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What are Gastric Ulcers?

Gastric ulcers also known as stomach ulcers are the formation of open sores in the lining of the stomach.

Causes of Gastric Ulcers

The stomach temporarily stores food and produces enzymes and acid to digest the food. The mucosa that lines the stomach protects it from the acid and harmful microorganisms. When this protective layer is compromised, it can result in the formation of open sores that cause bleeding and abdominal pain. The main factors associated with gastric ulcers include:

  • Helicobacter pylori bacteria
  • Regular use of non-steroidal anti-inflammatory drugs (NSAIDs)

Other factors which may play a role or worsen symptoms include: 

  • Consumption of alcohol
  • Smoking 
  • History of radiation therapy
  • Physical stress

Symptoms of Gastric Ulcers

Symptoms of gastric ulcers include:

  • Stomach pain
  • Nausea and vomiting
  • Heartburn
  • Belching
  • Abdominal bloating
  • Feeling of fullness on eating
  • Loss of appetite
  • Weight loss

Severe symptoms include:

  • Perforation of the stomach wall
  • Bloody or black tarry stool
  • Hematemesis (vomiting blood)
  • Gastric outlet obstruction where the stomach becomes narrow due to inflammation and scarring preventing the passage of food.

Diagnosis of Gastric Ulcers

Your doctor will review your medical history and ask about your symptoms and any medications you are taking. A physical examination will then be performed. Your doctor may also recommend the following diagnostic tests:

  • Upper GI Series: This study uses a barium-based contrast material that enhances the details of structures observed on X-ray images. A series of images are obtained of the esophagus, stomach, and upper part of the intestine.
  • Endoscopy: This procedure involves the use of a long flexible tube (endoscope) with a camera at one end that is inserted through the mouth into the stomach. This will help your doctor to visualize the inner lining of your stomach to look for ulcers and also to obtain a biopsy sample.
  • Urea breath test: In this test, you will be asked to consume a special drink which is broken down by H. pylori in your stomach. Carbon dioxide produced as a byproduct can be detected in your breath thus denoting the presence of H. pylori.
  • Blood test: This test is performed to detect the presence of antibodies against H. pylori in the blood.
  • Stool test: H. pylori can also be detected on stool examination.

Treatment for Gastric Ulcers

Treatment for gastric ulcers is based on the root cause. Some of the common therapeutic measures include:

Conservative methods

  • Antibiotics: Your doctor may recommend antibiotics to kill H. pylori.
  • H2 receptor antagonists: This medication blocks acid production in the stomach allowing the ulcer to heal.
  • Proton pump inhibitors: Thesemedicationsalso reduce acid production in the stomach and are stronger than H2 receptor antagonists.
  • Antacids: Antacids work to neutralize stomach acid.
  • Lifestyle changes: This includes limiting the use of NSAIDs and avoiding alcohol and smoking as well as foods that can worsen your symptoms.

Most cases of gastric ulcers are treated by conservative methods. Surgery is rarely recommended for refractory ulcers and complications. Your doctor may recommend:

  • Endoscopic laser treatment: This can help control bleeding from an ulcer.
  • Partial gastrectomy: This method involves partial removal of the stomach to remove an ulcer or to control acid levels.
  • Vagotomy: This involves cutting the vagus nerve or its branches to control acid secretion.
  • Surgical closure of an area of perforation with sutures
  • Tying of Artery: The artery to the ulcer will be removed or tied to prevent bleeding.
  • Pyloroplasty: This method involves widening the passage from the stomach (pyloric sphincter) to facilitate emptying of the stomach contents into the intestine.