Stomach or duodenal ulcer (peptic ulcer)

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What is it about ?

The inside of the digestive tract is lined with a mucous membrane. It protects the stomach and the duodenum in particular against the effects of gastric acid, which has a biting action. If the lining is not optimal or if too much acid is produced, a sore can develop in the lining. A small crater appears, which is the ulcer (also called peptic ulcer or peptic ulcer). The nerves in the lining end up being exposed deep within the ulcer. They then come into contact with the acidic content, causing severe pain.

The ulcer can be in the stomach (gastric ulcer) or in the first part of the small intestine, the duodenum (duodenal ulcer). We speak, more generally, of peptic ulcer.

The main causes of peptic ulcer disease are infection with bacteria (Helicobacter pylori) and taking aspirin oranti-inflammatory drugs (NSAIDs). In the past, it was believed that stress could be a cause, but this is not true. Stress, however, can make symptoms worse.

Peptic ulcer disease can cause complications: bleeding or perforation (very rare) of the wall.

What is its frequency?

About 1 in 10 people eventually develop a peptic ulcer. It is twice as common in men than in women. Infection with Helicobacter pylori does not necessarily lead to a peptic ulcer. This only happens in 1 to 2 in 10 infected people.

How to recognize it?

The main symptom of peptic ulcer disease is severe pain in the upper abdomen. There may also be nausea, from stomach pains, referrals, bloating, vomiting, loss of appetite, weightloss or, rarely, black stool or some vomiting blood. In the latter two cases, the peptic ulcer is so deep that it causes bleeding.

The sudden onset of unbearable pain that does not go away and is accompanied by fever or even loss of consciousness may be due to perforation of the wall at the ulcer.

With peptic ulcer disease, the pain usually decreases with eating or taking an antacid. When after a few hours the stomach is empty, the pain gets worse again. You may also have pain at night.

How is the diagnosis made?

The doctor makes the diagnosis of peptic ulcer based on a gastroscopy. He introduces a camera through his mouth to see the inside of the stomach and the first part of the small intestine (the duodenum). If the doctor finds an ulcer, they often do a biopsy, which means they take a piece of tissue from the edge of the ulcer to examine it in the lab.

He also looks for the cause of the ulcer. He looks at what medicine you have taken and if there is an infection Helicobacter pylori.

What can you do ?

If you have a peptic ulcer, use the following tips:

  • Stop smoking. Smoking leads to increased production of stomach acid, in addition to other negative effects.
  • Don’t drink alcohol.
  • Stop her taking non-steroidal anti-inflammatory drugs. Paracetamol is not a problem. If you are taking aspirin to thin the blood, talk to your doctor. He may be able to prescribe another medicine for you.
  • Eat small portions several times a day.
  • Avoid fatty foods.
  • Chew food well.
  • Avoid foods and drinks that worsen symptoms such as spicy meals, citrus fruits, onions, peppermint, chocolate, coffee, acidic or carbonated drinks.

In case of black stool or from vomiting blood, consult a doctor promptly. Indeed, it may indicate bleeding.

If you have ever had a peptic ulcer and need to take painkillers or anticoagulants, tell your doctor or pharmacist. In this way, he can adapt the drug treatment or give additional medicine to protect the stomach.

What can your doctor do?

Peptic ulcer can be treated well with medication. Treatment depends on the location and cause of the ulcer. If the doctor finds an infection with Helicobacter pylori, you will be given a combination of two antibiotics and a medicine that stops acid production (proton pump inhibitor (PPI)).

In some cases, it is necessary to redo gastroscopy to check if the stomach ulcer is completely healed.

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Source

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