Stomach ulcer

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A stomach ulcer is a sore in the lining of the upper digestive tract, usually found in the body of the stomach (gastric ulcer, as shown in the picture) or the upper part of the small intestine (duodenal ulcer).  Symptoms vary, but include dull or burning upper abdominal pain (often at night), pain made worse by food (gastric ulcer) or temporarily improved by food (duodenal ulcer), nausea and vomiting, filling up fast when eating and/or unintentional weight loss.  An undiagnosed and untreated ulcer can bleed and ultimately break through the lining of the stomach (perforate), leading to significant blood loss, infection and potentially death.

We used to think that stress and/or certain foods caused an ulcer.  Although these factors can make a preexisting ulcer worse, it is now believed that the bacteria H. pylori is the causative agent in many cases.  Other substances are stomach irritants and can cause or contribute to ulcer formation, including NSAIDs (such as aspirin, ibuprofen and naproxen sodium), prescription medications like prednisone, tobacco, alcohol and caffeine.  The typical diagnostic and treatment regimen is for a physician to check for H. pylori and, if present, treat the patient with combination antibiotic therapy for two weeks.  This is usually paired with an acid suppressing medication such as Prilosec or Prevacid, taken for six to eight weeks.  If symptoms don’t start to improve within one week or worsen in the interim, a fiberoptic scope is often used to help better evaluate the symptoms and fine tune the treatment plan…..Richard R Samuel, MD     Family Practice and Urgent Care   Hayden, ID  USA 

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