How to identify a stomach ulcer?

Stomach ulcer: what is it?

A stomach ulcer Or gastric ulcer is a type of peptic ulcer. A peptic ulcer is a kind of wound that appears on the mucosa, which is the inner layer of the upper digestive tract.

This ulcer can be located in the first part of the small intestine, being called a duodenal ulcer, or in the stomach, a condition we will discuss next.

Causes

A significant proportion of peptic ulcers (including stomach ulcers) are caused by infection with the Helicobacter pylori bacterium or by the use of anti-inflammatory drugs (such as ibuprofen) or antiplatelet agents (such as acetylsalicylic acid).

Symptoms

Approximately 70% of peptic ulcers are asymptomatic, meaning they have no symptoms.

When a stomach ulcer occurs, the most common symptom is burning/scarcity and/or severe pain in the upper and middle abdomen, which may sometimes radiate to the neck, belly button, or back.

This pain may last for a few minutes or hours (especially between meals) and disappear, only to reappear a few days or months later. In addition to discomfort, other symptoms that may be associated with stomach ulcer include:

  • Swelling/distension of the abdomen;
  • Early bloating;
  • Nausea and vomiting (which may sometimes contain blood);
  • Black stools (due to the presence of digested blood);
  • Weight loss;
  • Indigestion/dyspepsia;
  • Heartburn;
  • Loss of appetite;
  • Discomfort;
  • Eructation (burping).

Diagnosis

To detect the existence of a stomach ulcer, it is necessary to perform an upper GI endoscopy. This endoscopic examination allows observation of the esophagus, stomach and duodenum.

In some cases, small fragments of the mucosa can be removed for microscopic analysis (biopsy) to confirm the diagnosis of ulcer and to detect the presence of Helicobacter pylori bacteria.

Treatment

In the presence of gastric ulcer, pharmacological treatment with a proton pump inhibitor is indicated, as well as avoidance of foods that relax the lower esophageal sphincter (e.g., alcohol, tobacco, coffee, chocolate).

Proton pump inhibitors, as the name implies, intensively and permanently inhibit acid secretion from the stomach cells. These drugs can be taken for 1 to 3 months to ensure complete healing of the stomach ulcer.

If the Helicobacter pylori bacteria is the cause of the stomach ulcer, the treatment includes the combination of three antibiotics and the proton pump inhibitor for 10 to 14 days.

Usually, after treatment, a breath test is performed to confirm eradication of the bacteria.

In addition, it is important to reduce and avoid the use of anti-inflammatory drugs and anti-platelet agents as much as possible.

When treatments do not prove effective, it may be appropriate to repeat upper GI endoscopy to exclude other gastric diseases.

Consequences and risks

If the stomach ulcer is not detected and treated in time, complications may occur, such as:

  • Digestive bleedingThis bleeding can be minor or major, depending on the amount of blood loss. In more severe cases, hospitalization, blood transfusions, endoscopic treatment of the hemorrhage and finally surgery may be required.
  • PerforationIn some cases, the ulcer can create a hole in the stomach wall, resulting in a process of inflammation and infection of the abdominal cavity (peritonitis). In these situations, urgent surgical intervention is indicated.
  • Scars and stenosisInflammation caused by the ulcer can also cause scarring which results in a narrowing that makes it difficult for food to pass through and causes food intolerance.

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