How do you determine if you have an ulcer and what is the best medicine for it?

— Rip torn

Dear Rip torn,

Ulcers can be a real pain in the gut! An ulcer is an open sore in the stomach or intestinal lining caused by exposure to acid from the digestive system. Peptic ulcers, the most common, occur in the stomach (gastric or stomach ulcer) and in the duodenum (duodenal ulcer). They are often uncomfortable, with a key symptom being stomach pain and may eventually prompt bleeding. However, actual symptoms may vary; some folks may not even experience any at all. There are two common causes for peptic ulcers: a bacterial infection and frequent use of certain pain relievers. The good news is that there is treatment available, ranging from making some lifestyle changes to medications depending on the cause. Keep reading for more on the what, where, and ultimately, how to clear up an ulcer.

First things first, how does an ulcer develop? One common culprit is an infection with the bacteria Helicobacter pylori that can cause damage to the stomach and duodenum lining. The bacteria can spread by contact with unclean food, water, utensils, and the bodily fluids of an infected person. Another cause of ulcers is the blockage of certain enzymes by certain painkillers in the body. These particular enzymes produce chemicals that promote pain, so the blockage caused by these medications is helpful. However, these same enzymes also produce another chemical that protects the lining of the stomach, making frequent painkiller users vulnerable to developing an ulcer. The medications most frequently associated with ulcers include aspirin, ibuprofen, or other non-steroidal anti-inflammatory drugs (NSAID), though there are a few others that can contribute to this risk as well. And, while they don’t cause ulcers, it’s worth mentioning that certain lifestyle concerns, such as stress, alcohol consumption, eating spicy foods, and smoking can make symptoms worse or slow the healing process.

So how do you know if you have an ulcer? When people experience symptoms (about 75 percent of those who have peptic ulcers don’t), the most common is a burning pain in the abdomen. It usually happens early in the morning, late at night, or between meals (when the stomach is empty). Sometimes, a person will also experience belching, heartburn, bloating, nausea, and sensitivity to fatty foods. More severe symptoms may include vomiting, changes in appetite, weight loss, fainting, and troubled breathing. With a bleeding ulcer, blood may appear in vomit or in the stool.

For those who experiencing some symptoms and are concerned that they may have an ulcer, the first step is to see a health care provider. In addition to a physical exam and health history, the process for confirming a diagnosis may include a test for Helicobacter pylori bacteria or an endoscopy (a procedure where a slim tube with a small camera at one end is placed down the throat to get a better view of the digestive tract). Another test, called an upper gastrointestinal series, requires the patient to swallow a barium solution so that looking at the stomach, esophagus, and intestine is made easier through a series of x-rays.

If an ulcer is detected, treatment depends on the cause. Antibiotics may be prescribed for those who have an ulcer caused by H. pylori. For other causes, medications (prescription and over-the-counter) may be recommended to reduce or neutralize stomach acid as well as promote healing. Still, there are a number of lifestyle behaviors, such as eating a balanced diet, adding probiotics, using pain relievers not associated with ulcers (such as acetaminophen), not smoking, practicing healthy stress-coping, limiting or eschewing alcohol use, and getting enough zzzs. Many of these lifestyle behaviors also serve as prevention methods to keep ulcers at bay, particularly being careful with the type of pain relievers and frequency of use, as well practicing proper hygiene to reduce the risk of infections.

Here’s hoping this satisfied some of your questions about this pesky stomach issue. For more information on ulcers, check out the National Institute of Diabetes and Digestive and Kidney Diseases


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