Health Centres - Peptic ulcers
What is an ulcer?
An ulcer is damage to the inner lining (the mucosa) of the stomach or the upper part of the intestine (duodenum). A bacterium,
Why do people get ulcers?
The most common cause is infection with
The second most common cause is damage inflicted by aspirin or non-steroidal anti-inflammatory drugs (NSAIDs, such as diclofenac or naproxen) used by many for arthritis, rheumatism, backache, headaches and period pain.
Ulcers can also occur in people weakened by severe disease (such as chronic respiratory disease or major trauma). This is thought to result from poor oxygenation to the lining of the stomach.
Occasionally (in Europeans), a stomach ulcer is caused by cancer and rarely, some other specific illness is found to be responsible. Such conditions include:
- excessive production of hydrochloric acid in the stomach (Zollinger-Ellison syndrome)
-
Crohn's disease (an inflammatory condition affecting any part of the gut).
What does an ulcer feel like?
This varies greatly from person to person. Many people never realise that they have an ulcer. Others feel pain or a burning sensation in their upper abdomen.
The symptoms are often described as indigestion, heartburn, hunger pangs or dyspepsia.
Some sufferers find that eating actually helps settle their discomfort for a while, others find it makes them worse. Citrus drinks, spicy and smoked foods can make the pain worse.
Finally, it is important to stress that most people with a stomach ache do not have ulcers.
An ulcer is potentially dangerous - the warning signs are:
- difficulty swallowing or regurgitation
- persistent nausea and vomiting
- vomiting blood or vomit with the appearance of coffee grounds
- black or tar-like stools
- unintended weight loss
- anaemia (paleness and fatigue)
- sudden, severe and incapacitating abdominal pains.
-
Smoking and drinking alcohol puts you at greater risk of developing an ulcer. It's a good idea to stop smoking and moderate your alcohol intake.
- If for any reason you have an increased risk of ulcers, it is important to seek advice before considering NSAIDs or aspirin.
- If you experience the symptoms of an ulcer, consult your doctor. You may need a thorough examination in hospital with a gastroscopy. This is a safe and commonly performed procedure that will help your doctor decide whether your symptoms are due to an ulcer or something else.
How does the doctor make a diagnosis?
The diagnosis can only be definitely confirmed or excluded by a gastroscopy. A gastroscopy (or upper GI endoscopy) involves the visualisation of the lining of your gullet (oesophagus), stomach and duodenum with a small fibre-optic camera that can be swallowed.
The gastroscopy is more helpful in diagnosis if it is performed before you take any acid-reducing medication.
An X-ray examination (involving a Barium meal) can also be used, but it is not quite as reliable or helpful a diagnostic tool as a gastroscopy. It does not offer any opportunity to take tissue samples (biopsies) for microscopic diagnosis of tissue abnormalities and infection.
What is Helicobacter pylori?
- elderly people
- people in developing countries.
Those who carry this bacteria today have most probably been infected during childhood. The risk of acquiring infection for an adult is modest - less than 1 per cent every year.
The bacteria may also have a role in the development of cancer of the stomach.
If the bacteria is not eliminated, most people get a recurrence of their ulcer after a short period of time.
How to detect an infection by Helicobacter pylori
- Gastroscopy, followed by biopsy of the lining of the stomach (the mucosa) can allow the bacteria, inflammation, and tissue abnormalities to be assessed under a microscope. From a biopsy, tissue from the mucosa can be cultured and an indicator fluid (a urease test) can verify the presence of bacteria.
- 'Breath test' examination: the expired air is tested, after ingestion of a small amount of labelled urea (in crystalline form).
- Blood sample: if you have, or have had,
- Stool sample: this technique is not yet perfected. But the method involves tracing bacterial DNA in stool samples.
© Copyright 1998 - 2008 NetDoctor.co.uk - All rights reserved 
