What is an ulcer?
An ulcer—also known as a peptic ulcer—is an open sore inside the body that forms in the lining of the stomach, the upper section of the small intestine (duodenum) or the tube that passes food from the mouth to the stomach (esophagus). Ulcers occur when a mucous membrane within the lining doesn’t heal after digestive acid has eaten away at it.
There are three types of ulcers:
- Duodenal ulcers: Sores that form at the beginning of the duodenum
- Esophageal ulcers: Sores that are found in the lining of the esophagus
- Gastric ulcers: Sores that develop on the inside of the stomach
What causes ulcers?
Ulcers are typically the result of an Helicobacter pylori (H. pylori) bacterial infection that creates inflammation in the lining, resulting in open sores. Constant use of over-the-counter pain medications (e.g., Advil®, aspirin, Aleve®) may also result in an ulcer.
It should be noted that consuming spicy foods and stress do not cause ulcers. However, they may make ulcer symptoms worse.
What are the symptoms of an ulcer?
While the majority of patients do not show any symptoms of ulcers, those who do may experience:
- Burning pain in the stomach
- Feeling full
- Intolerance for fatty foods
More severe symptoms may include:
- Changes in appetite
- Dark blood in stool
- Difficulty breathing
- Fainting sensation
- Unexplained weight loss
- Vomiting/vomiting blood (may appear red or black in color)
How are ulcers diagnosed?
Following a physical exam and an exploration of medical history, a physician may recommend diagnostic tests, such as a/an:
- Breath test to detect the presence of H. pylori
- Capsule endoscopy to examine the lining of the duodenum by swallowing a pill-sized camera
- Endoscopy to inspect the upper digestive system with a camera attached to a thin tube
- Upper gastrointestinal series to view the upper digestive system using X-ray imaging
How are ulcers treated?
Depending upon the cause, treatments may include:
- Acid-blocking medications, known as histamine (H-2) blockers
- Antibiotics to kill H. pylori
- Proton pump inhibitors, a type of medication that reduces stomach acid and promotes healing
- In rare cases, surgery may be necessary
What happens if ulcers fail to heal?
When ulcers fail to heal following initial treatment, they are referred to as refractory ulcers. Refractory ulcers may be the result of:
- Certain H. pylori bacteria that are resistant to some types of antibiotics
- Continued regular use of over-the-counter pain relievers
- Diseases that normally cause ulcer-like sores, including Crohn’s disease
- Other infections of the mucous that are not the result of H. pylori
- Overproduction of stomach acid
- Smoking cigarettes or consuming other tobacco products
- Stomach cancer
- Taking medication incorrectly
Treatment for refractory ulcers includes lifestyle change and/or change in antibiotics.