In the general population, ulcers of the GI tract are one of the better known gastrointestional conditions. Such peptic uclers can occur in the stomach (gastic ucler), and, even more commonly, in the first foot or so of the small intestine leading from the stomach (duodenal ucler), and less often in the esophagus. Treatment for peptic uclers has evolved in recent decades. These sores on the interterior lining of the upper GI tract can become more than uncomfortable; they can debilitate or sometimes require urgent care. On a day-to-day basis, these lesions-which are usually a fraction of an inch in size-can cause:
- burning sensation;
- and other symptoms.
|Understanding and treatment of ulcers has improved in recent decades, and Lourdes GI specialists bring the very latest knowledge to bear for every case.|
A Number of Causitive Factors Can Come Into Play
Experts continue to debate the relative importance of and sequence of events among variables that cause these ulcers, but several factors can play a role:
- compromised digestive lining from high stomach acid or NSAID use. Unusually caustic conditions in the stomach can set the stage for ulcers by creating pre-ulcerous irritations on the stomach lining at places where hydrochloric acid (present in stomach digestive juices) have caused destruction to the mucosal lining of the GI tract or where nonsteroidal anti-inflammatory drugs (NSAIDs) have directly irritated it. Psychological stress, dietary habits, and natural predisposition to produce acids can contribute to an acidic environment in the stomach.
- bacteria. Microbes can find opportunity to invade and grow in tissue left weakened and unprotected by inflammation. Helicobacter pylori is a type of bacteria particularly implicated as present in gastric ulcers.
- genetics. Individuals with a natural tendency to develop stomach irritations, due to family history or individual inheritance, are vulnerable to developing ulcers-sometimes chronically and sometimes in multiple locations.
In many people, some combination of these factors results in stomach ulcers. Smoking and drinking alcohol also can worsen ulcers and prevent healing. In some people, an ulcer may be a passing, temporary albeit unpleasant condition. For others, it is a long-term problem that can compromise life and that can worsen without treatment, even cause serious complications in some cases.
Stepwise Evaluation and Intervention
Lourdes gastroenterologists diagnose peptic ulcers based on history, signs and testing. Medical treatment for a week or two with ulcer medications can often resolve the symptoms and begin to heal the ulcer, thus also confirming the diagnosis. If the symptoms don’t so easily clear, more testing may be indicated. Endoscopy can help the specialist visually confirm the presence of an ucler. Barium x-ray may also help. A number of different tests can additionally indicate the presence of H. pylori.
Stomach ulcers, while usually benign, are more likely than duodenal ulcers to become malignant, and so many require more careful monitoring, multiple biopsies or more aggressive treatment. For any ulcer-related symptoms, the goal is to find the source of the discomfort and relieve symptoms by beginning a healing process.
Effective Medications and Other Steps
Treatment seeks to reduce and resolve the ulcer in the least invasive manner possible. To this end, Lourdes GI specialists use conservative means-medications and change in lifestyle and habits-to cure uclers whenever possible. Medical treatment may include:
- antiacids. These medications serve to reduce the acidity of the stomach environment by neutralizing acid or preventing its production or release. They are also used for relfux disease. Learn more.
- antibiotics. More recently, with knowledge of the role of bacteria such as H. pylori, physicians have prescribed combinations of antibiotics against the types of bacteria that can invade a stomach ulcer. This approach can be particularly effective in healing these digestive track sores.
- dietary intervention. Foods that irritate uclers vary from one person to the next but can include foods that are highly acidic, spicy or otherwise caustic. Adjusting eating habits and diet can help to calm and heal an ucler.
- stress reduction. For patients where stress can be factor, the Lourdes team recommends a number of conventional and alternative steps to reduce anxiety and promote relaxation.
If noninvasive treatments such as these ultimately prove unsuccesful, and the patient has serious, long-term symptoms, surgery may prove a wise option. Ruptured uclers can cause gradual, or sometimes sudden and significant, gastrointestinal bleeding. In the latter case, emergency care may be required. If the ucler has perforated the exterior of the stomach, surgery may be needed on an acute basis. In addition to any necessary repairs to the site of the ulcer itself, operations for gastric uclers seek to disrupt the nerve or hormonal stimulation of acid secretion in the stomach, usually by cutting parts of the vagus nerve and sometimes by removing a portion of the lower stomach. Experienced surgeons at Lourdes can usually perform these operations endoscopically, sparing the patient open surgery and allowing for a quicker recovery.
Lourdes gastroenterologists are experienced at evaluating individuals with symptoms that my point to a stomach ulcer. They have ample success in therapy to cure these lesions and free patients of their symptoms.