Peptic Ulcers

Peptic ulcers are open sores that develop on the lining of your stomach and your upper small intestine. Peptic ulcers can be gastric (occurring on the inside of the stomach) or duodenal (occurring on the duodenum – inside of the upper portion of your small intestine). The most common symptom of a peptic ulcer is stomach pain and the most common causes are H. pylori bacteria and long-term use of nonsteroidal anti-inflammatory drugs. Spicy foods and stress can make peptic ulcers worse. Nearly three quarters of people with peptic ulcers don’t have any symptoms.

Symptoms

You are likely to have a peptic ulcer if:

• You have a burning pain in your stomach
• Your stomach feels bloated and full
• You belch frequently
• You are intolerant of fatty foods
• You have heartburn
• You have nausea (feeling sick)

Less common and more severe symptoms include:

• Vomiting
• Vomiting blood (which may appear black or red)
• Dark or black stools (which indicate blood in the stools)
• Trouble breathing
• Nausea and vomiting
• Unintentional sudden weight loss
• Feeling faint
• Loss of appetite

Possible complications of peptic ulcers can include:

• Infection (peptic ulcers can eat a hole through the wall of your stomach or small intestine and put you at serious risk of an infection in your abdominal cavity (peritonitis)
• Internal bleeding (peptic ulcers are open sores and can bleed)
• Obstruction (peptic ulcers can block the digestive tract and cause you to lose weight through swelling and scarring, block the passage of food through the tract and even cause you to vomit

When to see an expert at Ahmeys?

If you are experiencing any of the severe signs listed above, we recommend that you call and or book an appointment with one of our experts at Ahmeys. You may be able to treat non-severe symptoms with over the counter antacids, acid blockers and painkillers, but speaking to one of our experts may help you to decide what treatment is right for you.

Causes

Peptic ulcers are caused by acid in the digestive tract eating away at the inner surface of the small intestine or stomach. The acid can create a painful open sore that may bleed. Normally, your digestive tract is coated with a protective mucus layer, but if the acid in the tract is increased or the amount of mucus is decreased you could be at risk of developing a peptic ulcer. Peptic ulcers can be caused by:

• A H. pylori bacterial infection (more common in older age groups and can be lifelong unless it is treated with eradication therapy. Infections caused by this bacterium are common and don’t usually cause symptoms, but it can sometimes lead to recurring bouts of indigestion due to the inflammation of the stomach lining)
• Regularly taking ibuprofen, aspirin, and other painkillers classed as non-steroidal anti-inflammatory drugs
• Regularly taking other medications along with non-steroidal anti-inflammatory drugs such as anticoagulants, steroids and selective serotonin reuptake inhibitors (SSRIs)

You may have an increased risk of peptic ulcers if you:

• Excessively consume alcohol or cocaine
• Smoke
• Are stressed
• Eat spicy foods

Diagnosis

If you are concerned that you may have a peptic ulcer, call Ahmeys to book an appointment with one of our experts to discuss your symptoms and potential treatments. An expert at Ahmeys will review your symptoms and potentially recommend one of the following tests:

• A stool sample test (to check for internal bleeding and infection)
• A H. pylori breath test (involves drinking a glass of clear, tasteless liquid that contains radioactive carbon and blowing into a bag)
• A barium swallow test (involves drinking a barium solution, which shows up on X-rays as it passes through your digestive system)
• An endoscopy (a flexible tube is passed down through your throat and into your oesophagus and stomach to look for inflammation

Treatment

Once one of our experts has assessed you, they will discuss treatment options with you. Your treatments will be based on what one of our experts determines is the cause of your peptic ulcer. Treatment may also depend on the results of any potential diagnostic tests. One of our experts may prescribe:

• Antacids
• Histamine 2 (H2) blockers (medicines that decrease acid production)
• Proton pump inhibitors (PPis) such as omeprazole (medicines that decrease acid production more effectively than H2 blockers
• If you have been diagnosed with an H. pylori infection by one of our Ahmeys experts, it is likely that you will also be prescribed antibiotics
• Medications that protect the lining of your stomach and small intestine (such as sucralfate and misoprostol)

How to manage your symptoms?

• Remember to wash your hands thoroughly with warm water and soap, especially after using the toilet and before eating and preparing food to avoid being infected with H. pylori bacteria
• If travelling abroad, practice good food and water hygiene and avoid undercooked food or any food or drink that has been prepared or contains unsafe tap water
• Moderate your diet and make sure that you are eating vitamin rich foods with vitamins A and C (vegetables and whole grains) to help your body heal
• Consider limiting your milk consumption (while drinking milk can ease ulcer pain, it can later cause excess acid)
• Consider switching pain relievers and talk to one of our experts about what pain killer could suit you and help to avoid further irritation
• Avoid or reduce your consumption of alcohol
• Avoid recreational drugs
• Avoid spicy, acidic or fried foods (as these irritate the stomach lining)
• Try to manage and reduce your stress
• Try to get enough sleep (as this can help your immune system)