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Last Updated: Mar 19, 2020
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Ulcer - Symptom, Treatment And Causes

About Types Symptoms Causes Diagnosis Treatment Complications Long term effects Home remedies Expert advice

What are Ulcers ?

Ulcers are breaks or holes in the protective lining of the stomach or duodenum. Duodenal ulcers are more common than stomach ulcers. Comparatively rare, esophageal ulcers, which forms in the esophagus (swallowing tube) are often the result of alcohol abuse or exposure to medications like certain anti-inflammatory drugs and antibiotics.

While secretion of excess stomach acids plays a key role in the formation of ulcers, in a recent research, it has also been found that bacterial infection is another major cause of ulcers. There are medical evidence that Helicobacter pylori (H. pylori) bacteria is present in more than 80% of stomach ulcers and 90% of duodenal ulcers.

What are the types of ulcer?

TYPES OF ULCERS are:

  1. PEPTIC ULCERS:

    These develop on the inside lining of the stomach and the upper portion of the small intestine or esophagus. They form when digestive juices damage the lining of the stomach or intestine. These are most often caused by inflammation after being infected by H.pylori and long-term use of painkillers. There are three types of peptic ulcers:

    • Gastric ulcers
    • Oesophageal ulcers
    • Duodenal ulcers
  2. ARTERIAL ULCERS:

    These are open sores that develop on the outer side of ankle, feet, toes and heels. They develop from damage to the blood vessels due to lack of blood flow to the tissue. Arterial ulcers appear as red, yellow or black with hairless skin and leg pain.

  3. VENOUS ULCERS:

    It is the most common type of leg ulcers and is often formed on the leg, below the knee, and on the inner area of the ankle. They are formed because of damaged veins which is caused by inadequate flow of blood back to the heart. A person may also have inflammation, swelling, itchy skin, scabbing and discharge.

  4. MOUTH ULCERS:

    These are small sores or lesions that develop in the mouth or at the base of gums. They are also known by the term canker sores. Mouth ulcers are triggered by biting the inside of the cheek, hard teeth brushing, food allergies, hormonal changes, vitamin deficiencies, bacterial infection and other serious illnesses.

  5. GENITAL ULCERS:

    These develop on the genitals including vagina, penis, anus or surrounding areas. Genital ulcers usually occur because of trauma, inflammatory diseases, sexually transmitted infections or allergic reactions to skincare products. They are accompanied by a rash, pain, itching, swollen glands in the groin and fever.

What are the early symptoms of an ulcer?

The early symptoms of ulcers may vary from one person to another. In general, the notable symptoms are as follows:

  • Having a burning sensation and pain in the stomach. It is mainly due to stomach acid which makes the condition worse in the stomach. The pain can be reduced by eating certain foods and acid-reducing medicines.
  • Intolerance to fatty foods
  • Having heartburn sensation
  • A feeling of fullness or bloating
  • Vomiting or nausea, in some cases, vomiting may appear to be in red or black color
  • Dark bloody stools
  • Experiencing appetite changes
  • Having unexplained weight loss

What are the causes of ulcers?

Causes of ulcers are as follows:

  • Stomach Ulcers are more likely to develop in people having a sedentary lifestyle or poor eating habits.
  • Oesophageal ulcers often result from exposure to medications such as certain antibiotics or anti-inflammatories and alcohol abuse.
  • Ulcers also form as a result of excessive stomach acid secretion, consuming fatty and oily foods, alcohol, caffeine and tobacco. All of these factors contribute to a build-up of stomach acids which decay the protective lining of the stomach, esophagus and duodenum.
  • According to a recent theory, bacterial infection is also one of the causes of peptic ulcers. For example, H.pylorii is present in 80% of stomach ulcers and 90% of duodenal ulcers.
  • Overuse of over-the-counter painkillers such as ibuprofen, aspirin or naproxen, alcohol consumption, psychological stress and smoking exacerbate the formation of ulcers, especially in those with H.pylori.
  • Stomach ulcers are more probable to occur in elderly people. With advancing age, the pylorus relaxes and allows excess bile to seep up into the stomach which erodes the stomach lining.
  • People with type A blood group are more prone to get cancerous stomach ulcers.
  • Duodenal ulcers develop in those who have an O blood group type. This is because people of this blood group are unable to produce certain substances on the surface of blood cells that protect the lining of the duodenum.

How to diagnose ulcers?

  • Urea breath test:

    The patient is diagnosed using a urea breath test where a specific drink is given to patient which gets broken down by H.pylori bacteria and the breath is then analyzed to see if he/she has H.pylori infection.

  • Stool antigen test/Blood test

    A blood test is done to analyze whether it contains antibodies to H.pylori which is nowadays replaced by stool antigen test.

  • Gastroscopy

    This is done to look inside the stomach directly and detect whether or not it contains an ulcer. The process involves passing an endoscope with a camera at one end into the mouth and the duodenum. A mild sedative may be given before the procedure and an anesthetic may be sprayed onto the throat to make the procedure more comfortable.

    The images captured by the camera usually confirm or rule out the ulcer. However, sometimes a small tissue sample may also be needed to be taken and tested for the same. This is usually an outpatient procedure and the patient is usually sent home the same day.

  • Endoscopy:

    Endoscopy is another procedure to diagnose ulcers. PPIs and H2 receptor antagonists are used to reduce acid levels until the swelling goes down. If an obstruction is caused by scar tissue, it may either need endoscopic balloon inflation.

How to treat ulcers?

Ulcers are easier to treat usually with antacids and antibiotics. There are also several other drugs that reduce the amount of acids produced by the stomach. A person suffering from ulcers should consult a physician. Ulcers if left untreated can lead to serious illnesses like anemia and stomach carcinoma.

Most of the ulcers are treated using various medications and in some cases, surgical procedure is required. Antibiotics may be used to eradicate H.pylori whereas anti-ulcer medications are used to inhibit the acid secretions and heal ulcers.

In cases of bleeding or perforated ulcers, Esophagogastroduodenoscopy may be performed and surgery is recommended. Your physician may advise to quit smoking, limit alcohol consumption and avoid overuse of NSAID's to prevent the development of ulcers.

What are the complications of ulcer?

Complications of these are quite rare but can get very serious. Some of the complications of stomach ulcers are as follows:

  • INTERNAL BLEEDING:

    It is the most common problem which occurs when the ulcer forms at the site of a blood vessel. Bleeding can either be slow and long-term leading to anemia or rapid and severe causing a person to pass blood in vomit or stools. Endoscopy is usually used to find the cause of bleeding.

  • PERFORATION:

    It is a rarer complication but can be quite serious if occurs. Perforation enables the bacteria of your stomach to escape and infect the lining of your abdomen causing peritonitis. From here, the infection rapidly spreads into the blood causing sepsis before spreading elsewhere. This comes with the risk of multiple organ failure and can be fatal if left untreated.

  • GASTRIC OUTLET OBSTRUCTION:

    In this condition, an inflamed stomach ulcer obstructs the normal passage of food through digestive tract. Symptoms are:

    • Repeated vomiting with large particles of undigested food particles
    • Persistent feeling of bloating or fullness
    • An easy feeling of fullness even after small meals
    • Unexplained weight loss

What are the long term effects of ulcers?

The ulcers, when left untreated for a long time, can lead to the following situations:

  • Bleeding: Patients may experience internal bleeding and blood loss, leading to anemia and blood in vomiting or stools. This may require hospitalization or transfusion.
  • Infection: The ulcer when left untreated can perforate through the walls of the stomach or small intestine and can cause serious infection in the abdominal cavity region.
  • It can lead to the blockage of the passage of the food via the digestive tract and thus can lead to symptoms of vomiting, nausea, weight loss, swelling in the intestine, etc.

What are the home remedies for an ulcer?

Home remedies for ulcer are as follows:

1. Flavonoids: Foods rich in these are:

  • Soybeans
  • Legumes
  • Red grapes
  • Kale
  • Broccoli
  • Apples
  • Berries
  • Tea's especially green tea

These are gastroprotective and help fighting against H.pylori.

2. Probiotics: Foods containing these are:

  • Buttermilk
  • Miso
  • Kimchi
  • Yogurt
  • Kefir

They are helpful in wiping out the H.pylori and ease the recovery as well.

3. Honey: It is a powerful antibacterial and antioxidant and fights against H.pylori.

4. Garlic: The extract of garlic can prevent the growth of H.pylori as tested on lab, animals and human trials.

5. Cranberry

6. Fruits, vegetables and whole grains: Polyphenols are known for protecting the ulcers and foods containing them are dried rosemary, Mexican oregano, dark chocolate and flaxseed.

7. To reduce acid reflux pain, you must also limit:

  • Caffeine and other caffeinated beverages
  • Carbonated beverages
  • Chocolate
  • Chilies and hot peppers
  • Processed foods
  • Foods with a high amount of salt
  • Deep-fried foods
  • Acidic foods like citrus and tomatoes
  • Limit alcohol
  • Avoid over-eating
  • Avoid eating within three to four hours of sleep

What does Experts Says about ulcers :

As per medical experts, people with blood group A are more prone to get stomach ulcers, which at times can also get cancerous. It has also been observed that duodenal ulcers often happens with people with blood type O since they are unable to produce certain substance which helps in protecting the lining of their duodenum.

Popular Questions & Answers

I have a venous ulcer and was prescribed diclofam a while back. It's started hurting again. Can I take the diclofam again on my own?

MBBS, MS - General Surgery, FRCS
General Surgeon, Mumbai
Diclofam is not good to be taken continuosly. Instead you have to look at the reason why your ulcer is not healing and do the necessary treatment.
2 people found this helpful

What is proper time to take pantocid hp. Doctor suggested to take in the morning and evening. But I am confused about the time. Can I take it after having dinner?

MBBS, MD - General Medicine, DNB- Gastroenterology
Gastroenterologist, Bathinda
Hi in pantocid hp there's pack of 6 tablets 3 morning and 3 evening in these 3 one (pantocid) you have to take empty stomach and rest 2 after breakfast or dinner.

Actually 3 years ago I took 2 ibuprofen pills 400 mg and suffered severe stomach pain next day. I looked up online and misdiagnosed this as gerd as painkillers is the cause of gerd. But actually it was possible gastritis or ulcer. I immediately stopped ibuprofen and took rabeprazole as an antacid. Now the thing is that for gastritis/ulcer, it is important to have a continuous therapy of ppi for 2-3 weeks. But I thought that 2 pills can not damage stomach that much. I used to take rabeprazole but with a gap of 1-2 days only when I felt pain in stomach. So basically used as" as needed" basis for symptomatic relief. This was my first mistake. But the bigger picture to my surprise was that my acidity and stomach pain issues lasted for about 6 to 8 months. And I used ppi as needed as I knew its a safe medication. But never did a course for 1-2 months with the medicine. I am having anxiety about 2 things. Question 1- did this happen because stomach lining could not repair due to inadequate acid suppression? Is stopping nsaid altogether not effective enough for stomach lining to repair itself without the introduction of ppi or h2 blocker in the body? Question 2- I regret that I did not see a doctor for this problem, later came to know that h pylori could also be responsible. Final question- if h pylori bacteria is not eradicated and leads to ulceration and person just takes occasional antacids for relief, and I assume the case becomes worst --progresses to gi bleeding or perforation. What is the ultimate prognosis. Is there any lifetime compromise with the digestion process. Are there patients eventually saved with endoscopic stoppage of blood followed by antibiotics and ppi suppression to kill the bacteria. Or vagotomy (removal of stomach) is also required in extreme cases. And also if any mortality/ death due to this event? Kindly enlighten me. I have faith in you. And also please comment on stomach lining ability to repair itself after stopping nsaids, but not providing enough acid suppression (assuming there is continuous irritation of hydrochloric acid on the affected inflamed/ulcerated area from time to time). Additional information - I never smoked or drank alcohol in my life.

MBBS, MS - General Surgery, Fellowship of Indian Association of Gastrointestinal Endo Surgeons (FIAGES)
IVF Specialist, Meerut
lybrate-user, you are thinking too much, gastritis after nsaid is very common esp in chronic use that's is the reason they are combined with ppi, gastric ulcer leading to bleeding and perforation are not very common it is usually seen with chronic...

For last 3 and half months I am suffering from duodenal ulcers and mild gastritis .now I am taking razo 20 and nervijen p tablet, how many months can I take these tablets what happens if I take these tablets another one month. Is eating garlic, hot turmeric water, onion,ginger, honey,yogurt, carrot, cabbage juice heals duodenal ulcers and mild gastritis fast please tell me.

MBBS, MD - General Medicine, DNB- Gastroenterology
Gastroenterologist, Ahmedabad
Within 8-12 weeks usually the ulcers heal. I am not aware of any diet which has property of ulcer healing. But you can consume whatever you like and feel is healthy.
4 people found this helpful

I have ulcer. The symptoms are serious pain at the back with stomach ache, sometimes I vomit and also purge. I do take flagyl, omeprazole and cimetidine and gascol. Want to know if the treatment is in order. Also went for blood text and was diagnosed of ulcer caused by h.pylori.

MBBS, FCPS - Surgery, DNB ( General Surgery ), Fellowship in Minimal Access Surgery, Fellowship of Indian association of gastroendoscopic surgeons, Fellowship of association of colo rectal surgeons of India
General Surgeon, Delhi
Hi, Get An upper GI endoscopy done, You can continue to take omeprazole or start on H pylori kit which contains PPI.Please share your endoscopy report and Kindly make a personal consultation to me regarding the specific medication and surgical opi...

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