A B C D E F G H I J K L M N O P R S T U V W

ULCER OF THE STOMACH

How does an Ulcer of the Stomach occur ?

Ulcers are formed by damage to the layer of mucus, the shiny substance that lines and protects the gut. This damage allows hydrochloric acid, made in the stomach, to penetrate the surfaceof the stomach. Some of the drugs which produce gastritis and gastric erosions, such as those used for arthritis, are known to interfere with the mucus lining and to bring about inflammation beneath it.

Why does an Ulcer of the Stomach occur ?

Both ulcers and gastritis can be triggered by many factors. Smoking is a common cause. Painkillers like aspirin and other anti-inflammation drugs can break down the mucus barrier, causing gastritis and ulcers. Steroid (cortisone-like) drugs can increase the acid of the stomach and also appear to interfere with the mucus lining.These agents appear not only to make ulcers occur, but also to make existing ulcers more likely to be painful, to bleed, or to perforate (burst). Sometimes gastric ulcers can be associated with a bacterium, Helicobacter pylori. If this is the case, the infection needs to be treated.

Treatment Involved for an Ulcer of the Stomach

When a gastric ulcer is suspected, it will need to be confirmed by either a barium meal x-ray or an upper gastrointestinal (GI) examination involving the doctor passing a tube through your mouth into the stomach,so that he can examine its lining (endoscopy). This enables the position, size and depth of the ulcer to be assessed. Occasionally, a gastric ulcer is found to be malignant(cancerous). This is confirmed by taking a small piece of tissue from the edge of the ulcer through the endoscope. It is then examined under a microscope. Nevertheless, most ulcers are benign (non-cancerous). Diet is not as important as was previously thought, although alcohol should be stopped and spicy foods avoided. Smoking should also be stopped. It stimulates acid and will delay healing. Antacids are given to neutralize the stomach acid, ideally four or more times a day after food. You may be given a drug called sucralfate, which works by coating the ulcer and protecting it from acid, or drugs called H2-blockers which reduce the amount of acid formed.These go by the name of cimetidine, ranitidine or omeprazole.H2-blockers should not be used as and when pain occurs,but must be taken continuously for the exact period agreed with your doctor. If the bacterium Helicobacter pylori is present,then triple therapy with bismuth tablets and two antibiotics is given. An operation is usually needed only for ulcers that perforate (burst) and occasionally for those that bleed (pepticulcer surgery).

During Treatment for an an Ulcer of the Stomach

Symptoms usually improve by the end of the first week. Notify your doctor if any pain or indigestion is still present after two weeks. Diarrhoea and constipation occur quite commonly with the antacids used. H2-blockers mayproduce vagueness and confusion in elderly people. Tripletherapy for Helicobacter pylori can cause diarrhoea and darkstools. A repeat endoscopy is usually performed approximately 4 weeks after starting treatment. This is to confirm that healing is taking place. Bleeding of an ulcer can occur. Vomiting of blood or coffee grounds material or the passing of black bowel motions are a sign of this. Sometimes there may bejust faintness (due to a fall of blood pressure), or paleness(due to anaemia). This is particularly if the bleeding is slowor on-and-off, as occurs with some of the irritant painkillers. The doctor needs to know immediately if any of these occur. Perforation (bursting) of an ulcer produces more or less severe, continuous upper abdomen pain, often with shock and collapse. The patient needs to go to hospital immediately.

After Treatment for an Ulcer of the Stomach

Gastriculcers may occasionally recur. This is more likely to be the case if you have not corrected the various factors known to bring about ulcer change in the first place.

If an Ulcer of the Stomach is left untreated

Gastric ulcers may heal by themselves, but there is a greater risk of delayed healing, bleeding, or bursting. There is no evidence that achronic (simple) gastric ulcer ever become malignant. Cancerous ulcers are usually malignant right from the start, and it is for this reason that the specialist will arrange a biopsy of the edge of the ulcer at the time of endoscopy.