Stomach Ulcer: Causes, Symptoms, and Diagnosis

Oct 11, 2019 | General Medical

It’s likely that 1 in 10 people will be diagnosed with a peptic ulcer or stomach ulcer in their lifetime. A peptic ulcer can occur at any age, and while many people believe that ulcers are directly related to stress, anxiety and stress are not the only causes of stomach ulcers. Most stomach ulcers are not incredibly serious and are relatively easy to treat. Read on to learn more about peptic ulcers, the symptoms you should look for, and how peptic ulcers are diagnosed and treated. 

About Stomach Ulcers

The contents of the stomach always include a high level of stomach acids and bile. Acidity can be quite toxic, and the lining of the stomach is coated with a thick, mucosal wall that protects the stomach from damage. When this wall of mucus begins to erode or fade away, the protection becomes ineffective. When this occurs, sores form where the mucosal wall once was. These sores are also known as ulcers.

A peptic ulcer is the broader term for all ulcers in the digestive tract, and there are two types. A gastric ulcer is a type of peptic ulcer that forms in the lining of the stomach, as described above. However, there is another type known as a duodenal ulcer, which forms in the lining of the small intestine. Both can be painful and can be problematic if left untreated; however, all types of peptic ulcers are relatively easy to treat. 

Peptic ulcers can occur at any age, but duodenal ulcers often form between the ages of 30 and 50 and are more common in male patients than female ones. Gastric ulcers often appear after the age of 60 and are more common in women than men. Some patients who have peptic ulcers have no noticeable symptoms, while others report symptoms such as burning pain. If left untreated, peptic ulcers can eventually cause internal bleeding, which can lead to the need for blood transfusions and hospitalization. 

What Causes Stomach Ulcers?

Stress and anxiety are widely associated with the development of stomach ulcers, but there are many more causes. In fact, the two leading causes of stomach ulcers are bacteria and medications. The bacteria most associated with the development of stomach ulcers is Helicobacter pylori (H. pylori), and overuse of ibuprofen is also linked to the occurrence of ulcers. In addition to ibuprofen, other nonsteroidal anti-inflammatory drugs (NSAIDs) can also contribute to peptic ulcers. The most common types of NSAIDs are aspirin and ibuprofen. Prescription NSAIDs, which are typically prescribed at a much higher dosage, are more likely to contribute to ulcers than the over-the-counter types, but overuse of OTC medications can contribute as well. 

Excess stomach acid, or hyperacidity, can contribute to the development of peptic ulcers but is not often a primary cause. Zollinger-Ellison syndrome is a rare condition that also causes excess stomach acid to be produced. 

Certain risk factors that contribute to ulcer development as well, such as:

  • Smoking
  • Frequent or heavy alcohol consumption
  • Overproduction of calcium
  • Steroid use
  • Genetics 

While ulcers typically affect adults and older people, they are possible in children. The risk is much higher for children to develop a peptic ulcer if their parents are smokers. 

Symptoms of Stomach Ulcers

The most common symptom of any type of peptic ulcer is indigestion. This often manifests as pain or discomfort in the stomach or abdomen, however, indigestion can also lead to heartburn. Many patients have a tendency to treat heartburn with over-the-counter antacids, which do work well for occasional episodes of indigestion or heartburn. However, if a patient is suffering from frequent heartburn, they should consult their healthcare professional for an evaluation. Frequent heartburn can be a symptom of many gastrointestinal disturbances, including ulcers and gastroesophageal reflux disease (GERD). It is important to note that some peptic ulcers may not present with symptoms at all in the beginning, and not all cases of ulcers have indigestion as a symptom. 

In most cases of peptic ulcer, however, at some point, the patient will notice a dull or burning pain in the stomach area that does not go away after a few days or a week. This is at the point where it’s imperative to be evaluated by a physician. 

Patients may also describe a feeling of hunger as a symptom. Other possible signs and symptoms of peptic ulcer include:

  • Nausea and vomiting
  • Sudden, unintended weight loss
  • Not eating due to pain
  • Bloating
  • Burping

Patients may find that symptoms are temporarily relieved by over-the-counter antacids, but symptoms come back the next day. Sometimes symptoms are so difficult to spot that a hole in the stomach may form (perforation), which is a serious condition. Always talk to your doctor, even if you’re experiencing intermittent heartburn or indigestion, as it may be indicative of a more serious cause. 

What Tests Diagnose Peptic Ulcers?

The most common way a stomach ulcer is diagnosed is through a question-and-answer session between doctor and patient, along with a physical exam. The doctor will likely ask where the stomach pain or indigestion is located, how long the patient has been experiencing it, and other questions related to diagnosing an ulcer. If the doctor believes that a patient has an ulcer, he or she may administer a stool test or a breath test, which looks for H. pylori infection. This way, the doctor can treat the underlying infection, which in turn treats the ulcer. 

If bleeding is suspected from a peptic ulcer, the physician will likely order more invasive tests to get a clearer, more thorough diagnosis. A barium enema with X-ray lets the healthcare professional see the lining of the gut via an X-ray. An endoscopy uses an endoscope (long, thin tube) with a camera attached at the end to see the lining of the gut. The doctor may also take a small biopsy during an endoscopy to give a more thorough diagnosis. In many cases, treatment comes in the form of lifestyle changes along with prescription antacids.

Peptic Ulcer Treatments

One of the first things a physician will require the patient to do is to adjust their diet along with changing other health habits. Patients should quit smoking and avoid the overconsumption of alcohol. The doctor will likely recommend adding a variety of different fruits and vegetables to the diet, along with more fiber. Probiotics (whether via supplement or through diet) can also help to limit stomach acid. The physician may also recommend supplements, such as extra vitamin C, zinc, and selenium to help keep stomach acid at bay. Avoiding caffeine can also aid in the treatment of a stomach ulcer. 

Treating H. pylori is up to the severity of the infection and each individual doctor’s discretion, but once the bacteria is treated, the ulcer usually disappears. If the ulcer is as a result of NSAID use, the patient will likely discontinue the medication in favor of another. Prescription medications can also help, such as proton pump inhibitors (PPIs), which cause a reduction in acid-producing cells, and H2-receptor antagonists, which prevent the stomach from producing acid. The doctor may also prescribe an antacid. 

In rarer cases, surgery is needed to correct an ulcer. Surgery is an option for an ulcer that does not respond to prior treatment, keeps returning, or is bleeding. Certain surgical procedures will remove the ulcer itself, sew tissue from an adjoining site onto the ulcer, cut the nerve to prevent stomach acid production, or tie off blood vessels. 

If you need more information about peptic ulcers or need to be seen by a physician, request an appointment at Gastroenterology Consultants of Savannah, P.C. today. We offer five convenient Georgia locations as well as one South Carolina location to ensure all of your Gi needs are being met.