Is Your Persistent Stomach Pain An Ulcer
Digestive Health, Gastroenterology
Its normal to have a stomachache every now and then. Maybe you ate something that isnt agreeing with you or youre having a stressful day. These run-of-the-mill pains usually resolve on their own or with basic treatment.
But if you experience daily abdominal pain, or pain that comes and goes frequently, you could have a more serious problem, such as a peptic ulcer.
UNC Rex Digestive Healthcare gastroenterologist Silpa Yalamanchili, MD, explains how peptic ulcers can develop and how to find relief.
Reasons For Your Sluggish Digestion
Overeating: You know, even one meal where you overeat can leave you feeling miserable, but constantly overeating can have long-term negative effects on your digestion. For example, when you overeat, your stomach is unable to produce enough acid to break down food, meaning it is not properly digested. Furthermore, large portions of food put added pressure on the stomach, which contributes to heartburn and indigestion.
The key here is to practice portion control and avoid eating too much at once.
Improperly chewing: Chewing is the first part of the digestion process. When we chew, we break down food into smaller bits so that it can be better digested. Additionally, saliva contains essential enzymes to assist the digestive process. If we do not take the time to properly chew our food, enabling the important enzymes in saliva to go to work, the digestive system has to work harder. This leads to cramps, gas, and constipation.
Its important that you are mindful when eating. Some experts suggest counting your chews as a means to chewing more and eating slower. Other tips include resting your fork down while eating, or eating with your less dominant hand so you put less food in your mouth.
Inadequate fiber consumption: It is known that Americans are not consuming enough fiber, and many face digestive problems because of it. Consuming adequate amounts of soluble fiber can help ease digestion and rid yourself of those discomforting symptoms.
How Do H Pylori Cause A Peptic Ulcer And Peptic Ulcer Disease
H. pylori are spiral-shaped bacteria that can cause peptic ulcer disease by damaging the mucous coating that protects the lining of the stomach and duodenum. Once H. pylori have damaged the mucous coating, powerful stomach acid can get through to the sensitive lining. Together, the stomach acid and H. pylori irritate the lining of the stomach or duodenum and cause a peptic ulcer.
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Knowing If You Have An Ulcer
Burning stomach pain, burping, bloating and heartburn are among the common signs of an ulcer, Abdi said. But Borum noted that its not unusual for people with ulcers to be asymptomatic until they develop a complication, such as bleeding or perforating, as in Dingells case. About 2 to 10 percent of ulcer patients will experience a perforated ulcer, which often manifests as acute, severe and diffuse abdominal pain, Borum said.
Because of the overlap between symptoms of various gastrointestinal problems, Borum urged people to pay attention to their bodies. If your symptoms are recurring, persistent and increasing in severity, you should definitely seek medical attention, she said.
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How Common Are Stomach Ulcers
It’s not known exactly how common stomach ulcers are. They have become much less common since the 1980s because of much more effective treatments. So people with stomach ulcers now usually get better much more quickly.
The term ‘peptic ulcer’ is used to describe ulcers that are caused by too much acid in the stomach. This includes stomach ulcers and also ulcers in the first part of the gut known as the duodenum. Stomach ulcers are less common than duodenal ulcers.
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What Is Indigestion And What Is An Ulcer
A lesion or sore that develops on the lining of your stomach or in the first part of your small intestine is called an ulcer. Ulcers are usually caused by the bacterium H. pylori or by non-steroidal anti-inflammatory medications, such as ibuprofen. A lesion can get aggravated by your stomach acid and causes pain and other symptoms.
Indigestion or dyspepsia, on the other hand, describes a chronic or recurring pain in your upper abdomen. Indigestion can be caused by many things, including stress, eating too much, taking certain medications, or having an underlying condition, such as gastroesophageal reflux disease or gallbladder disease.
Antacids And H2 Blockers
Antacids
Antacids neutralize existing acid in the stomach. Antacids such as Maalox, Mylanta, and Amphojel are safe and effective treatments. However, the neutralizing action of these agents is short-lived, and frequent dosing is required. Magnesium containing antacids, such as Maalox and Mylanta, can cause diarrhea, while aluminum containing agents like Amphojel can cause constipation. Ulcers frequently return when antacids are discontinued.
H2 blockers
Studies have shown that a protein released in the stomach called histamine stimulates gastric acid secretion. Histamine antagonists are drugs designed to block the action of histamine on gastric cells and reduce the production of acid. Examples of H2 blockers are cimetidine , nizatidine , and famotidine . While H2 blockers are effective in ulcer healing, they have a limited role in eradicating H. pylori without antibiotics. Therefore, ulcers frequently return when H2 blockers are stopped.
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Bacteria In Your Large Intestine
Your large intestine contains a large number of bacteria and some fungi and viruses that make up the gut microbiomethe microbes in your digestive tract that help with digestion. Bacteria in the large intestine help break down carbohydrates and create gas in the process.
Certain foods and drinks contain types of carbohydratessugars, starches, and fiberthat your stomach and small intestine dont fully digest. Undigested carbohydrates will pass to your large intestine, where bacteria break them down and create gas. You may have more gas symptoms if you consume more carbohydrates that your stomach and small intestine dont fully digest.
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Diagnosis Of A Stomach Ulcer
Diagnosing a stomach ulcer is done using a range of methods, including:
- Endoscopy a thin flexible tube is threaded down the oesophagus into the stomach under light anaesthesia. The endoscope is fitted with a small camera so the physician can see if there is an ulcer.
- Barium meal a chalky liquid is drunk and an x-ray is performed, showing the stomach lining. These tests are less common nowadays, but may be useful where endoscopy is unavailable.
- Biopsy a small tissue sample is taken during an endoscopy and tested in a laboratory. This biopsy should always be done if a gastric ulcer is found.
- C14 breath test this checks for the presence of H. pylori. The bacteria convert urea into carbon dioxide. The test involves swallowing an amount of radioactive carbon and testing the air exhaled from the lungs. A non-radioactive test can be used for children and pregnant women.
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Change In Stool Appearance
Individuals suffering from a peptic ulcer may experience darker or even bloody stools, Dr. Harvey says. Black dark sticky and foul smelling faeces is termed Melena. It is a result of blood being digested and mixed with the normal stool. Melena is considered a more severe symptom of peptic ulcers. This can be a frightening experience for many and usually indicates that the ulcer is growing or becoming more severe, he adds.
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What Are The Complications Of Peptic Ulcers
With modern treatment, people with ulcer disease can lead normal lives without lifestyle changes or dietary restrictions. Cigarettesmokers have been found to have more complications from ulcers and treatment failure.
Eradication of the bacteria H. pylori not only heals ulcers but also prevents the recurrence of ulcer disease.
Patients with ulcers generally function quite comfortably.
Some ulcers probably heal even without medications . Therefore, the major problems resulting from ulcers are related to ulcer complications. Complications include
- obstruction of emptying of the passage of food.
Patients with bleeding ulcers may report
- a sense of light-headedness or ay even pass out upon standing ,
- and vomiting blood . Initial treatment involves rapid replacement of fluids intravenously.
Patients with persistent or severe bleeding may require blood transfusions. An endoscopy is performed to establish the site of bleeding and to stop active ulcer bleeding with the aid of specialized endoscopic instruments.
Duodenum A peptic ulcer that forms in the narrow outlet from the stomach, it can obstruct the flow of stomach contents into the duodenum. Duodenal ulcers sometimes also may obstruct the flow of intestinal contents.
Patients with obstruction often report
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What Are The Symptoms Of A Peptic Ulcer
A dull or burning pain in your stomach is the most common symptom of a peptic ulcer. You may feel the pain anywhere between your belly button and breastbone. The pain most often
- happens when your stomach is emptysuch as between meals or during the night
- stops briefly if you eat or if you take antacids
- lasts for minutes to hours
- comes and goes for several days, weeks, or months
Less common symptoms may include
- feeling sick to your stomach
Even if your symptoms are mild, you may have a peptic ulcer. You should see your doctor to talk about your symptoms. Without treatment, your peptic ulcer can get worse.
What Is Peptic Ulcer Disease
Peptic ulcer disease is a condition with an open sore or ulcer in the lining of the stomach or duodenum, the first part of the small intestine. The main symptom is burning pain in the upper part of the belly after meals. Other symptoms are heartburn, burping, bloating and nausea. The symptoms of a peptic ulcer usually worsen over time. Peptic ulcers can lead to bleeding, a hole in the bowel and other medical emergencies. These complications may cause symptoms which start suddenly.The treatment of peptic ulcer disease depends on the cause. Once the cause is recognized and treated, the outlook is usually good.
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What Causes Stomach Ulcers
Your stomach normally produces acid to help with the digestion of food and to kill germs . This acid is corrosive, so some cells on the inside lining of the stomach and the first part of the gut known as the duodenum produce a natural mucous barrier. This protects the lining of the stomach and duodenum.
There is normally a balance between the amount of acid that you make and the mucous defence barrier. An ulcer may develop if there is an alteration in this balance, allowing the acid to damage the lining of the stomach or duodenum. Causes of this include the following:
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The most common stomach ulcer symptom is, not surprisingly, stomach paintypically, a dull, burning sensation in the mid-abdominal area. Because ulcers are literally sores in the lining of the stomach or small bowel, pain classically presents in relation to acid secretion in the intestines, says Rusha Modi, M.D., gastroenterologist and assistant professor of clinical medicine at Keck Medical Center in California. The pain usually peaks between meals and at night, when acid has been secreted into the stomach but theres no food to act as a buffer. Taking antacids can temporarily relieve the pain, but odds are it will keep coming back until the ulcer is treated by a professional.
Because the ulcer is being perpetually doused in acid, stomach pain can often be paired with chronic heartburn and regurgitation . Other symptoms, such as bloating, burping, or feeling perma-full, may not be far behind, says Ravella. If taking an OTC antacid only relieves symptoms temporarily, or they seem to strike no matter what you eat, you may want to discuss this with your physician.
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Are These Signs Or Symptoms Accompanying Your Bloat
Fortunately, if you feel bloated its usually harmless and caused by something as simple as gas, indigestion, or premenstrual symptoms.
But when there are other symptoms occurring with your persistent bloating symptoms you may want to dive deeper into the actual cause.
Other signs and symptoms to look out for with your constant bloating include:
- Severe abdominal pain
Dont shrug your constant bloating off if youre experiencing any of the above symptoms.
Because when detected early, certain diseases such as colon cancer, pelvic inflammatory disease, or diverticulitis are easier to treat and can reduce more complications.
And if gastrointestinal issues like leaky gut syndrome and inflammatory bowel diseases arent properly treated it could lead to other complications such as autoimmune diseases or cancer.
Ways To Avoid Bloating After Eating
Once you know the reasons behind bloating,you can take steps to deal with it. Here is what you can do to keep bloating at bay.
1. Avoid Carbonated Drinks
You should avoid carbonated drinks or at least limit their intake. Drink more of these drinks and carbon dioxide will build up in your system. This will lead to bloating. The best thing is to stick with plain water or add a slice of lemon to make it taste better.
2. Eat Slowly
Do not eat too fast because this makes you swallow air that leads to bloating after eating. Take more time to eat this keeps you from swallowing air and also helps reduce your overall food intake.
3. Take a Walk
Go for a walk after you eat your meal. Even a short walk after a meal can work wonders in reducing the gas buildup that usually leads to bloating. Besides, walking will also benefit your overall health.
4. Mind the Food You Eat
Whats more, several difficult-to-digest, bloat-inducing foods can make things extremely difficult when you are already having a hard time dealing with bloating after eating.
5. Try a Supplement
You can find gas-busting or anti-gas supplements such as a-galactosidase tablets to avoid dealing with gas after eating certain foods. These pills not just help relieve bloating, but they also prove effective against flatulence and belching. You need to take most of these supplements before every meal, but talk to your doctor about how often you should take it.
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What Are The Types Of Gastritis
There are two main types of gastritis:
- Erosive : Erosive gastritis causes both inflammation and erosion of the stomach lining. This condition is also known as reactive gastritis. Causes include alcohol, smoking, NSAIDs, corticosteroids, viral or bacterial infections and stress from illnesses or injuries.
- Non-erosive: Inflammation of the stomach lining without erosion or compromising the stomach lining.
When To See A Healthcare Provider/go To The Hospital
You may feel relief with an antacid, but you should not ignore symptoms of a peptic ulcer. If you have persistent symptoms for longer than a week, it is best to see your healthcare provider. He or she will determine whether you need prescription medications and whether you have complications, such as bleeding or anemia.
Make an appointment with your healthcare provider if you have:
- Pain that radiates to the back
- Pain that doesnt go away when you take medication
- Unintended weight loss
- Loss of consciousness
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Burning Pain In The Abdomen
Persistent burning pain in the abdomen is one of the first signs of a stomach ulcer. The sensation of pain occurs when juices in the stomach, which help in digestion, come into contact with an open sore in the stomach lining.
In most cases, the pain is felt from the breast bone to the navel, and it often worsens during the night. If you skip meals, particularly breakfast, you may also experience this burning sensation in the stomach during the daytime.
If the dull and burning ache of the ulcer often turns into a sharp, stabbing pain, it is a sign that your ulcer is acting up and you need medical help. It could mean that the ulcer has caused a more critical problem like a perforation in the wall of your stomach or intestine, or a blockage in your digestive tract, and it is triggering intense pain.
What Are Peptic Ulcers
A peptic ulcer is a sore in the wall of the gastrointestinal tract caused by stomach acid. Peptic ulcers typically result from inflammation caused by infection with a bacterium called Helicobacter pylori or medicines, such as nonsteroidal anti-inflammatory drugs .
Peptic ulcers can form in the stomach or the duodenum, the first part of the small intestine.
The stomach produces acid, but its walls are typically coated with a layer of mucus that protects them from erosion. However, those medicines or an H. pylori infection can impair the mucus barrier of protection in the stomach, Dr. Yalamanchili says. This can eventually lead to a sore developing in the lining of the stomach or duodenum. Its not uncommon for gastric and duodenal ulcers to occur at the same time.
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Culprit: Constipation Or Diverticulitis
Signs: Chronic constipation causes hard stools and strained bowel movements. Over time, it can lead to diverticulosis, which can be thought of as pockets or balloons that tend to develop in the lower part of the large intestine. These can sometimes become inflamed .
Who: Diverticulosis usually occurs after age 50 and in patients with a history of chronic constipation and straining. We are seeing it in younger and younger patients with low-fiber, highly refined diets as well as rising rates of obesity. Low- fiber diets, medications and sedentary lifestyles may all contribute to constipation.
Take Action: Your primary care doctor or pharmacist can suggest diet/lifestyle modifications. Weight loss, exercise, drinking more fluids and eating a diet higher in fiber and lower in fat also help. Over-the-counter laxatives can be used for mild symptoms.
Head to the emergency room if pain and vomiting become relentless, fevers exceed 100.4 degrees or youre unable to drink water or have bowel movements. Fevers with left lower quadrant abdominal pain, especially in a patient with known constipation, may indicate diverticulitis. Extreme discomfort in the left quadrant that spreads to the entire belly is worrisome and requires immediate care.
Patients over 4550 years of age who present with new-onset, unexplained constipation should talk to their primary care physician about getting a colonoscopy to screen for colorectal cancer.