A gastric ulcer is a peptic ulcer that occurs in the stomach. Ulcers are open sores and peptic refers to the stomach, upper small intestine and esophagus.
No single cause has been found for gastric ulcers. However, it is now clear that a gastric ulcer is the end result of an imbalance between digestive fluids in the stomach and duodenum.
Gastric ulcers can be caused by:
* Infection with a type of bacteria called Helicobacter pylori (H. pylori)
* Use of painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve, Anaprox, Naprosyn, and others), ibuprofen (Motrin, Advil, Midol, and others), and many others available by prescription. Even aspirin coated with a special substance can still cause gastric ulcers.
* Excess acid production from tumors of the acid producing cells of the stomach that increases acid output, which occurs with Zollinger-Ellison syndrome.
What Are the Symptoms?
A gastric ulcer may or may not have symptoms. When symptoms occur, they include:
* A burning pain in the middle or upper stomach between meals or at night
* Nausea or vomiting
In severe cases, symptoms can include:
* Dark or black stool (due to bleeding)
* Vomiting blood (can have a "coffee-grounds" appearance)
* Weight loss
* Severe pain in the mid to upper abdomen
How Serious Is this Condition?
If not properly treated, gastric ulcers can lead to serious health problems, including:
* Perforation (a hole through the wall of the stomach)
* Gastric outlet obstruction from swelling or scarring that blocks the passageway leading from the stomach to the small intestine.
Taking NSAIDs can cause any of the above without warning. The risk is especially concerning for the elderly and for those with a prior history of having gastric ulcer disease.
Who Is More Likely to Get Gastric ulcers?
People are most likely to develop gastric ulcers if they:
* Are infected with the H. pylori bacterium
* Take NSAIDs such as aspirin, ibuprofen, naproxen, and many others
* Have a family history of gastric ulcers
* Have another illness, such as liver, kidney or lung disease
* Drink alcohol regularly
* Are 50 years older
How Are Gastric Ulcers Diagnosed?
A doctor may prescribe a series of PPIs or proton pump inhibitors to determine if the symptoms decrease.
If needed, your doctor may recommend a procedure called an upper endoscopy. It involves inserting a small, lighted tube (endoscope) through the throat and into the stomach to look for abnormalities.
Most doctors will now test for H. pylori and will treat specifically for that in addition to giving medications to reduce the symptoms.
How Are Gastric ulcers treated?
Though gastric ulcers often heal on their own, don’t ignore their warning signs. If not properly treated, gastric ulcers can lead to serious health problems.
There are several ways in which gastric ulcers can be treated, including making lifestyle changes, taking medication and/or undergoing surgery.
To treat an gastric ulcer, first eliminate substances that can be causing the gastric ulcers. If you smoke or drink alcohol, stop. If the gastric ulcer is believed to be caused by the use of NSAIDs (non-steroid, anti-inflammatory drugs), they need to be stopped.
* Proton pump inhibitors medications (PPI). Proton pump inhibitors reduce acid levels and allow the gastric ulcer to heal. They include Prilosec, Prevacid, Aciphex, Protonix, and Nexium. Some are available over the counter and some are available by prescription only.
* Antibiotics. If the gastric ulcer is caused by an H. pylori infection, then antibiotics are used. There are multiple combinations of antibiotics that are taken for one to two weeks along with a PPI. Some doctors also recommend taking Pepto-Bismol.
* Upper Endoscopy. Bleeding gastric ulcers are a medical emergency and require immediate attention. Some bleeding gastric ulcers can be treated through the endoscope, while most require surgery.
* Surgery. Sometimes an operation is needed if the gastric ulcer has created a hole in the wall of the stomach or if there is serious bleeding.
The best treatment is always prevention. To prevent gastric ulcers:
* Don't smoke.
* Avoid over consumption of alcohol.
* Don't overuse NSAID (non-steroid, anti-inflammatory drugs).
If you have symptoms of a gastric ulcer, contact your doctor or a gastroenterologist.
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