Ulcers can be extremely painful and require proper care in order to heal. The term “ulcer” is commonly used and often sparks curiosity, as there are many myths surrounding the food and treatment associated with it. Ulcers refer to erosions, lesions, wounds, or sores that occur in the inner lining of the stomach, duodenum, or esophagus. Depending on their location, they may be referred to as gastric or duodenal ulcers. The term “peptic ulcer” is a general term used to describe an ulcer.
Understanding ulcers
Ulcers occur when the acid in the stomach damages its lining. Although acid is necessary for digestion, it can sometimes harm the stomach itself. There are various reasons why ulcers develop, but the most common cause is an infection by a bacterium called H. pylori. This spiral-shaped germ typically resides in the innermost layer of the stomach without causing any issues. However, it can occasionally disrupt the lining and lead to an ulcer. Essentially, an ulcer arises from an imbalance between protective and harmful factors. The stomach produces protective chemicals called prostaglandins through the action of an enzyme or catalyst called cyclooxygenase.
Excessive acid production can be harmful to the lining of your stomach and can overwhelm its natural defenses. When you regularly use pain relieving medications like NSAIDs, it can cause irritation and inflammation in your stomach and small intestine, potentially leading to ulcers. These medications inhibit the action of certain enzymes and reduce the protective prostaglandins. Additionally, smoking and excessive drinking can increase acid secretion and further irritate the lining of your stomach and intestines. Stress is also known to stimulate acid production and weaken the protective lining, making you more susceptible to ulcers. In rare cases, a medical condition called Zollinger-Ellison syndrome, which involves a tumor in the pancreas that produces acid-stimulating factors, can also lead to ulcers.
Symptoms
Pain is the most common indication of an ulcer. Typically, this discomfort is experienced in the upper abdomen, right below the chest. It can be described as a burning or gnawing sensation and may persist for a few minutes or even several hours. The pain may worsen at night or when the stomach is empty. However, it can be temporarily alleviated by acid-neutralizing medications or foods that help neutralize the acid. Although the pain may temporarily disappear, it often returns after a few days. In addition to pain, ulcers can also lead to bloating, burping, vomiting, indigestion, stomach upset, poor appetite, and weight loss.
Diagnosis
The doctor might inquire about your symptoms and check if you have been using NSAIDs for a chronic condition such as knee or back pain, or after a serious injury. They will also inquire about your smoking and drinking habits and conduct an examination of your abdomen. If there is a suspicion of an ulcer, they will need to rule out an infection caused by H. pylori. This may require blood, stool, or breath tests. Additionally, you may need to undergo a series of X-rays after consuming a white solution known as a barium meal. This will provide a clear view of your stomach and intestines, allowing any ulcers to be detected. In some cases, an endoscopy may be necessary. During this procedure, a flexible tube equipped with a camera will be inserted through your mouth into your stomach to directly examine the ulcer. If an ulcer is identified, a biopsy may be performed, where a small piece of tissue is taken from the ulcer for further examination under a microscope in the laboratory.
Treatment
Ulcers can be effectively treated through a two-step approach. Firstly, the H. pylori infection is eradicated, and secondly, the secretion of acid in the stomach is either reduced or neutralized. Antibiotics such as amoxicillin, clarithromycin, and metronidazole are commonly prescribed to eliminate the bacteria. To decrease acid production, H2 blockers like ranitidine, famotidine, or cimetidine are utilized. These medications work by blocking histamine, a chemical signal that triggers acid production in the stomach. Proton pump inhibitors (PPIs) such as omeprazole, pantoprazole, rabeprazole, or lansoprazole can effectively block the acid-secreting pumps in the stomach. Additionally, antacids containing substances like Sodium bicarbonate (baking soda) and calcium carbonate can help neutralize excessive acid. The specific combination of these treatments depends on the individual’s symptoms and the severity of the ulcer.
Triple therapy is a combination of antibiotics, PPIs, and H2 blockers that is commonly used to treat ulcers caused by H. pylori. Antibiotics such as clarithromycin, amoxicillin, or metronidazole, along with a PPI, are taken for a period of 10 to 14 days. This treatment regimen has been proven to be both safe and effective.
There are other medications available that can be helpful. For instance, there are cytoprotective agents like sucralfate, which creates a protective coating on the lining to safeguard it. Another option is misoprostol, a drug that prevents ulcers in individuals who regularly take NSAIDs. In treating H. pylori, a 10 to 14-day course of triple therapy is usually effective in 80-90% of cases. Additionally, other medications may be prescribed for a duration of 4 to 8 weeks.
Tips on healing your ulcer
To promote the healing process of an ulcer, it’s important to steer clear of things that can exacerbate it. One key step is to quit smoking and be mindful of your alcohol consumption. It’s also advisable to consult with your doctor and reduce your intake of NSAIDs. Additionally, finding ways to reduce stress and incorporating relaxation techniques like meditation or yoga can be beneficial.
Food has been associated with ulcers. Consuming spicy and fried food can aggravate an ulcer. However, restricting your diet is no longer considered an effective treatment for ulcers. Contrary to popular belief, milk does not have the ability to heal ulcers. To prevent acid reflux from the stomach into the food pipe, it is advisable to avoid lying down right after eating.
Complications
Some ulcers may not improve with treatment even after 8 to 12 weeks. These ulcers are considered refractory and require a more intensive therapy. In some cases, surgery may be necessary to remove the ulcer or reduce acid secretion if the ulcer does not heal, recurs, bleeds, perforates, or causes obstruction.
If left untreated, an ulcer can worsen over time. This can lead to symptoms such as a feeling of nausea, vomiting blood, dark or bloody stools, unexplained weight loss, changes in appetite, and indigestion. You may also experience fatigue, shortness of breath, palpitations, or irregular heartbeats, which could indicate the development of anemia. It is important not to ignore these signs and to seek immediate medical attention.
Outlook
Taking some precautions can help you stay away from H. pylori. Make sure to maintain cleanliness. Consume safe and clean water and eat food that is properly washed and cooked. Remember to wash your hands before every meal and after using the toilet. The initial step in taking care of your ulcer is to avoid triggers such as smoking and alcohol. It’s important to note that ulcers are not always a cause for concern. Follow your entire treatment plan to help your ulcer heal and prevent any additional damage.
