Summary about Disease
A stomach ulcer, also known as a gastric ulcer, is a sore that develops on the lining of the stomach. It's a type of peptic ulcer, which can also occur in the duodenum (the first part of the small intestine). Stomach ulcers are often caused by bacterial infection with Helicobacter pylori (H. pylori) or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Symptoms
Burning stomach pain (most common)
Pain that is often worse between meals or at night
Pain that may be temporarily relieved by eating or taking antacids
Bloating
Heartburn
Nausea or vomiting
In severe cases: Dark or bloody stools, vomiting blood (which may look like coffee grounds), unexplained weight loss, appetite changes
Causes
Helicobacter pylori* (H. pylori) infection: This bacterium damages the protective lining of the stomach and duodenum.
Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs): These medications can irritate and erode the stomach lining.
Rarely: Zollinger-Ellison syndrome, a rare condition that causes the stomach to produce too much acid.
Medicine Used
Antibiotics: To eradicate H. pylori* infection (e.g., amoxicillin, clarithromycin, metronidazole, tetracycline). Usually combined with other medications.
Proton Pump Inhibitors (PPIs): Reduce stomach acid production, allowing the ulcer to heal (e.g., omeprazole, lansoprazole, pantoprazole, esomeprazole).
H2 Blockers: Also reduce stomach acid production (e.g., cimetidine, ranitidine, famotidine, nizatidine).
Antacids: Neutralize stomach acid for quick relief of symptoms (e.g., calcium carbonate, aluminum hydroxide, magnesium hydroxide).
Bismuth Subsalicylate: Can protect the ulcer and also has some antibacterial effects against H. pylori.
Sucralfate: Forms a protective coating over the ulcer.
Is Communicable
H. pylori infection is communicable. It is usually spread through:
Contaminated food or water
Close contact with an infected person (e.g., through saliva) Stomach ulcers themselves are not directly communicable, but the H. pylori infection that often causes them is.
Precautions
Practice good hygiene: Wash your hands frequently, especially after using the toilet and before eating.
Eat properly prepared food: Ensure food is cooked thoroughly and from safe sources.
Drink clean water: Avoid drinking water from potentially contaminated sources.
Limit NSAID use: If you must take NSAIDs, do so with food and talk to your doctor about ways to protect your stomach lining.
Avoid excessive alcohol and smoking: These can irritate the stomach lining.
Manage stress: While stress doesn't directly cause ulcers, it can worsen symptoms.
How long does an outbreak last?
Without treatment, a stomach ulcer can persist for weeks, months, or even years. With proper treatment (antibiotics for H. pylori and acid-reducing medications), healing typically occurs within a few weeks to a couple of months. The length of time for an outbreak is highly variable and depends on the severity of the ulcer, the underlying cause, and the individual's response to treatment.
How is it diagnosed?
Upper Endoscopy (Esophagogastroduodenoscopy or EGD): A thin, flexible tube with a camera is inserted into the esophagus, stomach, and duodenum to visualize the lining and take biopsies.
Barium Swallow: X-rays are taken after drinking a barium solution, which coats the esophagus, stomach, and duodenum.
H. pylori Testing:
Blood Test: Detects antibodies to H. pylori.
Stool Test: Detects H. pylori antigens in the stool.
Urea Breath Test: Measures the amount of carbon dioxide produced after swallowing a urea solution.
Biopsy: A sample taken during endoscopy can be tested for H. pylori.
Timeline of Symptoms
The timeline of symptoms can vary greatly.
Early Stages: Mild burning pain, often after eating or at night. May be mistaken for heartburn or indigestion.
Progressive Stages: Pain becomes more frequent and intense. Nausea, bloating, and loss of appetite may develop.
Severe Stages: Vomiting blood (coffee-ground appearance), dark or bloody stools, unexplained weight loss, and severe abdominal pain. Complications like bleeding or perforation can occur. Symptoms may wax and wane over time.
Important Considerations
Seek medical attention: Don't self-treat suspected stomach ulcers. See a doctor for diagnosis and treatment.
Complete the full course of antibiotics: If H. pylori is present, it's crucial to finish the entire course of antibiotics to eradicate the infection.
Avoid irritants: Limit or avoid alcohol, caffeine, and spicy foods, especially during treatment.
Follow-up: Follow-up endoscopy may be recommended to ensure the ulcer has healed, especially if it was large or complicated.
NSAID users: If you must continue taking NSAIDs, discuss protective strategies with your doctor (e.g., taking PPIs concurrently).
Cancer risk: While rare, stomach ulcers can increase the risk of stomach cancer in the long term, especially if associated with H. pylori.