What is stomach ulcer?

stomach mucosa infected by Helicobacter pylori bacteria causing sores and ulcer

Key takeaways:

  • There are many different types of ulcers; however, stomach ulcers are among the most common types.
  • Stomach ulcers are sores that develop in the stomach lining, often caused by long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) or infection by the bacteria Helicobacter pylori.
  • Stomach ulcers can cause symptoms that can resolve within 3 months if treated, but if left untreated can lead to further complications, such as internal bleeding and stomach lining perforations.

Ulcers that affect the esophagus, stomach, and smaller intestine are called peptic ulcers. However, when the ulcers develop only in your stomach wall, it is called gastric or stomach ulcers. As of 2019, approximately 8.09 million people in the world had peptic ulcer disease.

If you have a stomach ulcer, you may experience intense abdominal pain that comes and goes, often accompanied by other symptoms. People tend to believe that eating spicy food or skipping meals is the major cause of stomach ulcers. But that is a misconception. Eating spicy meals or skipping meals like breakfast do not directly cause stomach ulcers.

In this article, we will look at what a stomach ulcer is and what causes it. We'll also discuss the symptoms, diagnosis, and treatment, as well as what to do when you experience ulcer symptoms.

Meaning of stomach ulcer

A stomach ulcer, also called a gastric ulcer, is a sore in the lining of the stomach. It is a type of peptic ulcer that occurs when painful, open sores develop in a person's stomach lining.

People sometimes mistake stomach ulcers for other related conditions like gastritis, but they don't exactly mean the same thing. Stomach ulcers are open sores in the lining of the stomach wall, while gastritis is an inflammation of the stomach lining often caused by irritation due to stress, alcohol use, bacterial infection, and chronic vomiting, among others.

Stomach ulcers occur as a result of a reduction in the protective mechanisms or barriers of the stomach wall. For example, the chance of getting a stomach ulcer increases if anything thins out the protective mucus that covers the inside of the stomach. This is because when those protective layers are not there, it makes the stomach lining open and vulnerable to digestive acids secreted by the parietal cells of the stomach.

While stomach ulcers cause openings and painful sores in the stomach wall, they can be treated. In most cases, with the right treatment, they heal within weeks or months. However, in some cases, they recur. It will be helpful to work with your healthcare team to treat and prevent the recurrence of stomach ulcers if you have already been diagnosed with it.

Causes of stomach ulcer

The major causes of stomach ulcers are infection by Helicobacter pylori or long-term use of NSAIDs.

I. Helicobacter pylori infection

Several studies have shown that a bacterial infection caused by Helicobacter pylori is the primary cause of stomach ulcers. H. pylori bacteria are spiral-shaped bacteria that cause damage to the stomach wall, weakening the protective mucous lining. This can lead to redness and soreness.

More than 50% of the world's population is infected by H. pylori. However, not everyone with this infection develops a stomach ulcer.

II. Non-steroidal anti-inflammatory drugs (NSAIDs)

NSAIDs are medications taken to relieve pain. Some of the most common examples of NSAIDs people take regularly are ibuprofen and high-dose aspirin. People who use NSAIDs regularly are at a higher risk of developing peptic ulcers compared to people who don't use them. Also, peptic ulcers tend to recur more in people who use NSAIDs than in people who don't.

NSAIDs cause stomach ulcers by inhibiting the body's production of prostaglandins. Some prostaglandins play important roles in maintaining the normal healthy condition of the stomach and intestinal mucosa and protecting the stomach lining from the corrosive effects of gastric acid.

Despite this downside to the use of NSAIDs, they have remained one of the first lines of treatment for pain. According to a 2017 study that evaluated the most prescribed pain relievers in one hospital in Nigeria, about 31% and 9% of patients used NSAIDs, diclofenac, and ibuprofen, respectively.

One way to tackle the widespread occurrence of gastric ulcers sweeping across the globe is to stop self-medicating on NSAIDs. Also, if you have a history of peptic ulcer disease, let your doctor know when they are prescribing pain relief medications for you. This will help them know the best medication to recommend, keeping in mind your medical history.

Read this piece that explains the relationship between meal patterns and stomach ulcer.

Symptoms of stomach ulcer

The symptoms of ulcers vary amongst individuals and mostly depend on the severity of the condition.

Most people with stomach ulcers will experience symptoms like:

  1. Dull or sharp pain or burning sensation in your abdomen
  2. Nausea
  3. Loss of appetite
  4. Bloating
  5. Acid reflux
  6. Feeling a burning sensation in your chest (heartburn)
  7. Dark stools

Diagnosis and treatment for stomach ulcer

The treatment and diagnosis of a stomach ulcer depends on how severe it is and the cause.

Your doctor may do the following while making a stomach ulcer diagnosis:

  • Medical history: Your doctor will first check your medical history and ask about the drugs you are already taking and the symptoms you are having.
  • Testing samples and breath test: They may require your blood or stool sample - in some cases, they may run a urea breath test. For the breath test, you will be asked to exhale into a balloon-like bag, and the amount of CO2 you exhaled will be measured. After that, you will be given a solution containing urea and asked to release your breath inside a bag again. For this test, one indicator that you have H.pylori infection is the presence of higher than normal CO2.
  • Endoscopy: In this procedure, the doctor wants to check for bleeding, ulcers, or any abnormal tissue. To do this, the doctor will pass a thin, lighted tube (attached to a camera) into your stomach to better view the stomach wall.
  • Endoscopic biopsy: This procedure requires that your doctor will collect a piece of your stomach tissue and send it to the lab for analysis.
  • Barium swallow: In this procedure, your doctor wants to see your stomach and small intestine using X-rays. They will ask you to ingest barium(a thick white liquid). Barium will help to coat or cover the upper part of your GIT and make it easy for your doctor to have a clear view of your stomach and small intestine.

How you treat your stomach ulcer will depend on things like what caused it in the first place, what symptoms you have, and how bad it is. If H. pylori bacteria is the cause of your stomach sores, your doctor may prescribe some antibiotics for you. Ensure you take the medications as instructed and in the right dosage to avoid antibacterial resistance.

For stomach ulcers caused by the use of NSAIDs, doctors sometimes proceed to use proton pump inhibitors and prostaglandin analogs to treat the patients. In rare cases, stomach ulcer patients may require surgery to treat the condition.

Even though stomach ulcers sometimes recur even after treatment, you shouldn't leave them untreated. Untreated stomach ulcers can lead to complications like stomach wall perforations, internal bleeding, and blockage in the digestive tract (gastric outlet obstruction).

How long does it take for a stomach ulcer to heal?

Most stomach ulcers heal within weeks or a few months. But the ulcer may come back even after treatment, especially if the main cause was not taken care of. Speak with your doctor about what you can do to reduce the risks of recurring.

Why stomach ulcers don't heal fast

Some stomach ulcers don't heal even after three months of appropriate treatment. They are considered refractory peptic ulcers. Refractory peptic ulcers are also ulcers that come back within a year of treatment, even though maintenance therapies were used.

About 20-30% of ulcers occur as refractory ulcers. These persistent ulcers are commonly caused by the continuous and regular use of NSAIDs and persistent Helicobacter pylori infection.

Smoking is also another factor that can contribute to a persistent ulcer that has refused to go away. This is why it is necessary to quit smoking, especially if you have health conditions like a stomach ulcer.

Also, health conditions like Zollinger-Ellison syndrome can cause your stomach ulcer to not heal quickly. Zollinger-Ellison syndrome is made up of a group of diseases that include peptic ulcer, chronic ulcer, and gastroesophageal reflux disease. The syndrome is marked by the development of a gastrin-secreting neuroendocrine tumor that can lead to the oversecretion of gastric acid.

What to do if you have ulcer symptoms

Burning stomach pain is one of the most common signs of a stomach ulcer. However, many other health conditions share the same symptoms. A certified medical doctor is the only person that can accurately diagnose you to determine what is causing your stomach pain. It will be wrong to assume you have a stomach ulcer without seeing a doctor.

Even after being diagnosed with an ulcer, you should still, speak with your doctor about a treatment plan for the condition. Some people have ideas about at-home remedies that can help with stomach ulcers; it would be best to run them by your healthcare provider to be sure they are helpful, safe, and won't worsen your symptoms.

Try to stick with lifestyle behaviors and diets that are helpful for stomach ulcer recovery.

Also, like many other health conditions, treatment for stomach ulcers will vary from person to person. Your doctor will recommend the best line of treatment unique to your case.

Wrap up

Stomach ulcers are a condition commonly caused by long-term or excessive use of NSAIDs and infection by the H. pylori bacteria. It is majorly characterized by the formation of open sores in the stomach lining. The sores are often painful, which explains the abdominal pain most people with stomach ulcers experience. However, not everyone with a stomach ulcer will experience the pain, while some people experience it much later.

If you suspect you have a stomach ulcer, you may be tempted to go out and get drugs on your own. But, that is not a safe way to take care of your health, as you may end up getting the wrong medications, which may cause further harm to you. Instead, check into a hospital, and have a doctor examine you and give you proper treatment.

Stomach ulcers are often not life-threatening. More often than not, it resolves within weeks of treatment.

Do you have stomach ulcer? Read about some healthy foods that are good for stomach ulcer patients and can help your recovery process.