What is it
Gastric ulcer (of the stomach) is a roundish lesion, a kind of wound, which forms on the inner wall of the stomach (the so-called mucous tunic) and can extend deep.
It develops when the protective factors of the gastric mucosa are lacking.
Symptoms of gastric ulcer
The most common symptom of ulcer is a dull pain, located below the sternum (the vertical anterior bone of the chest), often assimilated to a particularly pronounced stomach pain.
Its appearance is heralded by burning and may be accompanied by symptoms such as:
- dyspepsia, or digestive difficulty;
- decrease in body weight, due in part to loss of appetite;
- sense of relaxation, heaviness or, vice versa, “emptiness in the stomach”.
In addition, belching, nausea and vomiting may also be present.
Symptoms of gastric ulcer tend to occur between meals and can last for periods lasting from one to two months, especially in spring and autumn.
Common causes of gastric ulcer
Until a few years ago it was believed that the causes of gastric ulcer were linked only to both physiological and behavioral favorable factors: chronic gastritis (prolonged inflammation of the gastric mucosa), excessive production of acid gastric juices, cigarette smoking, stress, excessive consumption of spirits, carbonated drinks and coffee, and the corrosive action of drugs taken for long periods (especially non-steroidal anti-inflammatory drugs (NSAIDs) and cortisone).
Recently, however, it has been discovered that in 50-65% of cases gastric ulcer is caused by the presence of a bacterium.
It is a very common microorganism that is located below the gastric mucosa and causes a local inflammatory reaction (more often known as gastritis).
Helicobacter pylori (this is the name of the bacterium) proliferates in the acidic environment of the stomach, damaging first the cells of the gastric lining, and then the walls of the stomach or duodenum (the initial tract of the small intestine).
Diagnosis
The diagnosis is made on the basis of the evaluation of symptoms and must be confirmed by instrumental examinations such as:
- gastroscopy, an endoscopy technique that allows observation of the inner surface of the stomach;
- radiographic examination with contrast medium (barium meal).
Helicobacter infection can be diagnosed with:
- analysis of a tissue sample taken by biopsy;
- detection of specific antibodiesin the blood;
- a specific exam, the H2-breath test.
The latter, more often known as a “breath test” involves the patient ingesting urea labeled with a carbon isotope and that, after waiting about 30 minutes, puffs inside a bottle.
The air thus collected is analyzed and compared with that collected before the ingestion of urea in search of carbon dioxide produced by the bacterium.
Treating gastric ulcer
In the past the most used treatment for gastric ulcer was surgery, while today it is reserved for severe and urgent cases, with perforation (few, according to statistics).
Currently the most widespread approach involves the prescription of drug therapies, identified according to the characteristics of the individual case.
The most used drugs are:
- antacids (such as aluminium hydroxide),
- histamine H2 receptor blockers (cimetidine, ranitidine)
- and proton pump inhibitors (omeprazole and derivatives).
In less severe cases, in addition to antacid drugs, bicarbonate can also be used.
In patients positive for Helicobacter pylori infection, an antibiotic targeted at proton pump inhibitors is associated.
For all these (except for some antacids and for the common baking soda) a prescription is required.
Lifestyle changes and nutrition care can also be useful in the treatment of gastric ulcer. For example, the consumption of “light” and therefore easy to digest foods, the use of “delicate” cooking methods such as steam and the abandonment of incorrect habits (such as smoking) can intensify the effects of drugs, helping to prevent relapses.
It is also important to eat small and frequent meals, at regular times, and not to fast for long periods.
The diet to be adopted in these cases should favor some foods and not others, as illustrated by the following table:
| Recommended foods | Foods to avoid or limit |
|---|---|
| Lean meats | Alcohol and spirits |
| Milk, preferably semi-skimmed | Garlic, onion, shallots, chilli, pepper |
| Bread | Fatty cheeses |
| Pasta, rice | Coffee, tea and, in general, caffeinated beverages, carbonated drinks, fruit juices |
| Raw or cooked vegetables | Particularly fatty meats and fish |
| Lean fish | Tomatoes |
| Yogurt | Fatty, spicy, preserved, smoked, fried foods |
| Fruit, except citrus fruits | Dried fruit |
Complications
The main and most dangerous consequence of a long-neglected ulcer is perforation of the stomach wall with subsequent internal bleeding (blood loss).
The bleeding can be expressed by loss of blood in the stool (hematochezia) or with dark, tarry stools (melena). In these cases, weight loss, anemia, low blood pressure, thirst and sweating may also be observed.
Other possible effects are:
- the chronicization of the condition, with more or less frequent recurrent manifestations;
- the narrowing (or stenosis) of the blood vessels of the area affected by the ulcer, due to the healing of the lesion;
- the involvement of nearby organs (liver and pancreas).
When to consult your doctor
When persistent abdominal pain is present and you notice strong and frequent nausea or digestive disorders, it is always best to hear what your family doctor thinks. Especially if, in addition to these symptoms, vomiting and rapid weight loss also occur.
How widespread is it
Gastric ulcer is quite widespread in the Western world, although it has been decreasing in the last 20 years.
It is estimated, today, that at least 10-20 percent of the adult population may have an ulcer in their lifetime. The highest incidence of gastric ulcer is in men between 50 and 60 years of age. The male/female ratio is 3:1.
Joycelyn Elders is the author and creator of EmpowerEssence, a health and wellness blog. Elders is a respected public health advocate and pediatrician dedicated to promoting general health and well-being.
The blog covers a wide range of topics related to health and wellness, with articles organized into several categories.