Gastric Ulcers

Written by David Heitz | Published on September 9, 2013
Medically Reviewed by George Krucik, MD, MBA on September 9, 2013

What Are Gastric and Duodenal Ulcers?

A peptic ulcer is an open sore. They are usually found in the lining of the stomach, esophagus, or upper small intestine. Ulcers that occur in the stomach are called gastric ulcers. Ulcers that occur in the upper area of the small intestine, which is called the duodenum, are called duodenal ulcers.

In the U.S., about 25 million people develop gastric and duodenal ulcers at least once during their lifetime. (Lucile Packard Children's Hospital at Stanford, 2013). 

What Causes Gastric and Duodenal Ulcers?

People once believed that stress and spicy foods were the main causes of these ulcers. Now, research has shown they usually are caused by a bacterium known as H. pylori. How this bacteria spreads remains unclear. Some believe it is spread by close contact such as kissing or even through food and water (Mayo Clinic, 2013).

Naturally occurring stomach acids may also bring on peptic ulcers.

Repeated use of aspirin or other over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may also cause these ulcers. 

Who Is at Risk for Gastric and Duodenal Ulcers?

Women and older people are more likely to develop these ulcers. However, a recent study shows that young men are more likely to experience duodenal ulcers, while older women have more gastric ulcers. This has been linked to aspirin use (Thorsen, et al., 2013).

High intake of aspirin also increases risk.

Some experts believe that alcohol, tobacco, and caffeine use contribute to the prevalence of the ulcers. There is very little research to back this up. Still, most doctors agree that people already experiencing the ulcers should stay away from these substances (Medscape, 2012).

Cancer patients can be at risk for these ulcers when undergoing radiation treatment or chemotherapy. The ulcers can sometimes go hand in hand with other infections. Conditions such as cystic fibrosis, hepatic cirrhosis, Crohn's disease, and HIV can also cause them.

If you've had an ulcer once, you are susceptible to having one again.

What Are the Symptoms of Gastric and Duodenal Ulcers?

The usual signs of a peptic ulcer are a sensation of gnawing, burning, or hunger in the stomach. Some patients also report a feeling of fullness.

Many people who suffer from peptic ulcers experience nausea. Vomiting often helps. Sometimes, however, the vomit can be bloody.

Other symptoms include bloody or tarry stools, weight loss, and chest pain.

Testing for Gastric and Duodenal Ulcers

To check for peptic ulcers, doctors look for the presence of the H. pylori bacteria when performing tests. They can find it by analyzing a patient’s blood, stool, or breath.

It is also necessary to conduct an endoscopy (insertion of a camera with light) down the throat to examine the upper digestive system. This can help doctors understand the type of ulcer and whether it may be malignant. They can also see if the ulcer has perforated the stomach, which can be a very serious complication.

An endoscopy is commonly used because biopsies can be taken during the procedure. Sometimes, an upper GI series of traditional X-rays is used instead.

How Are Gastric and Duodenal Ulcers Treated?

There are many treatments for gastric and duodenal ulcers. Usually, only medication is required.

A doctor may prescribe antibiotics to kill the H. pylori bacteria. But some strains are resistant to antibiotics.

There are medications that stop acid production. Proton pump inhibitors, omeprazole, and others help people whose ulcers come from taking too much aspirin.

There are also medications that heavily coat the stomach's lining. These make peptic ulcers less likely to occur. In mild cases, an over-the-counter antacid can provide temporary relief.

Sometimes surgery is needed, usually if an ulcer is bleeding, is cancerous, or has caused a perforation.

Recent research shows that as time lapses between peptic ulcer perforation and surgery, morbidity and mortality rates increase. Every hour counts (Surapaneni, et al. 2013).

What Is the Outlook for Gastric and Duodenal Ulcers?

Medication usually takes care of the problem. If surgery is done quickly, the prognosis usually is good. 

How Can You Prevent Gastric and Duodenal Ulcers?

One of the best ways to prevent peptic ulcers is to use common sense when taking aspirin or other NSAIDs. The American College of Gastroenterology issued guidelines for taking these medications in 2009.

Above all, the guidelines call for an H. pylori test before starting an aspirin regimen. If the test is positive, aspirin or NSAID use should be discontinued. If that is not possible, other medications can be used to prevent the onset of the ulcers (Lanza, et al., 2009).

People who know their ulcers are caused by aspirin should switch to acetaminophen or another pain reliever.

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