Stomach Ulcers

What is a stomach ulcer?

Stomach ulcers, which may be known as peptic ulcers, are painful open sores in the lining of the stomach. Gastric ulcers develop on the inner lining of your stomach while duodenal ulcers develop on the inside of the upper part of your small intestine. They occur when the thick layer of mucus which protects your stomach from digestive enzymes is reduced as this enables the digestive acids to destroy the tissues lining your stomach.

What causes a stomach ulcer?

Stomach ulcers cannot be attributed to a single cause. However, certain factors decrease the mucus lining of your stomach which leads to an ulcer. The most common ones are

  • An infection by Helicobacter pylori bacteria (H. pylori)
  • Long-term usage of certain painkillers. Taking aspirin, ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) may irritate and cause inflammation in the lining of your stomach and small intestine
  • Too much acid in your stomach, which may be hereditary as seen in Zollinger-Ellison syndrome, caused by lifestyle habits (e.g. stress, smoking) or consuming certain foods.


What puts you at risk of developing a stomach ulcer?

Certain factors may increase your risk of stomach ulcers, such as

  • Age, especially in those 50 years old and above
  • Having a family history of stomach ulcers
  • Smoking or tobacco
  • Drinking excessive alcohol
  • Frequent use of steroids

How do I know if I have a stomach ulcer?

Around three in four people with stomach ulcers do not have symptoms. However, if you do experience symptoms, common ones of a stomach ulcer include:

  • Burning stomach pain, which may worsen between meals or at night
  • Heartburn
  • Feeling of fullness or bloatedness
  • Intolerance of acidic foods
  • Nausea or vomiting

In more severe cases, symptoms include:

  • Dark blood in stools
  • Vomiting blood which may look red or black
  • A sudden and acute pain in your stomach that gets worse gradually
  • Feeling unwell
  • Unexplained weight loss

How are stomach ulcers diagnosed?

During a consultation session, your doctor will first take a medical history and carry out a physical examination. You will likely be scheduled for diagnostic imaging tests such as:

Urea breath test- This is done to check if you have a H. pylori infection.

Gastroscopy- A small, lighted tube called an endoscope is passed down your throat and into your stomach to check for abnormalities. This is carried out especially if you have severe, recurring symptoms of ulcers.

Barium swallow- You will swallow a white liquid containing barium during the X-ray. This creates clearer images during the series of your X-rays of your upper digestive system.

Why surgery to cure a stomach ulcer?

Surgery for stomach ulcers are usually done as an emergency. If an ulcer continues to grow until it creates a hole in your stomach or intestinal wall, it is called a perforated ulcer. Surgery is the main mode of treatment for a perforated ulcer, where your surgeon sews up the hole. Early management of the ulcer is needed to avoid severe problems which may occur without proper management

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