What Are Stomach Ulcers?

A gastric ulcer is a wound that occurs in the wall of the stomach. It is due to an increase in the amount of acid, or a decrease in the protective mucosa. The most common cause is a bacterium, Helicobacter pylori.

Written and verified by Farmacéutica Clara Sebastin.

Last update: 05 May, 2023

Stomach ulcers are wounds that occur in the stomach wall, as a result of the acid secreted by the stomach itself. This wall is usually protected by mucosa that prevents the appearance of these ulcers.

The most common symptom is stomach pain. However, the vast majority of people with stomach ulcers have no symptoms.

Causes of stomach ulcers

If the amount of acid in the stomach increases or the mucosa decreases, an ulcer may develop. The acid damages the wall and causes an open wound, causing pain and burning.

The most common causes of stomach ulcers are:

• Helicobacter pylori. This bacteria anchors itself to the stomach lining and damages the mucosa. In addition, it increases the secretion of acid and alters the defenses, producing inflammation. It’s very rare, but Helicobacter pylori has also been linked to gastric cancer.
• Regular consumption of certain painkillers: The so-called NSAIDs or non-steroidal anti-inflammatory drugs – commonly used drugs, such as aspirin, ibuprofen or naproxen. Continued use can cause stomach ulcers and bleeding.
• Certain diseases, such as Zollinger-Ellison syndrome.

Risk factor’s

The risk of developing a stomach ulcer is increased by:

• Tobacco: In addition to increasing the risk, it delays the healing of ulcers and favors their reappearance.
• Caffeine: This increases the secretion of acid by the stomach.
• Physical stress: Serious injuries, such as burns or surgeries, can lead to the appearance of wounds in the stomach wall.
• Spicy or very spicy food: This should be avoided.
• Alcoholism.

Until recently, emotional stress was included in the cause of ulcers. However, it has been seen that by itself it isn’t a cause, although it can be a risk factor.

Symptoms

Stomach ulcers can give the following symptoms:

• Heartburn and pain
• A feeling of heaviness after meals
• Slow digestions
• Acidity
• Vomiting

However, these symptoms are nonspecific and a doctor should be consulted for a correct diagnosis when a stomach ulcer is suspected.

Complications

Without proper treatment, a stomach ulcer can suffer serious complications such as bleeding, perforation, and digestive obstruction:

• Bleeding. Erosion of some blood vessels occurs that can break causing small hemorrhages. It isn’t very frequent.
• Drilling. A hole can form in the stomach wall from erosion. Undigested food or bacteria can leak out of this hole, infecting and inflaming the surrounding tissues.
• Obstruction. An obstruction can occur if the ulcer is at the end of the stomach, near the intestine. Thus, food is prevented from passing into the intestine and therefore prevents normal digestion. It’s a serious complication and surgery may be necessary.

Diagnosis

Diagnosis is an important part since treatment will be different depending on the origin of the ulcer. First of all, the doctor performs a physical examination to determine if there are complications.

Diagnostic procedures usually include:

• Endoscopy: This is the most reliable. It’s a technique that allows us to take tissue samples and study the state of the ulcer. It also provides a differential diagnosis – getting to know the cause of the ulcer and ruling out the others.
• Radiography: Sometimes contrasts are used, which allow the ulcers to be better visualized. Contrasts are substances that help to distinguish the areas of the body that interest us.
• Breath test – to detect Helicobacter pylori bacteria.
• Blood test: It has little validity, but it does allow the detection of bleeding.

Treatment

It’s important to make lifestyle changes to avoid negative factors. This includes reducing and cutting out tobacco, alcohol, caffeine, or very fatty or spicy foods, for example. It’s also advisable to eat regular and not copious meals, chew food well, and eat slowly.

If you are taking NSAIDs regularly, doctors recommend reducing or monitoring their consumption. Also, stomach ulcers can be treated with antiulcer medications, including:

• Proton pump inhibitors: Omeprazole or pantoprazole, for example. They reduce the secretion of acid by the stomach, which prevents further damage.
• Acid secretion antagonists: These decrease acid production, as do proton pump inhibitors.
• Mucosal protectors: These protect the stomach wall from acid, but do not modify its production.
• Antibiotics: If the cause of the ulcer is Helicobacter pylori, a combination of these and the above drugs is used.

Finally, surgery may be necessary in complicated cases that don’t respond to drugs. However, this is rare, and antiulcer medications often heal ulcers quickly and effectively.