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Gastric ulcer

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A gastric ulcer is one kind of peptic ulcer which appears in the lining of the stomach; the other kinds of peptic ulcers can occur in the small intestine or in the esophagus. They occur everywhere around the world, and in the United States one in five people younger than 30 and one in two people older than 60 are infected with the bacteria that commonly cause gastric ulcers.

GASTRIC ULCER SYMPTOMS

The most common symptom of a gastric ulcer is a burning pain in the stomach. The ulcer is the primary cause of the pain, but it is made worse by coming into contact with the acid from the stomach. The pain might be felt anywhere in your abdominal region, from your navel to your breastbone, and it can last anywhere from a few minutes to several hours at a time. In most cases, it is worst when your stomach is empty, and for many people, their ulcers flare up the worst at night. In some cases, there are worse symptoms, which can include the vomiting of red or black blood, dark blood in your stools, or stools that are black and tarry. You might also experience nausea, vomiting, unexplained weight loss, or pain in your chest.

GASTRIC ULCER CAUSES

Most gastric ulcers are caused by an infection of a common bacterium called Heliobacter pylori, or simply H. pylori. H. pylori is found in the mucous lining of the stomach, and in most cases causes no problems. But in other cases, it can disrupt the mucous layer and inflame the lining of the stomach. When that kind of inflammation occurs, a gastric ulcer is produced. Gastric ulcers are more likely to occur in people who have already had some damage to the lining of the stomach, because in those cases, the bacteria can more easily get into the lining of the stomach and inflame it.

There are causes of gastric ulcers besides H. pylori, however. One of the common causes of gastric ulcers is the regular use of pain relievers, especially nonsteroidal anti-inflammatory drugs, or NSAIDs, such as aspirin, ibuprofen, naproxen, and ketoprofen. NSAIDs stop the production of an enzyme that protects the stomach lining against the eroding effects of acid. Another cause of gastric ulcers is smoking, because the nicotine in tobacco increases stomach acid, and more stomach acid means more risk of an ulcer. Even if you are getting treatment for your ulcer, smoking can slow any healing that may take place. Alcohol, as well, can increase the amount of stomach acid and irritate your stomach lining. A final contributor to gastric ulcers is connected to stress. It doesn’t cause the ulcers, but it can aggravate the symptoms that already exist and can delay healing. Stress can come from emotional causes or from some sort of physical stress that harms your body.
Gastric ulcer
Image: Gastric ulcer


Many people self-treat their gastric ulcers with absorbent foods that help soothe the pain of the ulcer, or with over-the-counter antacids and acid blockers. These methods can result in a short-term relief of the pain, but it doesn’t last long, and it always returns. If you have the signs and symptoms that might indicate an ulcer, you should see your doctor. Many of the symptoms of an ulcer are common to other disorders, but a gastric ulcer can become very serious if it is left untreated. A doctor can prescribe medication that can relieve your pain and eventually clear up your infection and heal your ulcer.

GASTRIC ULCER DIAGNOSIS

If you have symptoms that might indicate an ulcer there are some tests that your doctor may give you to make sure of that diagnosis. These may include:
- An upper gastrointestinal X-ray. This test outlines your esophagus, stomach, and duodenum. You drink a barium solution, and any ulcers that you may have appear more clearly on an x-ray. However, not all ulcers can be detected this way.
- An endoscopy. In this procedure, your doctor will thread a long, narrow tube down your throat and into your stomach. At the end of this tube is a very small camera, and it allows your doctor to look inside your digestive tract for any ulcers that might be present.
- A blood test. A blood test can check for the antibodies caused by the presence of H. pylori. This test is imprecise because the antibodies may still be present from previous infections, but it does help your doctor to discern the problem.
- A breath test. This test requires you to drink a liquid with a clear, radioactive carbon liquid in it, which can help detect the presence of H. pylori. The advantage of this test is that it is non-invasive and can be administered repeatedly to help discern whether the treatment is effective and the H. pylori are being reduced.
- A stool antigen test. This test detects the presence of H. pylori in the stool and can also help discern how successful the treatment is.

GASTRIC ULCER TREATMENT

It is very important that you get an accurate diagnosis for your stomach pain. If you don’t get a gastric ulcer treated, it could cause internal bleeding, and the excess acid could eat a hole through the wall of your stomach. This can lead to serious infections in your abdominal cavity, known as peritonitis. These ulcers can also produce scar tissue which can then obstruct the passage of food through the digestive tract. Obstructions like this can lead to you getting full too easily and not getting the nutrition you need.

Doctors use a two-pronged approach to treat gastric ulcers. They try to kill the bacteria and to reduce the acid in your stomach, which relieves pain. This is done through the use of a combination of two or more of the following medications:
- Antibiotics. These treat the H. pylori.
- Acid blockers. These reduce the amount of acid released into the stomach.
- Antacids. These neutralize acid and relieve pain.
- Cytoprotective agents. These are for protecting your stomach lining.
- Proton pump inhibitors. These help reduce acid in your stomach lining.
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