Gastric Ulcer
Also
called: Stomach Ulcer
What
is it?
A
gastric ulcer, also called a stomach ulcer, is a
raw, eroded area in the lining of the stomach.
Who
gets it?
About
two percent of the adult population in the United
States has active ulcers, and about ten percent
will develop ulcers at some point in their lives.
Of the approximately 500,000 new cases of ulcers
in the United States each year, about sixteen
percent are gastric ulcers. Gastric ulcers are
most common in males between the ages of 55 and
70.
Gastric
ulcers occur in people who take anti-inflammatory
drugs, such as aspirin, ibuprofen, and naproxen;
drink alcohol; smoke tobacco; have a high caffeine
intake and often feel stressed.
What
causes it?
A
gastric ulcer develops when stomach acids and
digestive juices injure the stomach’s lining of
protective mucus. Gastric ulcers most commonly are
caused by the use of nonsteroidal
anti-inflammatory drugs (NSAIDs) such as aspirin,
ibuprofen and naproxen. Aspirin is the NSAID most
likely to cause ulcers. The widespread use of
NSAIDs may be why the incidence of gastric ulcers
in the United States is rising.
Gastric
ulcers may also develop from the presence of
bacteria called Helicobacter pylori (H. pylori),
decreased resistance of the lining of the stomach
to gastric acids, increased production of gastric
acids and infection, certain types of medication,
and disorders that cause over secretion of stomach
juices. Ulcer can also be caused by the use of
tobacco, alcohol and caffeine.
What
are the symptoms?
The
symptoms of gastric ulcers include indigestion and
heartburn in the middle of the upper abdomen,
nausea and loss of appetite, weight loss and
repeated episodes of gastrointestinal bleeding.
About 30% of patients with gastric ulcers are
awakened by pain at night. Many patients have
periods of chronic ulcer pain alternating with
symptom-free periods that last for several weeks
or months. The pain may be relieved by eating or
taking antacids, and may get worse a couple of
hours after meals or before meals.
If the
gastric ulcer is bleeding, the patient may vomit
bright red blood or digested blood that looks like
brown coffee grounds and have black, tarry bowel
movements.
How is
it diagnosed?
To
diagnose a gastric ulcer, the doctor may first
examine the patient and look at the medical
history. The doctor may suspect gastric ulcers
based on risk factors such as male sex, age over
45, location of pain, anemia, history of using
NSAIDs, history of heavy smoking and alcohol use,
and family history of ulcers or stomach cancer.
The
doctor may perform an endoscopy and imaging
studies to determine if the patient has a gastric
ulcer. An endoscopy is considered the best
procedure for diagnosing gastric ulcers and for
taking samples of stomach tissue for biopsies. An
endoscope is a slender tube-shaped instrument that
allows the doctor to view the tissues lining the
stomach and duodenum.
The
doctor may also test for H. pylori because almost
all ulcer patients who are not taking NSAIDs are
infected. Noninvasive tests include blood tests
for immune response and a breath test. The doctor
may also take a blood test to see if the patient
is anemic due to a bleeding ulcer.
What
is the treatment?
To
treat a gastric ulcer the doctor may prescribe
drugs that will lower the rate of stomach acid
secretion or protect the mucous tissues that line
the stomach. Surgical treatment of ulcers is
usually recommended if the doctor suspects
complications and malignancies. Possible
complications of untreated ulcers include
hemorrhaging, a perforation of the stomach wall,
and an obstruction (ulcer scarring that prevents
passage of food).
The
doctor may also recommend treatment to eliminate
H. pylori in order to prevent ulcer recurrences.
Without such treatment there is an eighty percent
chance the ulcer will reoccur within one year. The
usual regimen used to eliminate the bacterium is a
combination of tetracycline, bismuth subsalicylate
(Pepto-Bismol), and metronidazole (Metizol).
Self-care tips
Patients with gastric ulcers can make several
lifestyle changes to prevent their recurrence,
including avoiding unnecessary use of aspirin and
NSAIDs, giving up smoking, and cutting down on
alcohol, tea, coffee, and sodas containing
caffeine. Other preventative measures include
eating balanced, nutritious meals, learning how to
manage stress, getting plenty of rest and
exercising as recommended.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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