Do you have abdominal discomforts (e.g. a dull or burning pain)? Does the pain flare up with empty stomach? If so, you may wonder whether the pain you’re feeling might be a stomach ulcer, an open sore (also called as peptic ulcer) that develops in the lining of the stomach. So what does it feel like?
Your stomach has thick layer of mucus to protect its soft lining. An open sore may form in the stomach lining when this mucus coating is diminished.
With improper functioning of the layer, the soft lining is more vulnerable to get damaged from irritating things like extreme stomach acid when the stomach digests food. The digestive acid may eat away at the soft tissue of the stomach, resulting in an ulcer.
There are several causes to blame. But you’re probably surprised to know that bacterial infection and pain relievers are the most common culprits behind the problem.
This bacterial infection is the leading cause for stomach ulcer. About 75 percent of all cases have to do with H. pylori infection [1]. Thanks to J. Robin Warren and Drs. Barry Marshall, they were awarded for the Nobel Prize in Medicine (2015) due to their finding on this.
Overgrowth of H. pylori in the stomach may provoke damage to the mucus layer, increasing the risk of developing inflammation and ulcers in the stomach lining.
Interestingly, not all people with H. pylori bacteria develop ulcers. About 30-40 percent of population in the U.S is infected. And did you know what? Most of them don’t get ulcer. This may suggest that other factors have a role to make the open sore more likely.
How we get H. pylori infection is also not fully understood yet. But it seems the infection may spread through water, saliva, food, or eating utensils. It’s also probably acquired during childhood (sometimes asymptomatic, without noticeable symptoms).
This is probably particularly true for NSAIDs (non-steroidal anti-inflammatory drugs). These include naproxen sodium, aspirin, and ibuprofen. Long-term use on these pills may raise the risk by about 20 times higher [2].
Frequent use of NSAIDs may hurt the defense mechanism of your stomach in a couple of different ways. This risk increases higher if you take more than two types of NSAIDs and take them regularly for a long time.
It’s thought that cyclooxygenase-1 (COX-1) may get impaired with long term use of NSAIDs. COX-1 plays a role in protecting the stomach lining since this enzyme is involved in producing prostaglandins (hormone-like natural chemicals, which are important to provide protection against a range of different harmful things that cause mucosal damage) [3].
Furthermore, NSAIDs may also interfere with the production of mucus and bicarbonate, making the stomach more vulnerable to negative effects of stomach acid and pepsin. Bicarbonate is important to help neutralize digestive fluids.
What else?Along with H. pylori infection and long-term use of NSAIDs, the following risk factors may also make stomach ulcer more likely:
- Age factor. In general, the risk increases with age especially at age 70 or older.
- A personal history of having stomach ulcer before.
- Lifestyle factors (drinking alcohol and cigarette smoking).
- Taking medicines to boost bone mass (corticosteroids for example).
- Having two or more health conditions.
The good news, the open sore is curable. Some effective treatments are available to get rid of the problem without leaving after effects.
Treatment plan depends on the underlying cause of the open sore. If it has to do with H. pylori infection, the use of antibiotics is a must. And you have to complete the course of these antibiotics to make sure that the infection is healed completely.
Since stomach acid also has an effect on healing process – a higher, uncontrolled acid can make the open sore take longer to heal – treatments to reduce or block acid production are also necessary. These include proton pump inhibitors and histamine (H-2) blockers.
Along with a few modifications of lifestyle (e.g. changes in diet, good stress management, avoiding alcohol, and avoiding tobacco smoke), treatments are often successful to carry a cure for most patients. Surgery is now rarely used!
The key is to take treatment as early as possible. Because once the problem becomes advanced, it’s relatively more difficult to treat and likely to cause complications such as internal bleeding, blockage (obstruction), or even a life-threatening perforation (hole).
So knowing any related signs and symptoms of stomach ulcer are important so you can seek medical help immediately when you have to!
The open sore can cause a number of signs and symptoms. And the severity of the ulcer is usually equivalent with the severity of the symptoms.
Among stomach ulcer symptoms, burning sensation or pain is the most common one. Typically, it is felt in the middle or upper part of abdomen specifically between the belly button and breastbone (chest), where your stomach is located in the body.
The pain usually feels like burning, gnawing, or dull sensation. In a few cases it also could be stabbing or intense, depending on the severity of the open sore. Sometimes it could be strong enough to radiate elsewhere in the body, such as the back.
So this may vary from person to person, including for duration. It may last in a few minutes or longer (several hours). Also, it could be chronic – come & go in days, weeks, or even a few months.
But one unique thing to remember, in general the pain is more likely to flare up with empty stomach.
Often, it gets worse between meals such as in the morning or at night – though again this varies by individual. People usually have a spike in stomach acid when their stomach is empty. And high level of this acid can worsen the symptoms and make the open sore take longer to heal.
On the other hand, the pain is likely to relieve for a while when you take antacids (acid-reducing medication) or if you eat foods that can buffer your stomach acid [4]. But not all foods are good to help deal with since certain foods would also exacerbate the pain and other stomach ulcer symptoms.
For instance, high fatty foods are one of common culprits since they’re likely to sit around in the gastric longer (this will drive more production of stomach acid).
Other things in diet that may provoke the symptoms include: alcohol, caffeine, milk, high trans-fat food (e.g. fried foods), acidic foods (including acidic fruits like citrus fruits), tomatoes, and heavily spiced foods.
However, see a doctor for accurate diagnosis since some signs and symptoms are quite vogue.
For examples, stomach ulcer may also cause vogue symptoms such as nausea, heartburn, bloating (feeling of fullness), or fatty foods intolerance. Even about almost 75 percent of patients don’t have signs and symptoms, according to Mayo Clinic. This suggests that many people probably don’t realize the disease until it becomes quite advanced [5].
Besides analyzing signs and symptoms you have, several tests are required to diagnose stomach ulcer accurately. These may include [6]:
- Labs and tests such as blood test, urea breath test, or/and stool test. These procedures are usually focused to look for the existence of H. pylori infection!
- Imaging tests such as CT scan, endoscopy (inserting small tube through the throat), or upper gastrointestinal series (barium swallow). These tests provide more detailed pictures of your stomach and its structure so doctors can find out whether there is an abnormal thing in there.
Moreover, several medical conditions can cause symptoms similar to those of stomach ulcer. Therefore doctors may also need to consider these issues. Some of these conditions are gastritis, esophagitis, nonulcer dyspepsia, or gastric cancer.
Again, it’s important to follow your ulcer treatment comprehensively to boost a complete cure more likely. Without proper treatment, it might turn into serious.
Less often, severe signs and symptoms of stomach ulcer may occur. Some of these are as follows: