As fearful and confusing the medical term might sound, peptic ulcer is nothing but wounds that develop in the oesophagus (esophageal ulcer), stomach (gastric ulcer), and small intestine (duodenal ulcer). These open sores are formed due to tissue damage and usually form when the acids produced in the stomach erode the lining of the digestive or gastrointestinal tract.
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It is approximated that over 10 million people suffer from peptic ulcers in India annually. As per recent research, while both men and women are at an equal risk of developing peptic ulcers, the mortality rate stands at one death per 10,000 cases. Yes, it may lead to death in rare cases.
However, not to unnecessarily alarm you, with timely consultation and medication, the disease can generally be cured within a couple of months. From symptoms to precautions, let’s touch upon everything you might ever need to know about peptic ulcers.
Causes
The word ‘peptic’ itself is related to acid. These ulcers are caused when excess acid is produced in the digestive tract and instead of helping digest food, erodes the protective layer of mucous in the stomach or small intestine. This creates inflammation and a painful open sore in the inner surface, which may or may not bleed. The two most common causes of peptic ulcer are infection via the Helicobacter Pylori bacteria and regular intake of pain killers.
The H. Pylori bacteria reside inside the protective mucous layer and causes inflammation of the stomach’s inner layer when excessive acid starts to permeate the tissue lining. The discovery of H. Pylori as the primary cause for peptic ulcers was so important, that Dr. Barry Marshall and Dr. J. Robin Warren were awarded the 2005 Nobel Prize in Medicine for this discovery.
Symptoms
When the mucous membrane erodes and causes a gradual breakdown of the tissue, a burning pain in the abdomen occurs, making it the most common symptom of peptic ulcer. This is merely to caution you and not to say that with even a mild stomach ache, you should get unduly worried.
The patient will usually encounter the pain at night, and it can be momentarily relieved or aggravated depending on what type of food you eat. As a peptic ulcer patient myself, I have felt that tangy foods especially tomato based preparations like rasam increase the likelihood of acidity at night. Taking antacids can also provide short-term relief. An empty stomach can worsen the pain as our body naturally produces more acids to satiate itself of hunger.
However, it is highly possible that a patient doesn’t experience anything at all except dull pains and minor discomfort. Nearly three-quarters of people with peptic ulcers don’t notice any symptoms. This unfortunately delays the entire process of diagnosis and treatment thereafter.
Other visible gastrointestinal symptoms include:
- Heartburn
- Nausea
- Excessive belching
- Indigestion
- Loss of appetite
- Feeling bloated
Some symptoms are more alarming like dark or black stool, vomiting blood, and inexplicable weight loss, in which case immediate medical help should be sought. A bleeding ulcer can make the person anemic and also cause a hemorrhage in some cases.
Diagnosis
Peptic ulcers are easy to diagnose. In low-risk cases, an upper gastrointestinal (GI) test is recommended. The patient is made to drink a white, chalky liquid called barium, post which an X-ray is taken of his stomach, oesophagus, and small intestine. The thick liquid enables the doctors to view and identify the ulcer. However, this method can sometimes miss small ulcers.
In cases that have a high risk of bleeding ulcers or stomach cancer, an upper endoscopy test is suggested. In this, a flexible, camera-equipped tube is lowered into the patient’s oesophagus and stomach. This enables the doctor to identify the exact condition of the ulcer and also remove tissue samples for examination.
To detect an H. Pylori infection, the doctor also often tests the patient’s blood, breath, or stool.
Treatment
The cure for peptic ulcer depends on its causal factors. In case of the aforementioned NSAIDs being the cause, medicines like proton pump inhibitor (PPI) are prescribed to reduce the production of acids in the stomach. This will enable the ulcer to heal gradually and naturally. This powerful acid-blocking drug can be prescribed till up to eight weeks. In this case, the doctor will also advise the patient to stop taking pain relieving tablets or suggest alternatives.
If an H. Pylori infection is responsible for the ulcers, antibiotics are given to kill the bacteria. But be forewarned, patients may experience certain side effects including diarrhoea due to the antibiotics. This medication can go up to two weeks.
Bleeding ulcers are usually treated during the upper endoscopy procedure itself. Also, small lifestyle changes like not mixing medicines with alcohol, limiting the intake of pain killers and quitting tobacco products can also help in the speedy recovery of peptic ulcers.
It is important that you make an appointment with your doctor, if you have signs and symptoms that worry you.
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