancreas, a disorder known as Zollinger-Ellison Syndrome (ZES).

How Are Ulcers Diagnosed?

Your doctor will ask you to describe your symptoms, and she may put you on medicine even before running diagnostic tests. That's because ulcer sufferers can often feel better quickly thanks to the treatment, and tests may become unnecessary. If tests are needed, they can include:

• Blood, stool, or breath tests: To check for H. pylori or other problems 
• Upper endoscopy: Your doctor checks the inside of your stomach and duodenum for ulcers using a special device
• Upper gastrointestinal (GI) series: In this test, X-rays are taken of your upper digestive tract so your doctor can look for ulcers
• Computerized tomography (CT) scan: This special scan uses X-rays combined with computer technology to help your doctor see what's going on inside your digestive tract

How Are Ulcers Treated?

Your doctor will prescribe a treatment based on the type of ulcer you have and what has caused it. Ulcer care can involve making some lifestyle changes, taking medicine, and in some cases, having surgery. 

The lifestyle changes could include:

• Avoiding certain foods that make your symptoms worse
• Quitting smoking
• Cutting back on alcohol and caffeine
• Stopping the use of non-steroidal anti-inflammatory medicines such as aspirin and ibuprofen)

Medical treatments for ulcers can include:

• Antibiotics: Used to kill the H. pylori bacteria, sometimes in combination with other medicines
• H2-blockers: Help reduce the amount of acid your stomach makes
• Proton pump inhibitors: Lower the acid levels in your stomach
• Mucosal protective agents: Protect the stomach lining from acid damage so it can heal
• Antacids: Help neutralize stomach acid

In those rare cases where medicine doesn't help, or if your ulcer is causing other problems, surgery might be needed.

The good news is that most ulcers can be healed quickly with treatment, and once the H. Pylori bacteria is gone, most ulcers don't come back.

Source: National Institute of Diabetes and Digestive and Kidney Diseases; Medline Plus; familydoctor.org