How Do You Know If You Have Peptic Ulcer?

Peptic ulcer is a disease condition which has no definite pattern with climate, diet, geographic location or culture. The incidence of peptic ulcer is on the increase in many developing countries.

Peptic ulcer is a break in the wall of the gastrointestinal tract as a result of exposure to the actions of gastric secretions which include hydrochloric acid and pepsin.

Recent research findings now show that peptic ulcers are not only caused by gastric secretions but also by bacteria (Helicobacter pylori). The part of the gastrointestinal tract commonly affected by ulcer includes the oesophagus, stomach and duodenum. The jejunum could be affected sometimes after surgical anastomosis (connection) to the stomach.

Types of peptic ulcer

• Gastric ulcer: This affects the stomach. It is mostly located on or near the lesser curvature of the stomach.
• Duodenal ulcer: This is located in the first 2cm of the duodenum away from the pylorus.

Peptic ulcer also can be classified as acute if it is sudden and of short duration, and chronic if it is of long duration.

Gastric and duodenal ulcers present with many similarities. Nevertheless, there are also identifiable differences between the two forms of ulcer.

Some types of peptic ulcer heal fast and completely while others refuse to heal completely they become chronic. There is also the tendency for some forms of ulcer to recur.

Signs and symptoms of peptic ulcer

• Burning abdominal pain: Abdominal pain that has a burning or gnawing (chewing) sensation is characteristic of peptic ulcer. This pain comes as a result of the hydrochloric acid of the stomach touching the nerve endings of the stomach or the duodenum.
• Heartburn: This is a burning sensation felt in the oesophagus which is mostly due to regurgitation or reflux of acid from the stomach. This often manifests as burning sensation around the chest region.
• Abdominal pains 2-3hrs after food: This is usually coming up as the stomach begins to get empty. The gastrin or gastric acid produced gets in direct touch with the sore surface of the stomach thereby producing pains.
• Pain at night: Pain can also occur in the night. Duodenal ulcer pain is often felt around the back while gastric ulcer pain is felt on the boundary between the abdomen and the chest (epigastric region).
  
• Indigestion: Indigestion is often a common occurrence in peptic ulcer.
• Vomiting: Vomiting and the feeling to vomit (nausea) are also very common.
• Pains relieved by antacids: Peptic ulcer pains are often relieved on taking antacid tablets or suspension. The antacid helps to dilute the effect of the gastric acid thereby bringing a relief to the person.
• Weight loss: Patient is likely to lose weight as a result of recurrent gnawing pain and vomiting or nausea.

Symptoms of peptic ulcer that require immediate action

Should you experience any of the listed symptoms, there would be need for you to inform your gastroenterologist immediately as these symptoms are considered an emergency:

• Sudden increase in abdominal pain: If there is a sudden increase in the abdominal pain or the quality of the pain is sharp then notify your gastroenterologist.
• Vomiting of blood: If you vomit a bright red blood or vomitus that is coffee ground in colour it means there may have been some form of intestinal perforation.
• Blood in your stool: If there is black or tarry stool, there has been intestinal bleeding. Call your gastroenterologist.
• Fainting: If you experience a fainting attack, it could be a sign of severe intestinal bleeding. Call your gastroenterologist immediately.

Peptic ulcers are painful sores or ulcers that develop in the lining of the stomach, lower esophagus, or small intestine (the duodenum), usually as a result of inflammation caused by the bacteria H. pylori.

• It can also occur due to continuous erosion of the secreting acids.
• It can also occur due to long term use anti-inflammatory medicine such as aspirin or ibuprofen.
• Peptic ulcer can get worse if not treated.

Types of Peptic ulcer:

There are three types of peptic ulcers:

• Gastric ulcers: ulcers that develop inside the stomach
• Esophageal ulcers: ulcers that develop inside the esophagus
• Duodenal ulcers: ulcers that develop in the upper section of the small intestines, called the duodenum

Causes of peptic ulcer:

Different causes of peptic ulcer may include:

• Helicobacter pylori (H. pylori)-A bacteria that can cause stomach inflammation
• Frequent and long-term use of anti-inflammatory drugs
• Drinking  of too much alcohol
• Radiation therapy
• Stomach cancer
• Smoking

Risk factors of peptic ulcer:

There are certain things which can increase the risk of peptic ulcer, they are:

• Having spicy food
• Being at age of 50 or older
• Smoking or chewing tobacco
• Stress
• Drinking alcohol
• Some medical problems such as lung, kidney and liver disease
• Having long term anticoagulant, anti-inflammatory and steroid drugs

Symptoms of peptic ulcer:

Certain symptoms may include:

• Burning pain in the stomach
• Bloating 
• Heartburn 
• Nausea or vomiting
• Loss of appetite
• Dark or black stool
• Weight loss 

Diagnosis of peptic ulcer:

Certain diagnosis technique may include:

• Test for H.pylori- Certain blood  and stool test must be done to look for H.pylori bacteria in the body
• Upper GI- X-rays of stomach, esophagus and small intestine is done by using a barium contrast X-ray method so that the areas of ulcer can e seen and treated.
• Endoscopy- An endoscopy can e done to detect ulcer for the person who are at higher age that 45 and may have high risk of stomach cancer, or have difficulty swallowing or anemia.

Treatments of peptic ulcer:

Certain treatments would include:

• Medications- use of antibiotics, proton pump inhibitors (PPIs) may help to relive the symptoms and release stomach acid.
• Change of lifestyle- Change of lifestyle and preventing the risk factors of ulcer can help to reduce the symptoms of ulcer.
• An upper endoscopy can treat a bleeding a ulcer.