What You Should Know About Peptic Ulcers

7/19/2018

Think that burning sensation in your stomach is just the orange juice you had for breakfast? That’s possible, but it could also be a sign of peptic ulcer disease. Peptic ulcers are sores that develop in some part of the digestive tract. These sores typically form as a result of inflammation caused by the bacteria H. pylori, or from erosion caused by an imbalance of stomach acids.

“Peptic ulcers are usually silent, meaning that people may not even know that they have an ulcer,” said Jessica Winn, MD, Gastroenterologist at Moberly Regional Medical Center. “They may seek medical care when the ulcer has become more severe and caused complications such as bleeding, perforation or blockages. Many people take common medications (such as NSAIDs) daily and this may lead to an ulcer.”

There are three types of peptic ulcers – gastric inside the stomach, esophageal inside the esophagus and duodenal in the upper section of the small intestine. The vast majority of peptic ulcers are gastric or duodenal, and it’s estimated that 10-15% of the adult population of the U.S. is living with a peptic ulcer.

Only about a quarter of people with ulcers experience symptoms. In some cases, eating a meal can ease the pain, while in others, eating only makes the pain worse. The most common symptoms include abdominal pain, bloating, or the feeling of fullness, belching, heartburn, nausea and/or vomiting.

For some patients, the first indication that they have a peptic ulcer is when that ulcer starts to slowly bleed, causing symptoms of iron-deficiency anemia. If you have any of the digestive symptoms listed above, you need to be particularly aware of any signs that you might be anemic – pale skin color, shortness of breath with physical activity, fatigue or lightheadedness. An ulcer that is bleeding more heavily may cause stools that are black and tarry, or signs of blood in your stool or vomit. These latter symptoms can be an indication of a life-threatening condition, and you should proceed immediately to an emergency room.

So, why do some people get ulcers and others – even with a similar lifestyle and diet - don’t?

“The cause of peptic ulcers is a defect in the lining of the wall of the stomach or small bowel,” said Dr. Winn. “It is most commonly caused by a bacteria H.Pylori and infection of this organism is related to how common it is in one’s country. Another factor includes the use of NSAIDs and that is also patient dependent.”

The cause of an ulcer can’t always be determined, but the two most common factors are the presence of Helicobacter pylori (H. pylori), and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). H. pylori is a bacterium that lives within the mucus in the digestive tract that can sometimes cause inflammation in the stomach lining that can lead to an ulcer. The risk is greater if you smoke.

NSAIDs are among the most commonly used medications in the world, but they can make it hard for your digestive tract to protect itself from stomach acids. Moreover, these medications reduce the ability of your blood to clot, which can make a bleeding ulcer much more dangerous. Medications in the NSAID category include aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve).

NSAIDs can also be present in combination medications used to treat colds or stomach upset, so you must be cautious about proper dosing, and talk to your physician or pharmacist about any prescription or over-the-counter product you intend to take. If you use multiple medications, there’s a good chance you are taking more NSAID than you realize. Your risk of NSAID-related ulcers is higher if you drink alcohol, use corticosteroids, are over the age of 65, or have had ulcers in the past.

The important thing is not to ignore signs of digestive pain or dysfunction that last more than a few days. Ulcers – and potentially related anemia – can be diagnosed with lab work, imaging, and/or an upper GI endoscopy. Your condition can be treated at most any stage with some combination of medication and lifestyle changes. The consequences of not getting diagnosis and treatment can be devastating, and are quite avoidable.

To make an appointment with Dr. Winn, call (660) 263-0524.

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