Stomach ulcers
Stomach ulcers (or gastric ulcers) are painful open sores that can develop in your stomach lining and along your gastrointestinal (GI) tract. Ulcers, called duodenal ulcers, can also be found in the first section of your small intestine. Both duodenal and stomach ulcers (both also known as peptic ulcers) cause the same symptoms and need the same treatment.
Overview | Symptoms | Causes | Diagnosis | Treatments
Symptoms
People don’t always have symptoms if they have stomach ulcers; they only notice when a complication develops.
If you experience symptoms, the most common is a burning or piercing pain in the abdomen (tummy), between your chest and your belly button. This pain can last for a few minutes to a few hours. The pain usually worsens between meals or at night when stomach acid has built up without food to digest. It can be temporarily improved by eating meals or taking an antacid (indigestion medication), but it will reoccur if the ulcer is not treated.
Other symptoms include:
- Bloated stomach
- Heartburn and indigestion, especially after eating fatty foods
- Nausea and vomiting
- Loss of appetite
- Weight loss
Other factors can also cause abdominal pain. Read our blog on the causes of abdominal pain to find out more.
If stomach ulcers are left untreated, they can lead to severe complications such as internal bleeding, perforation (a hole in the stomach or intestinal wall), obstruction, and stomach cancer.
Stomach cancer vs stomach ulcers
Many symptoms overlap with both stomach cancer and stomach ulcers. You should seek medical assistance if you experience any concerning symptoms, as it’s important to get treatment quickly for both conditions.
Contact our clinic to arrange private diagnostic tests for stomach cancer and stomach ulcers.
Causes
Stomach ulcers are caused by damage to the inner lining of the stomach and/or small intestine. The damage to the lining creates an open sore, which can be painful and bleed, causing an ulcer to form.
If your gastric acid has increased or the mucous in the lining of your GI tract has decreased, this can leave you vulnerable to developing ulcers. People of any age, including children and teenagers, can get stomach ulcers, but it most commonly occurs in people aged 50 or over.
There are two common causes of stomach ulcers.
Helicobacter pylori (H. pylori) bacterial infection
The H. pylori bacteria lives and thrives in the stomach lining but can irritate it, exposing the lining to damage. H. Pylori is relatively common but only causes the irritation that leads to a stomach ulcer in some people.
We don’t yet know why some people are more vulnerable to the effects of H. pylori than others. People of any age can catch it.
Non-steroidal anti-inflammatory drugs (NSAIDs)
These are common over-the-counter pain relief medications typically used to treat pain, high fever, and swelling, including Ibuprofen, diclofenac or aspirin.
Long-term overuse can irritate the lining of your stomach and small intestine. NSAIDs also suppress your body’s defence and repair of the mucous lining, leaving it vulnerable to damage.
NSAIDs are generally safe, as many people take this medication without any problems. You may be advised not to take NSAIDs if you have a stomach ulcer or have had one previously. Paracetamol is a suitable alternative.
Diagnosis
If you are concerned about your symptoms, you should speak to your GP or medical professional. Based on your symptoms and medical history, they will discuss whether they suspect you have stomach ulcers and may order some tests to be sure.
Testing for H. pylori infection
To rule out whether you have an H. pylori infection, you may have the following tests:
- Stool (poo) test – sometimes a small sample of poo is needed to test for the bacteria. This test is the preferred and most accurate way to detect H. Pylori. It can also help determine the type of bacteria present in your GI tract. We offer private stool tests here at Digestive Health UK, contact us for further information.
- Breath test – you will be instructed to drink a clear liquid and breathe into a bag. If you have an H. pylori infection, it will show higher-than-normal carbon dioxide levels. This is not done commonly nowadays as the stool test is easier and more convenient.
- Blood test – This only shows if you had H. Pylori infection at some point in the past, but we cannot rely on it to check if you have current active infection. This is why we may perform a blood test alongside other diagnostic testing.
Endoscopy
Also known as a gastroscopy, an upper endoscopy may be needed so we can see what may be wrong with your stomach lining. It can also allow us to take a tissue sample for further analysis if needed. An upper endoscopy involves a camera on a small, thin, flexible tube that passes down your throat and into your stomach. Learn more about the endoscopy procedure here.
You may need to come back in 6 weeks for another endoscopy to check the ulcer has healed after treatment.
Imaging
Imaging tests can scan the stomach and small intestine for ulcers, including a CT scan. This test may be recommended to only check if any complications may have occurred due to an ulcer, such as a perforation. It is not typically used to diagnose ulcers. It is also useful to assess other organs around your stomach, such as the pancreas and liver.
Treatments
Treatment will vary depending on the cause of the ulcer. Most ulcers can heal if your stomach and intestines can recover from what caused the ulcers initially. With treatment, you should recover within a month or two.
Some treatment options include:
- Antibiotics – if your ulcer is caused by an H. pylori infection, we will recommend a course of antibiotics. Usually, you will take two different antibiotics simultaneously to kill the bacteria.
- Antacids – to stop high levels of stomach acid, this medication may be prescribed to help lower levels and provide pain relief. Antacids provide relief but not a cure for stomach ulcers.
- Proton pump inhibitors (PPIs) – these medications help stop your stomach from producing too much acid and successfully heal any ulcers. PPIs also may help prevent ulcers caused by NSAIDs.
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