Patient's Complete Guide to Ulcer

Overview of Ulcer

Ulcer (السر) or peptic ulcer is a fairly common health condition in which sores develop on either the stomach lining or the duodenum. An ulcer is basically the discontinuity and the breakage in the membrane of our body, thus affecting our normal functions. An ulcer is formed in our body when the digestive tract is damaged by stomach acid. Most ulcers are located in the small intestine and are called duodenal ulcers. The ulcers in the stomach are called gastric ulcers. In the throat, these ulcers are called oesophagal ulcers.

Signs and Symptoms of Ulcer

Common symptoms of the ulcers include:

  • Discomfort while taking meals or especially at night
  • Discomfort while eating or drinking anything
  • Discomfort
  • Feeling full fast
  • Bloating
  • Dull pain or burning in the stomach
  • Keep waking up at night due to stomach pain
  • Heartburn
  • Intolerance of fatty foods

If the ulcer becomes torn or perforated, it can turn into a bleeding ulcer. If this happens, the symptoms would be:

  • Nausea
  • Unexpected weight loss
  • Vomiting blood
  • Backpain
  • Dark stools or  blood in your stool

Types of Ulcer

Depending upon the location of the ulcers in the body, it is divided into the following types.

  • Bedsores or Pressure Ulcers
  • Corneal Ulcer - It is an infectious and an inflammatory condition that occurs in the cornea
  • Diabetic Foot Ulcer - It is a major health complication in case of the diabetic foot
  • Mouth Ulcer - It is an open and painful sore inside of the mouth
  • Stomach or Peptic Ulcer - It is a sore on the stomach lining
  • Genital Ulcer - This type of ulcer occurs in the genital area of our body
  • Venous Ulcer - Due to poor functioning of the valves of the veins a wound would occur in that area
  • Ulcerative Dermatitis - It is a form of ulcer and skin disorder due to the growth of bacteria

Causes of Ulcer

A person would suffer from an ulcer when the stomach acid damages the wall of the stomach or the intestine. When the stomach produces too much acid or when the mucus layer becomes too thin, our gut would feel it.

Following are the three major causes of the ulcer:

  • Bacteria - Helicobacter pylori (H.pylori) is normally present in half of the population. But not everyone infected with it suffers from an ulcer. However, others can raise the amount of the acid, irritate the digestive tract or break down the protective layer of the mucus. The mode of transmission of H.pylori is still not sure. But, experts say that this infection can spread from kissing, close contact, unclean food, or water.
  • Pain Relief Medication - Certain pain relievers such as aspirin, if taken for a long time can cause peptic ulcers. NSAIDs or nonsteroidal anti-inflammatory drugs such as naproxen or ibuprofen can also cause ulcers. NSAIDs block the function of your body in forming the protective layer of the inner wall of your stomach and intestine. These protective layers are important in protecting the stomach and intestine from the stomach acid and intestine acid.
  • Drinking Alcohol and Smoking - If you are smoking and drinking alcohol, you are more likely to suffer from ulcers.

Risk Factors of Ulcer

While spicy foods and stress can trigger worsening your ulcer. But, these won’t increase your risk of suffering from ulcers. Here are a few things that increase your risk are:

Pain relievers - Such as NSAIDs, aspirin, ibuprofen or naproxen sodium. Your risk for suffering from an ulcer would increase if you are taking any of these medications and if:

  • You are over 65 years of age
  • Taking more than one NSAID at one time
  • Infection due to Helicobacter pylori (H.pylori)
  • Had a peptic ulcer in the past
  • You are taking a selective serotonin reuptake inhibitor (SSRI)

Prevention

To prevent the spread or transmission of the bacteria that can cause stomach ulcers, you need to wash your hands regularly and thoroughly. Make sure to properly clean and thoroughly cook the food.

In order to prevent the ulcers that are caused by the NSAIDs, you need to either limit or reduce the use of these medications. If, however, you need to take the NSAIDs, make sure to follow the recommended dose. You need to take medications with plenty of water and food. Last, but not least, you need to manage your stress and avoid smoking to reduce your risk of ulcers.

Diagnosis

Your doctor will first inquire about your symptoms, and medical history, also if you have taken any medication or other drugs such as NSAIDs or others. The doctor will also inquire about the bloating in the belly or pain. This would be enough for the diagnosis.

For the confirmed diagnosis, your doctor would recommend diagnostic tests such as X-rays, biopsy, and the endoscopy test. In the endoscopy test, a thin tube is allowed to pass into the stomach and intestine via the throat. A small camera is attached at the end of the tube in order to check the ulcers. The doctor would also recommend a breath, stool test for H.pylori, and blood test to screen for the H.pylori bacteria.

Treatment of Ulcer | When to Consult a Doctor

Treatment of the ulcer varies depending upon the type and cause of your ulcer. Mostly, ulcers can be treated with medication, but in rare cases, surgery may also be required. So, it is important to properly talk with your doctor and prepare a customised treatment plan.

  1. Non-Surgical Treatment

Some ulcers heal on their own. But, in general cases, your doctor will prescribe antibiotics in case of an ulcer due to H.pylori bacteria infection. It would be a course of 2-3 weeks. You might also have to undergo triple therapy. It is a combination of proton pump inhibitors (PPI) and 2 antibiotics. Your doctor may also recommend some medications to reduce the stomach acids for up to 8 weeks.

There are other medications which are given to treat ulcers. PPIs and H2 blockers are responsible for reducing the amount of stomach acid. For temporary relief, over-the-counter medication, or antacid can help you. You need to avoid alcohol and smoking as it makes the situation worse.

Some of the common side effects of the ulcer medication are nausea, headaches, abdominal pain, dizziness and diarrhoea. These are temporary side effects and if these side effects become severe and cause extreme discomfort, you need to talk to your doctor.  If anti-inflammatory or aspirin medication irritates your stomach, your doctor may suggest you take misoprostol.

  1. Surgical Treatment 

Without getting proper treatment, ulcers get worse. In severe cases, you may also have to undergo surgery. Surgical treatment is recommended when the ulcers:

  • bleed
  • don’t heal
  • continue to return
  • tear through stomach
  • keep food from flowing out of the stomach and into the small intestine

The surgical methods may include:

  • Removing the entire ulcer
  • Tying the bleeding artery
  • Patching the tissue on the site of the ulcer from any other part of the intestine
  • Cutting the nerve supply, in order to reduce the production of acid in the stomach
  1. Healthy Diet

In the past, people used to believe that food can cause or cure ulcers. This is not completely true. But, eating a healthy diet is beneficial for your overall health. Healthy food consists of a diet that has a good amount of vegetables, fibres and fruits.

Research shows that some food products are also responsible for treating and eliminating H.pylori bacteria infection. Such food includes:

  • Green leafy vegetables (kale and spinach)
  • Fruits such as apples, strawberries, raspberries, blueberries and blackberries
  • Radishes, cabbage, cauliflower and broccoli
  • Foods rich in probiotics such as miso, yoghurt, kombucha, sauerkraut

People suffering from ulcers may also face acid reflux disease. Therefore, you also need to avoid spicy foods as they hinder the healing of ulcers.

(Note: Take medication only after doctor’s prescription)

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