Gastric ulcer
Definition
A gastric ulcer
is a break in the normal tissue that lines the stomach.
See also: Duodenal ulcer
Alternative Names
Ulcer - stomach; Peptic disease; Stomach ulcer
Causes
Non-cancerous (benign) gastric ulcers are caused by an imbalance between stomach acid, an enzyme
called pepsin, and the natural defenses of the stomach's lining. This imbalance leads to inflammation, which can be made worse by aspirin and nonsteroidal anti-inflammatory medications (NSAIDs) such as ibuprofen.
Risk factors for benign gastric ulcers include:
- Use of aspirin and NSAIDs
-
Helicobacter pylori
(H. pylori
) infection
-
Chronic gastritis
- Smoking
- Increasing age
- Mechanical ventilation (being put on a breathing machine)
- Certain blood clotting problems
Stress does not cause or worsen gastric ulcers.
Symptoms
Note: There may be no symptoms.
Exams and Tests
Treatment
For people with Helicobacter pylori
infection, the main goal is to get rid of the bacteria that causes the infection. Many different medicines work. They usually include either an H2 receptor antagonist such as famotidine (Pepcid) or nizatidine (Axid) or a proton pump inhibitor such as omeprazole (Prilosec) or esomeprazole (Nexium) to suppress acid, combined with two antibiotics.
After you finish your medicines, your doctor will likely order a test to make sure that the H. pylori
infection is gone.
Those who do not have an H. pylori
infection may be prescribed ulcer-healing medications such as antacids, H2 receptor antagonists, or proton pump inhibitors. Long-term treatment may be needed.
If the ulcer bleeds, endoscopy
can control bleeding in most cases.
Surgery may be recommended for persons who do not respond to medicines or endoscopy. Surgical procedures for gastric ulcers include:
- Vagotomy -- cuts the vagus nerve, which controls the stomach's production of gastric acid
- Partial gastrectomy
-- removes part of the stomach
Self-help measures include eating several small meals a day at regular time periods and avoiding the following:
- Smoking
- Tea, coffee, and soft drinks containing caffeine
- Alcohol
- Aspirin and NSAIDs
Outlook (Prognosis)
Most ulcers heal with medication in 6 to 8 weeks. Recurrence is common, but is less likely if H. pylori
infection is treated and acid-blocking medications are continued.
Possible Complications
- Bleeding from the ulcer
- Perforation (hole) in the stomach
- Blockage in the stomach that prevents movement of stomach contents
Complications can often be corrected by medication, endoscopy, or (in rare cases) with surgery.
When to Contact a Medical Professional
Call your health care provider if symptoms of gastric ulcer develop.
Prevention
If you are at risk for ulcers, use caution when taking aspirin and NSAIDs.
