Open sores that occur on the stomach's inside lining and the upper portion of your small intestine are known as peptic ulcers. Stomach pain is the most common symptom of peptic ulcers.
Additionally, peptic ulcers are of two categories, such as:-
- Gastric ulcers that develop on the inside part of the stomach
- Duodenal ulcers that develop on the inside of the upper portion of the small intestine (duodenum).
Possible causes of peptic ulcers are infections caused by the bacterium Helicobacter pylori (H. pylori). Additionally, long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve), can also lead to the occurrence of peptic ulcers. Stress and spicy foods do not contribute to the development of peptic ulcers. But, yes, they can make your condition worse.
As per the systematic review of 31 published studies, the pooled incidence of uncomplicated peptic ulcer disease (PUD) was approximately 1 per 1000 person-years in the general population.
More than 6 million population in the United States are affected by peptic ulcers every year, resulting in a high economic cost to the healthcare system, says the Center For Disease Control And Prevention.
What Are The Symptoms Of Peptic Ulcer Disease?
Some of the symptoms of peptic ulcer disease are listed below, you can have a look to be sure about the existence of peptic ulcer disease:-
- Pain and burning in the stomach
- Feeling of fullness, bloating, or belching
- Intolerance to fatty foods
Burning stomach and pain is the most common peptic ulcer symptom. Acid of the stomach makes the pain worse, as does having an empty stomach. Some food items that buffer stomach acid and acid-reducing drugs can help you resolve the pain temporarily. But the pain usually gets worse between meals and at night. In fact, some people with peptic ulcers don’t even have symptoms.
Here are some of the consequences of the development of ulcers, such as:-
- Vomiting, which may contain blood, sometimes
- Presence of dark blood in stools
- Difficulty while breathing
- Feeling faint
- Nausea or vomiting
- Uncertain weight loss
- Change in diet
What Causes Peptic Ulcer Disease?
When the acid produced by the stomach eats its own inner surface or small intestine, an ulcer develops, known as a peptic ulcer. The acid is strong enough to cause you a painful open sore that can cause bleeding.
The human digestive system is coated with a mucous layer that protects against acid but only up to some extent. In case the stomach starts secreting an excess amount of acid, these layers of mucus start getting eroded. Once the mucus is eroded completely, an ulcer is developed on that particular location, causing peptic ulcer disease.
Below are the possible reasons why the mucus layer gets eroded and cause peptic ulcer disease:-
- Bacterium: Helicobacter pylori bacteria commonly present in the mucous layer protecting the tissues that line the stomach and small intestine. Usually, the bacteria do not cause any harm, but it may contribute to the cause of inflammation in the stomach's inner layer, producing a peptic ulcer disease.
It is not that clear how bacteria spreads, but as per the doctors, it might get transmitted from one person to others through close contacts, such as kissing or sharing food or water.
- Regular use of some pain relievers: Consuming aspirin along with some over-the-counter painkillers, such as nonsteroidal anti-inflammatory drugs (NSAIDs), contribute to eroding of the mucus layer inside the stomach causing peptic ulcers.
Some other painkillers include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox DS, others), ketoprofen, and others but not acetaminophen (Tylenol, others).
- Other medications: Consuming drugs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax), and risedronate (Actonel) along with NSAIDs can put you at risk of developing peptic ulcer disease.
How Is Peptic Ulcer Disease Diagnosed?
The first line diagnosis of peptic ulcer is a medical history and some physical examinations. For that, the doctor may ask you to go under some diagnostic tests, such as:-
- Laboratory tests for H. pylori: This procedure involves an examination of blood, stool, or breath in order to detect the bacterium H. pylori. Among all of these, the breath test is the most accurate one.
For the breath test, you will be asked to drink or eat things containing radioactive carbon. Later, you will be asked to blow into a bag, which is then sealed. That breath sample is further examined for the presence of radioactive carbon in the form of carbon dioxide.
- Endoscopy: In this procedure, a scope is used to examine the endoscopy (upper digestive system). During endoscopy, the doctor passes a hollow tube equipped with a lens (endoscope) inserted down into the throat through the esophagus, stomach, and small intestine.
The lens attached to the equipment helps the doctor to examine the inside stomach and intestines. In case the doctor suspects an ulcer, he might take a small tissue of it in order to examine it under a microscope(biopsy).
This examination procedure is usually recommended for older adults or people with severe peptic ulcer disease symptoms, such as difficulty while swallowing or eating.
- Upper gastrointestinal series. It is also known as barium swallow, a series of X-rays of the upper digestive system that creates the esophagus, stomach, and small intestine images.
During such examination, the person has to swallow a white liquid (containing barium) that coats the digestive tract making the ulcer more visible.
Can Peptic Ulcer Disease Be Cured?
Treatment for peptic ulcer disease depends on its cause. Mostly, treatment for peptic ulcer involves the killing of H. pylori bacterium if present. Secondly, eliminating or reducing the use of NSAIDs as much as possible can also help resolve the disease.
- Antibiotic medications to kill H. pylori: In case the H. pylori bacteria is the cause of the peptic ulcer, the doctor may recommend a combination of antibiotics to eliminate them. Antibiotics, such as amoxicillin (Amoxil), clarithromycin (Biaxin), metronidazole (Flagyl), tinidazole (Tindamax), tetracycline, and levofloxacin.
The medicine course duration depends on the severity of the disease, but in most cases, the antibiotics are prescribed for two weeks. Usually, only antibiotics are not enough, additional medications may be required to lower stomach acid, along with a proton pump inhibitor and possibly bismuth subsalicylate (Pepto-Bismol).
Drugs that block acid production and promote healing, such as proton pump inhibitors(PPIs), help reduce stomach acid by blocking the acid's secretion. Such drugs include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), and pantoprazole (Protonix).
Long-term use of PPIs at high doses increases the risk of hip, wrist, and spine fracture. Therefore, please consult with the doctor before consuming any medicine and take them as directed.
- Medications to reduce acid production: Acid blockers, also known as histamine (H-2) blockers, helps lower the secretion of stomach acid, resolving ulcer pain, and encourages healing.
Medications to lower the secretion of stomach acid include famotidine (Pepcid AC), cimetidine (Tagamet HB), and nizatidine (Axid AR).
- Antacids that neutralize stomach acid: Antacids are medicines that neutralize existing stomach acid and provide rapid pain relief. Sometimes it may cause some mild side effects, such as constipation or diarrhea, depending on the main ingredients.
Such medicines can help you relieve the peptic ulcer symptoms but cannot be used to cure it.
- Drugs for protecting the lining of the stomach and small intestines: The doctor may prescribe medications known as cytoprotective agents in some cases to help protect the tissues that line your stomach and small intestine from the stomach acid.
Such medications include sucralfate (Carafate) and misoprostol (Cytotec).
What Are The Complications Of Peptic Ulcers?
If the peptic ulcer is left untreated, it can lead to some complications, such as:-
- Internal bleeding: Here, bleeding means slow blood loss causing anemia or in case of severe blood loss, it may lead to hospitalization or a blood transfusion. Severe loss of blood may cause black or bloody vomit or black or bloody stools.
- A hole (perforation) in your stomach wall: Peptic ulcers can cause a hole through (perforate) the stomach or small intestine wall. This can put you at an increased risk of serious infection of your abdominal cavity (peritonitis).
- Obstruction: Severe peptic ulcer can lead to difficulty in passing the food and consequently difficulty in eating full, vomiting, and weight loss either because of swelling or the pain. This obstructs the flow of food inside the stomach.
- Gastric cancer: As per the studies, people who are infected with H. pylori bacteria have a higher risk of gastric cancer.
How Long Can You Live With A Peptic Ulcer?
Peptic ulcers that are developed because of medications will begin to heal shortly after you stop taking medicine. Anti-acid medicine can help you resolve the symptoms within 2-6 weeks.
Ulcers caused by H. pylori bacteria can heal once the bacterias are killed. This can be done through antibiotics along with acid-suppressing medicine and may take 2 weeks to resolve.
Gastric ulcers get healed more slowly as compared to duodenal ulcers. Uncomplicated gastric ulcers may take 2-3 months to heal completely.