A peptic ulcer is an open sore that can form on the lower esophagus, the stomach lining or the small intestine. It may develop when stomach acids erode the lining of these organs or due to a bacterial infection. In general, the best way to deal with ulcers is to see a stomach specialist Singapore residents trust, who can give you a proper diagnosis and prescribe the necessary medications. Getting prompt medical attention and advice for ulcers prevents them from worsening and causing harmful complications later on.
Peptic ulcer is a common digestive problem, affecting about four million people around the world each year. It can occur at any age, and current studies estimate that approximately 5 to 10% of the general population will likely experience a peptic ulcer at some point in their life. This guide explores the causes, symptoms and complications of peptic ulcers. It also describes how stomach ulcers are diagnosed and treated.
Causes and Risk Factors of Peptic Ulcers
Peptic ulcers develop when the protective lining of the stomach, small intestine or the esophagus breaks down, most frequently due to the following factors:
- Stomach infection and inflammation caused by the bacteria Helicobacter pylori ( pylori), which is most commonly transmitted through food and water contaminated with fecal matter or person-to-person through the saliva
- Frequent use of aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs)
- Excessive alcohol consumption
- Excessive smoking
- Stomach cancer
- Radiation therapy
Symptoms of Peptic Ulcers
Small peptic ulcers may not produce any symptoms in the earliest stages of their development. The most common and recognisable symptom of peptic ulcers is a burning pain in the abdomen, which may be mild or severe. Pain from ulcers is likely to spread across a wide area, stretching from the navel to the chest, and may occasionally wake the affected person from sleep.
Other notable symptoms to keep an eye out for include the following:
- Chest pain
- Bloated stomach
- Dark or bloody stool
- Sudden, inexplicable weight loss
- Appetite changes
Potential Complications of Peptic Ulcers
If left untreated, peptic ulcers will worsen over time and may lead to severe health complications, including:
- Internal bleeding – This is the most common complication associated with untreated peptic ulcers. People with bleeding ulcers may experience symptoms of anemia, such as weakness, dizziness, shortness of breath or fatigue. Heavier bleeds, which produce bloody or dark-colored stool or bloody vomit, require immediate and urgent medical attention.
- Perforation of the stomach or intestinal wall – Ulcers that are continually eroded by stomach acids eventually produce holes in the stomach or small intestine. These perforations are intensely painful and also allow bacteria from the digestive tract into the abdominal cavity, where they can cause an infection known as peritonitis. If this infection spreads throughout the rest of the body, a life-threatening condition known as sepsis can occur.
- Obstruction of the digestive tract – Healed ulcers may thicken and enlarge as they develop scar tissue. At times, this scar tissue may block the digestive tract and make it difficult for food to pass from the abdominal cavity to the small intestine. This stalling of the digestive process may lead to vomiting, weight loss, and numerous other side effects.
Diagnosing Peptic Ulcers
Healthcare providers typically begin diagnosing peptic ulcers by interviewing patients about their symptoms and medical history, particularly regarding their use of NSAIDs and possible experiences with H. pylori infection. If your doctor suspects you may have a peptic ulcer, they may require you to undergo one or a combination of the following tests:
- Endoscopy – This medical examination involves passing a thin tube with a small camera on the end down the patient’s throat. It allows doctors to view their stomach and the upper portion of their small intestine. Doctors also collect tissue samples for laboratory analysis during endoscopies.
- Imaging tests – CT scans and upper GI X-rays are common examples of tests that allow doctors to examine the stomach and small intestine in great depth.
- Tests for pylori infection – Healthcare providers may test for H. pylori through a stool test, a breath test, or a blood test.
Treating and Managing Peptic Ulcers
Peptic ulcer treatment focuses on reducing stomach acid, neutralising any bacterial infections and protecting the ulcer as it heals. Doctors will usually prescribe a mix of medications that may include:
- Antibiotics to kill pylori infections
- Proton pump inhibitors (PPIs) to lower stomach acid levels
- Acid blockers, which further help reduce stomach acid and can help relieve ulcer pain
- Cytoprotective agents to coat the stomach lining and protect it from further erosion
Regular ulcers generally respond well to medication, but some ulcers with severe complications may require surgery.
Drinking alcohol, smoking, and taking NSAIDs are likely to irritate an ulcer and slow the healing process. It’s best to avoid these activities as you recover and take all medicines as prescribed. Certain dietary changes, like cutting back on acidic foods and consuming more alkaline foods like fruits and vegetables, can also help facilitate healing.
While peptic ulcers are common, you should always take them seriously to avoid serious complications. Getting immediate medical attention will help you identify the underlying cause of a peptic ulcer, get the medication you need and make the lifestyle changes necessary to help heal the affected organs.