What
does a stomach Ulcer Feel Like
A
stomach ulcer is a sore that develops in the lining of the stomach or the first
part of the small intestine (duodenum) when the lining is eroded by stomach
acid. Pain is the most likely symptom, but not everyone with a peptic ulcer
experiences pain. Most ulcers heal and recur, so symptoms tend to come and go
Symptoms
of stomach ulcer
The
most common symptom of a stomach ulcer is a burning or gnawing pain that
develops in your abdomen (tummy).
However,
some stomach ulcers aren’t painful and are only noticed when a complication of
a stomach ulcer develops, such as bleeding from the ulcer.
Tummy
pain
The
pain caused by a stomach ulcer can travel out from the middle of your tummy up
to your neck, down to your belly button, or through to your back.
It
can last from a few minutes to a few hours and often starts within a few hours
of eating. You may also wake up in pain during the night.
Taking
antacids (indigestion medication) may relieve the pain temporarily, but it will
keep coming back if the ulcer isn’t treated.
Other symptoms
Less
common symptoms of a stomach ulcer can include:
indigestion
heartburn
loss
of appetite
feeling
and being sick
weight
loss
Some
people also find they burp or become bloated after eating fatty foods.
If
you develop signs of a serious complication, including:
vomiting
blood – the blood can appear bright red or have a dark brown, grainy
appearance, similar to coffee grounds
passing
dark, sticky, tar-like stools
a
sudden, sharp pain in your tummy that gets steadily worse
Causes
Peptic
ulcers are usually caused by an infection with Helicobacter pylori bacteria or
by medications that weaken the stomach or duodenal lining. These medications
include non-steroidal anti-inflammatory drugs such as ibuprofen or aspirin, and
contortionists.
A
stomach ulcer usually feels like burning, gnawing or aching pain anywhere from
the navel to the breastbone. This pain can last a few minutes to several hours,
and typically is worse when the stomach is empty.
Time
Frame
The
person may experience pain over a few weeks, once or several times a day. At
this point the pain may gradually disappear, then develop again within a year
or two
Warning
Bleeding
ulcers can have signs of tarry black stools or vomiting blood. A perforated
ulcer, or an ulcer that penetrates further than the upper layer of the lining,
causes sudden intense pain throughout the abdomen. This condition is a medical
emergency.
Treatment
Treatment
for most ulcers includes medicines to reduce stomach acid, such as proton pump
inhibitors. If the ulcer is caused by H. pylori bacteria, antibiotics are also
prescribed. Bismuth medications can help relieve symptoms and also kill some of
the bacteria.
It
is estimated that about 1 in 10 people in The Gambia will have a stomach ulcer
during some point in their life
Stomach
ulcers can affect people of any age, including children, but mostly in adults.
Stomach
ulcers, also known as gastric ulcers, are open sores that develop on the lining
of the stomach. Similar ulcers can occur in bit of intestine just beyond the
stomach, known as duodenal ulcers. Both stomach and duodenal ulcers are
sometimes referred to as peptic ulcers. Here the term “stomach ulcer” will be
used, although the following information applies equally to duodenal ulcers.
A
stomach ulcer is a defect in the lining of the stomach or the first part of the
small intestine. Normally, the lining of the stomach and small intestines is
protected against the irritating acids produced in your stomach. If this
protective lining stops working correctly and the lining breaks down, it results
in inflammation or an ulcer.
Most
ulcers occur in the first layer of the inner lining. A hole that goes all the
way through the stomach is called a perforation. A perforation is a medical
emergency.
The
most common cause of such damage is infection of the stomach by bacteria called
Helicobacter. Most people with peptic ulcers have these bacteria living in
their stomach and bowels tract. Yet, many people who have these bacteria in
their stomach do not develop an ulcer.
The
following also raise your risk for stomach ulcers:
Drinking
too much alcohol
Regular
use of aspirin, ibuprofen, naproxen, or anti-inflammatory drugs. Taking aspirin
once in a while is safe for most people.
Smoking
cigarettes or chewing tobacco
Small
ulcers may not cause any symptoms. Some ulcers can cause serious bleeding.
Abdominal
pain is a common symptom, but it doesn’t always occur. The pain can differ from
person to person.
Other
symptoms include:
Feeling
of fullness -- unable to drink as much fluid
Hunger
and an empty feeling in the stomach, often 1 - 3 hours after a meal
Mild
nausea (vomiting may relieve this symptom)
Pain
or discomfort in the upper abdomen
Upper
abdominal pain that wakes you up at night
Other
possible symptoms include:
Bloody
or dark tarry stools
Chest
pain
Fatigue
Vomiting,
possibly bloody
Weight
loss
Exams
and Tests
Diagnosis
The
diagnosis is mainly established based on the characteristic symptoms. Stomach
pain is usually the first signal of a peptic ulcer. In some cases, doctors may
treat ulcers without diagnosing them with specific tests and observe whether
the symptoms resolve, thus indicating that their primary diagnosis was
accurate.
Confirmation
of the diagnosis is made with the help of tests such as endoscopies or barium
contrast x-rays. The tests are typically ordered if the symptoms do not resolve
after a few weeks of treatment, or when they first appear in a person who is
over age 45 or who has other symptoms such as weight loss, because stomach
cancer can cause similar symptoms. Also, when severe ulcers resist treatment,
particularly if a person has several ulcers or the ulcers are in unusual
places, a doctor may suspect an underlying condition that causes the stomach to
overproduce acid.
To
diagnose an ulcer, your doctor will order one of the following tests:
There
is a special test performed by a specialist. A thin tube with a camera on the
end is inserted through your mouth into the GI tract to see your stomach and
small intestine. Also a series of x-rays taken after you drink a thick
substance called barium.
Special
test is also done on people who are at high risk for stomach cancer. Risk
factors include being over age 45 or having symptoms such as:
Anaemia
Difficulty
swallowing
Stomach
and bowel bleeding
Unexplained
weight loss
Your
doctor may also order these tests:
Haemoglobin
blood test to check for anaemia
Stool
occult blood test to test for blood in your stool
Treatment
involves a combination of medications to kill the bacteria (if present), and
reduce acid levels in the stomach. This strategy allows your ulcer to heal and
reduces the chance it will come back and you must take all of your medications
exactly as prescribed.
You
may also be prescribed this type of medicine if you must continue taking
aspirin for other health conditions.
•
If a peptic ulcer bleeds a lot may be needed to stop the bleeding. Methods used
to stop the bleeding include injecting medicine, or applying metal clips to the
ulcer. Surgery may be needed if bleeding cannot be stopped, or if the ulcer has
caused a tear (perforation).
Bleeding
inside the body (internal bleeding)
stomach
outlet obstruction
Inflammation
of the tissue that lines the wall of the abdomen
Perforation
of the stomach and bowels
Peptic
ulcers tend to come back if untreated. If you follow your doctor’s treatment instructions
and take all of your medications as directed.
Possible
Complications
Complications
of a stomach ulcer are uncommon, affecting around 1 in 50 people.
Some
of these complications are regarded as medical emergencies, although they are
rarely life-threatening. Older people aged over 70 are most at risk of
experiencing fatal complications of a stomach ulcer.
If
the underlying causes of a stomach ulcer are addressed, the ulcer usually goes
away after treatment. However, new ulcers can sometimes form so it’s important
to address the underlying cause of any ulcers.
When
to contact a medical professional
Seek
urgent help if you:
Develop
sudden, sharp abdominal pain
Have
a rigid, hard abdomen that is tender to touch
Have
symptoms of shock such as fainting, excessive sweating, or confusion
Vomit
blood or have blood in your stool (especially if it’s maroon or dark, tarry
black)
The
Diet
-
There are a couple of general guidelines to follow that are not food-specific.
Someone suffering from ulcers should try not to have periods of hunger, but he
should also avoid overeating. Neither condition will make the ulcer better. It
is best to eat regularly and refrain from eating for a few hours before
bedtime. He should chew thoroughly and take his time eating, and sit up both
during a meal and for about an hour afterward.
There
several types of food and drinks that he should avoid or pay close attention
to, so he can judge whether or not they irritate his stomach and make his
ulcers worse. Caffeinated drinks, such as coffee (even decaf) or soda, should
be avoided or limited, as should foods or beverages that are highly acidic,
such as citrus fruits and juices and tomato products. These items are likely to
increase acid production in the stomach, which is likely to cause irritation.
Spicy or highly seasoned food, alcohol and greasy foods should also be limited.
Also, while it is important to get plenty of fibber and fresh produce, someone
with ulcers should pay close attention to anything that may cause gas or other
discomfort, and limit them or remove them from the diet. Examples of those
foods include beans, broccoli and cabbage.
It
is a good idea to include a high-quality protein source at each meal. Dairy is
OK to have, but should be limited to about three servings per day. High fibber
foods are also recommended, especially whole grains, fruits and vegetables.
Antacids can be taken, and the user should follow the directions carefully.
Aspirin
For
further information, you can see specialist at the Edward Francis Small Teaching
Hospital in Banjul, and in a number of NGOs and private clinics. or email:
drh_azadehmd@yahoo.com and text to00220 7774469/3774469
Author:
DR AZADEH Senior Lecturer Medical School at the University of the Gambia,
Senior Physician, Clinical Director at Medicare Health Cervices
