The condition commonly referred to as ‘ulcers’ is medically called Peptic Ulcers Disease. It refers to painful sores or ulcers in the lining of the stomach or first part of the small intestine, called the duodenum. Peptic ulcers occur when the lining of these organs is corroded by the acidic digestive (peptic) juices which are secreted by the cells of the stomach. A peptic ulcer differs from an erosion because it extends deeper into the lining of the esophagus, stomach, or duodenum and excites more of an inflammatory reaction from the tissues that are eroded.
CAUSES OF STOMACH ULCERS
The two most important initiating causes of ulcers are infection of the stomach by a bacterium called “Helicobacter pyloricus” (H. pylori) and chronic use of nonsteroidal anti-inflammatory medications or NSAIDs, including aspirin.The lining of the stomach is coated with mucus, which protects the lining from harmful effects of the acid. H. pylori bacteria and anti-inflammatory drugs (NSAIDs) can break down the stomach’s defence against acid, allowing the acid to cause an ulcer.
One’s lifestyle is always an important factor of health. Some medical practitioners conclude that cigarette smoking not only causes ulcers, but it also increases the risk of complications from ulcers such as ulcer bleeding, stomach obstruction, and perforation. Cigarette smoking also is a leading cause of failure of treatment for ulcers.
However the thought that stomach ulcers is caused by certain lifestyle factors, such as spicy foods, stress, smoking and alcohol is not confirmed as a fact. There is little hard evidence to confirm that this is the case.
It may be that although these types of lifestyle factors do not cause ulcers, they may make the symptoms of ulcers worse.
SYMPTOMS OF STOMACH ULCERS
- The most common symptom of a stomach ulcer is a burning or gnawing pain that develops in your abdomen (tummy). The pain can also travel up to your neck, down to your navel (belly-button) or through to your back.The pain associated with a stomach ulcer is caused by the ulcer itself and stomach acid that comes into contact with the ulcer and irritates it.
- Loss of appetite
When it’s a severe, stomach causes serious complications such as :
- vomiting blood – the blood can appear bright red or have a dark brown, grainy appearance similar to coffee grounds
- passing black tar-like stools
- a sudden, sharp pain in your stomach that gets steadily worse and does not improve
The treatment depends on what causes the patient’s stomach ulcers: H. pylori infection or non-steroidal anti-inflammatory drugs (NSAIDs) or both.
Antiacids and Alginates
Antacids neutralize existing acid in the stomach. Antacids such as Maalox, Mylanta, and Amphojel are safe and effective treatments. However, the neutralizing action of these agents is short-lived, and frequent dosing is required. Magnesium containing antacids, such as Maalox and Mylanta, can cause diarrhoea, while aluminum containing agents like Amphojel can cause constipation.
Bananas are also thought to be effective at protecting against stomach acid, and can be an alternative way to relieve your symptoms, if you don’t want to take antacids or alginates.
H2-receptor antagonists work by blocking the actions of a protein called histamine, which is also responsible for stimulating the production of acid.
Ranitidine is the most widely used H2-receptor antagonist for treating stomach ulcers.Side effects are Diarrhoea, headaches, dizziness, skin rashes and tiredness.
Reviewing NSAID use
If your stomach ulcer has been caused by taking NSAIDs, your GP will want to review your use of them.You will usually be advised to use an alternative painkiller not linked to stomach ulcers, such as paracetamol or a low-dose opiate-based painkiller.
Proton pump inhibitors (PPIs)
Proton pump inhibitors (PPIs) work by blocking the actions of proteins called proton pumps, which are partially responsible for producing stomach acid. Reducing the amount of stomach acid prevents further damage to the ulcer, allowing it to heal naturally.
H. pylori treatment
Treatment requires a combination of several antibiotics, sometimes in combination with a proton-pump inhibitor, H2 blockers, or Pepto-Bismol. Commonly used antibiotics are tetracycline, amoxicillin, metronidazole (Flagyl), clarithromycin (Biaxin), and levofloxacin (Levaquin). Eradication of H. pylori prevents the return of ulcers (a major problem with all other ulcer treatment options). Elimination of this bacteria also may decrease the risk of developing gastric cancer in the future. Treatment with antibiotics carries the risk of allergic reactions, diarrhea, and sometimes severe antibiotic-induced colitis (inflammation of the colon).
- Cut down on the amount of coffee and tea you drink. This can increase the amount of acid your stomach produces. Try herbal teas instead.
- Drink milk and eat milk-based foods, such as yoghurt and cheese. Milk is thought to coat the stomach and neutralise the effects of stomach acid.
- Lose any extra weight you are carrying.
- Eat little and often. This could help reduce the build-up of stomach acid between meals.
- Limit your intake of alcohol. Too much alcohol can irritate the areas of inflammation in your stomach.
- Avoid spicy or excessively rich foods if they make your symptoms worse.
- Quit smoking. It may put you at greater risk of developing an ulcer and slow down your recovery.
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