Ulcers

What is an ulcer?

An ulcer is an open sore on an internal surface of the body. The sore is the result of a break in the mucous membrane that doesn’t heal.

Types of ulcers

Peptic ulcers are sores found in the lining of the esophagus, stomach or small intestine and are classified by their location within those sections of the digestive tract.

  • Duodenal ulcers: Open sores located at the beginning of the small intestine, known as the duodenum
  • Esophageal ulcers: Open sores found in the lining of the esophagus, the tube that passes food from the mouth to the stomach
  • Gastric ulcers: Open sores that form on the inside of the stomach

What causes a peptic ulcer?

Peptic ulcers form when the acid in the digestive tract eats away at the protective mucous layer that coats the linings of the esophagus, stomach or small intestine. This may be due to an increase in acid formation or a decrease or weakness of the mucous layer caused by:

  • Bacteria: Helicobacter pylori (H. pylori) are commonly found in the mucous layer of the stomach and small intestine. The presence of these bacteria may cause inflammation, resulting in an ulcer.
  • Pain relievers: Regular use of over-the-counter pain relievers, like ibuprofen, naproxen, aspirin and others, may irritate or inflame the linings of the stomach or small intestine.
  • Other medications: Certain prescription medications may also cause ulcers, including bisphosphonates used to treat osteoporosis.

Symptoms of an ulcer

Pain is the main and most common peptic ulcer symptom. It is caused by both the ulcer itself and any digestive acid that comes in contact with it. The pain may be felt anywhere from the middle of the abdomen up to the breastbone and may:

  • Feel better temporarily after taking acid-reducing medication or eating certain foods that shield linings from acid
  • Feel worse on an empty stomach
  • Flare up at night
  • Stop and then return sporadically

Other Symptoms

In some cases, ulcers may cause severe symptoms including:

  • Bloody stool that appears dark or black
  • Changes in appetite
  • Nausea or vomiting
  • Unexplained weight loss
  • Vomiting blood that may appear red or black in color

Diagnosing a Peptic Ulcer

To effectively diagnose a peptic ulcer, your physician may recommend diagnostic testing such as:

  • Capsule endoscopy
  • Testing for the presence of H. pylori through a breath, blood or stool test
  • Upper endoscopy
  • Upper gastrointestinal series

What treatment options are available for peptic ulcers?

Depending on what causes the ulcer, treatments may include:

  • Antibiotics to kill H. pylori bacterium
  • Proton pump inhibitors that reduce stomach acid and promote healing of the lining
  • Acid-blocking medications, also known as histamine (H-2) blockers

Refractory Ulcers

Refractory ulcers are peptic ulcers that fail to heal. This may be due to:

  • Certain H. pylori bacteria that are resistant to antibiotics
  • Diseases that commonly cause ulcer-like sores, such as Crohn’s disease
  • Extreme overproduction of stomach acid
  • Infection of the mucous lining that is not due to H. pylori
  • Repeated, regular use of over-the-counter pain relievers
  • Smoking or use of other tobacco products
  • Stomach cancer
  • Taking medication incorrectly

When refractory ulcers occur, recommended treatment may include making lifestyle changes to promote healing and taking different antibiotics.

For more information on ulcers or to schedule an appointment with one of our specialists, contact us today.

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