- Diseases, Disorders & Conditions
Identifying Signs and Symptoms of Stomach Ulcers
Stomach ulcers can be very serious and even life-threatening. Understanding how to identify the signs and symptoms of stomach ulcers is, therefore, important.
First, it is important to understand that stomach ulcers cannot and should not be diagnosed without a doctor's input as there are too many variables to be considered. Even if you have all the symptoms, there are other medical conditions that could be the culprit. So, don't rely on this or any other item on the Internet for diagnosis or treatment of any condition.
Example of the Difference between Signs and Symptoms
Mr S. has a blocked artery in his heart.
He has symptoms of chest pain, shortness of breath, sweating and nausea. Symptoms are what you experience of feel.
When he is seen in the E.R., he has signs of heart disease such as changes on his EKG, a high troponin level on his labs and a low oxygen level. Signs are what the doctor sees or what shows up on lab or other testing.
Before discussing the signs and symptoms of stomach ulcers, it is important to make sure the medical terminology is clear.
STOMACH: The stomach is a sac-like organ between the esophagus (food pipe) and the first part of the small intestine (duodenum). The stomach collects and is involved in the beginning mechanical processes of digestion, by churning and breaking down food. The stomach also secretes enzymes such as gastrin that aid in this early phase of digestion. Some people use "stomach" to refer to all parts of the gastrointestinal (digestive) system or all organs in the abdomen. In discussing stomach ulcers, the term refers only to the anatomic stomach organ.
ULCER: An ulcer is a disruption in the lining of a membrane. Ulcers represent the erosion of the normal tissue, causing a raw area or even a hole all the way through the lining or organ.
SYMPTOM: A symptom is something that you, the patient, notices that points to a disease or disorder.
SIGN: Medically, a sign is something a doctor sees or finds on exam or testing that points to a disease or disorder.
Causes of Stomach Ulcers
Stomach ulcers are also called gastric ulcers and form in the lining of the stomach. Gastric ulcers are a type of peptic ulcer. The other type is duodenal ulcer which forms in the duodenum (the top part of the small intestine). Peptic ulcers may form in the lining of the lower esophagus (food pipe), as well.
A quick word about the main causes of peptic ulcers can help us understand the symptoms and signs we might experience.
Very often, gastric ulcers (and the other peptic ulcers) are caused by, or related to Helicobacter pylori infection.H. pylori is a bacterium that has been found to be present in the gastrointestinal systems of many people. Some people with H. pylori develop serious acid reflux or peptic ulcers and others have no symptoms.
H. pylori can be detected by blood, breath or stool tests. If you have symptoms of acid reflux, gastritis or ulcer, you will be treated with antibiotics (usually two different ones) plus an acid blocker for two weeks or more.
NON-STEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)
NSAID usage is another main cause of stomach ulcers in people who take these medications frequently over an extended period of time. The purpose of NSAID medications is to relieve pain. They do this quite well by inhibiting certain enzymes. Unfortunately, these enzymes are also needed to produce other substances called prostaglandins that help to protect the stomach lining. Without the prostaglandins, the lining of the stomach can be more easily damaged by stomach acid. Eventually, ulcers can form and bleed.
Some people who have stomach ulcers don't have either of these major risk factors.
What are the Symptoms of Stomach Ulcers
The stomach secretes acid in order to digest food. The lining of the stomach is usually adequate protection for the tissues underneath to keep it from being damaged by the acid. When that lining is disrupted for any reason, the tissues can be eaten away by acid. When this process occurs more rapidly or frequently than the healing response can fix it, ulcers can form.
SYMPTOMS OF STOMACH ULCERS
- Pain shortly after eating
- early satiety (feeling full after small meals)
- nausea and vomiting
- vomiting blood
- blood in the stool
SIGNS OF STOMACH ULCERS:
If you present to your doctor or the emergency room with the above symptoms, the doctor may start to look for signs that can point to a diagnosis. If a gastric ulcer is present, you may have
- abdominal tenderness or 'guarding' when your upper abdomen is examined
- blood in the stool (that you can't see) detected on a rectal exam
How is a Stomach Ulcer Diagnosed
The history and physical exam will give hints that a stomach ulcer exists. Once it is suspected, an endoscopy can be done to confirm the diagnosis. An endoscope is a thin, flexible tube with a camera on the end. It can be passed down the esophagus, usually under a degree of sedation, to actually see the lining of the stomach. Ulcers, if present, can be seen and photographed.
As mentioned above, there are blood and breath tests that can be performed to confirm the presence of the H. pylori bacterium, the most common cause of peptic ulcers.
Other tests, such a xrays taken with special dye can also be used to detect ulcerations in the stomach and other parts of the digestive system.
This is what an ulcer looks like on endoscopy.
Treatment of Stomach Ulcers
Aside from causing pain, stomach ulcers can be the site of infection in the GI tract. More dangerously, they can erode through the wall and cause contamination of the abdominal cavity with stomach contents. This perforation is a life-and-death surgical emergency. The abdomen must be washed out and the hole sewed or stapled closed. A course of antibiotics will also be necessary.
For these reasons- to relieve pain and prevent complications, stomach ulcers are treated when they are diagnosed.
Controlling the amount and pH level of the stomach acid helps the lining of the stomach heal. Several kinds of medicines are used to achieve these goals.
block acid production
cimetidine, famotidine, ranitidine,
Tagamet, Pepcid, Zantac
Proton Pump Inhibitors
block acid production- stronger and longer lasting than H2 blockers
esomeprazole, lansoprazole, omeprazole, pantoprazole, rabeprazole
Nexium, Prevacid, Prilosec, Protonix, Aciphex
treat H. pylori infection
Protection of Stomach Lining
treat H. pylori and 'coat' the stomach to protect from acid