Understanding Stomach Ulcers: Causes, Symptoms, and Treatments

Stomach ulcers are open sores that develop on the lining of the stomach or the upper part of the small intestine. These ulcers can cause a range of symptoms, including abdominal pain, bloating, and indigestion, affecting an individual's quality of life. Stomach ulcers form for a variety of reasons and impact millions of people around the world. The following blog will dive into the causes, symptoms, and treatments of stomach ulcers.

What are Stomach Ulcers?

Stomach ulcers, known medically as peptic ulcers, are painful sores that form on the mucosal lining of the stomach and/or the upper area of the small intestine. Stomach ulcers are characterized by a break in the mucosal barrier that protects the stomach lining from digestive acids. The mucosal lining typically serves as a defense against the harsh acidic environment of the stomach, which is essential for digestion. When this protective layer becomes compromised, the underlying tissue can be exposed to acid, leading to the formation of ulcers. The process of ulceration can occur gradually over time, often beginning as small erosions that expand if left unchecked. These ulcers tend to develop when the balance between the stomach’s digestive acids and the protective mechanisms are disrupted, leading to the erosion of tissue.

What Causes Stomach Ulcers?

Stomach ulcers are caused when the balance between stomach acid and the protective lining of the stomach is disrupted, leading to the erosion of tissue. Factors that weaken the stomach's defenses make stomach ulcers more common. Some common causes of stomach ulcers are:

·      Helicobacter pylori Infection: Helicobacter pylori is a type of bacteria that weakens the stomach's protective lining, allowing stomach acid to damage the tissue underneath, leading to ulcer formation. It is a major cause of peptic ulcers and is commonly transmitted through contaminated food or water.

·      Zollinger-Ellison Syndrome: This rare condition involves tumors in the pancreas or duodenum that produce excessive amounts of gastrin, a hormone that stimulates acid production. The excess acid can lead to the development of ulcers.

·      Long-Term Use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): NSAIDs like aspirin and ibuprofen reduce the stomach’s ability to produce protective mucus, making the stomach lining vulnerable to acid. Chronic use or high doses of these drugs can lead to irritation and ulcer development.

·      Excessive Alcohol Consumption: Alcohol can irritate the stomach lining, increase acid production, and impair the mucosal barrier, contributing to ulcer formation. Chronic heavy drinking significantly raises the risk of developing ulcers.

·      Smoking- Smoking decreases blood flow to the stomach lining, reducing its ability to heal and defend itself against stomach acid. It also increases acid production, both of which heighten the risk of ulcers.

·      Stress- While stress does not directly cause ulcers, it can increase stomach acid production and slow ulcer healing. Stress may also lead to unhealthy behaviors like smoking or drinking alcohol, further contributing to ulcer risk.

·      Spicy/Acidic Foods: Spicy or acidic foods do not directly cause ulcers, but they can irritate an existing ulcer, worsening symptoms. These foods may increase acid production or cause discomfort for individuals with sensitive stomachs.

·      Old Age- As people age, the stomach lining naturally becomes thinner and less resilient. This makes older adults more susceptible to ulcers, especially when compounded by factors like NSAID use or infections.

·      Genetics- A family history of stomach ulcers or H. pylori infections can increase the likelihood of developing ulcers. Some people may be genetically predisposed to weaker stomach lining defenses or more frequent acid production.

Types of Stomach Ulcers

There are many types of stomach ulcers, each type varies in location and underlying causes, but they all involve damage to the protective lining of the digestive tract. Some of the most common ulcers are:

·      Gastric Ulcers- Peptic ulcers that occur on the inner lining of the stomach. They are often caused by Helicobacter pylori infection or the long-term use of NSAIDs, damaging the stomach's protective mucus layer, allowing stomach acid to erode the tissue.

·      Duodenal Ulcers- Form in the upper part of the small intestine, known as the duodenum. They are the most common type of peptic ulcer and are typically caused by an H. pylori infection or an excess of stomach acid, which damages the duodenal lining.

·      Stress Ulcers- Primarily caused by severe physical stress, such as trauma, surgery, or burns. They are commonly found in critically ill patients, as the body’s response to stress can lead to increased stomach acid production, which damages the stomach lining.

·      Cushing Ulcers- These are stress ulcers specifically linked to brain injuries or diseases. They are often associated with increased intracranial pressure, leading to excessive acid production and ulcer formation in the stomach or duodenum.

Symptoms of Stomach Ulcers

The symptoms to having stomach ulcers are extremely uncomfortable. Some symptoms include weight loss, poor appetite, and dark or tarry poop, which is a sign of bleeding. Some more common symptoms of stomach ulcers include of:

·      Burning Stomach Pain: A dull or burning pain (depending on the severity) in the stomach area is common with stomach ulcers. The pain may improve or worsen after eating or drinking certain substances.

·      Nausea or Vomiting: Feeling nauseous or vomiting, especially if the ulcer leads to irritation in the stomach lining or causes a blockage.

·      Bloating and Belching: Feeling full or bloated after eating small amounts of food. This can also be accompanied by frequent burping or excessive gas.

Treatments for Stomach Ulcers

Treatment for stomach ulcers typically focus on reducing stomach acid, promoting healing, and addressing any underlying causes, such as bacterial infections. The following are common treatments used to manage and heal stomach ulcers:

·      Proton Pump Inhibitors (PPIs): Medications like omeprazole or lansoprazole reduce stomach acid production, helping the ulcer heal and relieving pain.

·      Antibiotics: If the ulcer is caused by Helicobacter pylori (H. pylori) infection, antibiotics like amoxicillin or clarithromycin are prescribed to eliminate the bacteria. This is typically combined with other medications for effective treatment.

·      Antacids and H2 blockers: Antacids (like Tums) neutralize stomach acid, while H2 blockers (like ranitidine) reduce acid production. These can provide relief from pain and help the ulcer heal by decreasing irritation.

Citations:

Inform, NHS. “Stomach Ulcer (Gastric Ulcer) | NHS INFORM.” Stomach Ulcer , 29 May 2023, https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/stomach-ulcer/#about-stomach-ulcers

Health, UC. “Stomach Ulcers: Symptoms, Diagnosis, and Treatment.” UCHealth, 13 Mar. 2024, https://www.uchealth.org/diseases-conditions/stomach-ulcers/

Staff, NIH. “Symptoms & Causes of Peptic Ulcers (Stomach or Duodenal Ulcers) - NIDDK.” National Institute of Diabetes and Digestive and Kidney Diseases, U.S. Department of Health and Human Services, Sept. 2022, www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers/symptoms-causes