Main
- Gastric ulcer — a defect of the mucosa that, without eliminating the cause, deepens and heals poorly on its own.
- Pain in the upper abdomen on an empty stomach or at night — a reason to book an appointment with a gastroenterologist routinely, within the next few days.
- Black tarry stools, vomiting blood, fainting and severe abdominal pain require an immediate ambulance call.
- Gastroscopy confirms the diagnosis and shows the size of the ulcer; if it is not possible, a gastric X-ray with contrast is performed.
- Smoking and alcohol slow down healing, while uncontrolled painkillers and anti-inflammatory drugs increase the risk of exacerbation.
What is a gastric ulcer
A gastric ulcer is a defect in the inner lining of the stomach that forms when its protective properties weaken. Most often this is linked to an infection or long-term use of certain painkillers, and without treatment the defect can deepen.
What happens in the body
The inner lining of the stomach is constantly in contact with acidic contents, but it has a protective layer of mucus that normally withstands such a load. When this layer thins or becomes damaged, acid and digestive juices begin to affect the wall itself. In the area where the protection has weakened, a defect gradually forms — first superficial, then increasingly deep. A person may notice this through discomfort in the upper abdomen, but often the changes remain unnoticed for a long time. If the damaging factor continues to act, the defect deepens and affects deeper layers of the wall. This makes the condition persistent and hinders natural healing without eliminating the cause. Therefore, with persistent discomfort it is important not to postpone a visit to the doctor and not to try to cope with it on your own.
What causes it to develop
- Infection: the bacterium damages the protective layer of the gastric mucosa, and it is with it that most cases of the disease are associated.
- Long-term use of painkillers and anti-inflammatory agents: such agents weaken the protection of the mucosa, so their uncontrolled use increases the risk.
- Smoking: tobacco smoke worsens the blood supply to the mucosa and slows healing, although by itself it does not cause an ulcer.
- Alcohol abuse: alcohol irritates the stomach lining and hinders tissue repair, intensifying the effect of other factors.
- Severe stress or a serious illness: heavy strain on the body weakens the protective properties of the mucosa, but acts more as a background than a direct cause.
- Hereditary predisposition: in some people a tendency to this condition runs in the family, so family history should be taken into account.
Who faces this more often
This condition is more often faced by people in whom several unfavourable factors combine rather than just one. Age plays a noticeable role: with the years the mucosa recovers more slowly, and concomitant diseases are more common. Men suffer somewhat more often than women, although the difference is not always pronounced. A separate group consists of those who are forced to take painkillers and anti-inflammatory agents for a long time because of other health problems. Smoking and alcohol abuse increase the risk regardless of other circumstances. In some people a family tendency can be traced, so if there are such cases among close relatives it is worth being more attentive to one's own condition. If you fall into several groups at once, it is reasonable to discuss with a doctor whether an additional assessment of the stomach is needed.
What symptoms can occur?
A stomach ulcer can go unnoticed for a long time, and its first signs are easily put down to fatigue or indigestion. Understanding which complaints occur with this condition and in which cases help is needed immediately helps you see a doctor in time.
How it is noticed at the very beginning
Pain from a stomach ulcer is usually felt in the upper part of the abdomen and may radiate to the back. In character it can be aching, burning or hunger-like, that is, it appears on an empty stomach. Quite often such pain subsides after eating or after taking antacids, and this reassures the person. Because of this, the discomfort is put down to overwork, a late supper or an accidental slip in the diet. Gradually nausea, bloating and a feeling of fullness after eating are added to the pain, and these also seem temporary. In some people the ulcer does not cause noticeable complaints for a long time and is discovered by chance when they consult for another reason. If unpleasant sensations in the upper part of the abdomen recur, it is reasonable not to wait for them to disappear, but to book an appointment with a gastroenterologist routinely, within the next few days.
Signs that occur most often
- Pain or burning in the upper part of the abdomen: the main sign, which intensifies on an empty stomach and often eases after eating.
- Nausea and vomiting: occur against the background of pain, make eating difficult and noticeably worsen the general well-being on such days.
- Bloating and a feeling of fullness after eating: even a small amount of food feels heavy, which makes the person eat less often.
- Heartburn or acid regurgitation: acidic contents are refluxed into the oesophagus, and this adds burning behind the breastbone to the main complaint.
- Black tarry stool: one of the signs of bleeding, in which one must not stay at home and wait for improvement.
- Vomiting blood or "coffee grounds": a direct indication of bleeding, in which an ambulance must be called immediately.
When to seek help urgently
Examinations and tests
Examination for suspected gastric ulcer is built around a doctor's assessment and instrumental methods that confirm the diagnosis and clarify the condition of the mucosa. Below is a breakdown of which procedures and tests are used and what information each of them provides.
How the examination begins
The examination begins with an appointment with a doctor, who asks about complaints, lifestyle and medications being taken. Then he examines the abdomen to assess tenderness and tension of the anterior abdominal wall muscles. This information helps to understand the overall picture and determine which confirmation methods are needed in a particular case. To confirm the diagnosis, gastroscopy is usually prescribed — examination of the stomach through a thin tube. During the procedure, the doctor sees the mucosa from the inside and can notice the ulcerative defect, its location and size. Additionally, the presence of the infection that caused the ulcer may be checked, and a blood test for anaemia may be done. If gastroscopy cannot be performed, X-ray with contrast is sometimes used. The results gathered together give the doctor grounds for further decisions, so it is important to undergo the prescribed procedures fully, rather than limiting yourself to just one.
What is prescribed and what it shows
What is worth preparing for the appointment
- Discharge summaries: bring previous doctors' reports and examination results so that the specialist can see the dynamics and does not prescribe anything unnecessary.
- List of medications: list everything you take regularly, including anything bought without a prescription — this affects the assessment of the stomach's condition.
- Description of complaints: write down when and after what the pain appears, how often it occurs and what accompanies it, so that you do not forget anything at the appointment.
- Referrals: bring any existing referrals for tests and procedures, if they were issued earlier at another clinic.
- Questions: formulate in advance what you want to clarify with the doctor — this way the appointment will be more organised and clearer.
Which doctor should I see?
A gastric ulcer is managed by a gastroenterologist, and if complications arise, a surgeon is brought in. Below is what the doctor does at an appointment and what the care consists of.
Which specialist manages this condition
A gastric ulcer is managed by a gastroenterologist, and if complications arise, a surgeon joins the follow-up. The gastroenterologist clarifies the size of the ulcer, the presence of an infection that damages the stomach, and the patient's concomitant diseases. At the first appointment, the doctor reviews the complaints and treatment history, including medicines that could have caused damage to the mucosa. A surgeon is needed when complications are involved or when the therapy being given is ineffective. If there is no gastroenterologist nearby, one can start with a general practitioner at the place of residence. The general practitioner will assess the condition and refer to the right specialist without delaying the resolution of the matter. The patient should bring to the appointment discharge summaries, the results of previous examinations and a list of the medicines being taken. Such a set of documents helps the doctor see the full picture more quickly and choose further steps.
What the treatment consists of
- Selection of therapy by the doctor: the specialist takes into account the size of the ulcer, the presence of infection and concomitant diseases, so the care is always individual.
- Elimination of the infection: if the ulcer is caused by an infection that damages the stomach, a separate line of work is carried out to eliminate it.
- Discontinuation or replacement of medicines: when the damage to the mucosa is related to the medicines being taken, the doctor reviews them and selects a replacement.
- Follow-up and repeat gastroscopy: monitoring the healing of the ulcer allows timely recognition that the chosen care is not giving the needed result.
- Surgery: surgical intervention is considered in case of complications or when conservative measures prove ineffective.
What depends on the patient himself
The result largely depends on how regularly the person is followed up by the doctor and follows his instructions. The ulcer heals gradually, so the condition is assessed over time, not by a single appointment. It is important for the patient to come to the scheduled examinations and not to skip the repeat gastroscopy, even if the complaints have subsided. If the doctor discontinued or replaced the medicine that caused the damage to the stomach, one should adhere to this decision and not return to the previous remedy on one's own. Any new sensations should be reported to the specialist so that he can adjust further steps. Records of appointments, examination results and a list of the medicines being taken are convenient to keep in one place. Such carefulness helps the doctor see the course of the disease as a whole and change tactics in time if necessary.
What helps prevent an exacerbation?
Preventing an exacerbation of a gastric ulcer is largely helped by the person themselves, if they review their daily habits and do not put off a visit to the doctor. Below we will discuss which everyday decisions support the mucosa and why regular monitoring is needed.
What is changed in habits
Painkillers and anti-inflammatory medicines without a doctor's prescription can damage the gastric mucosa and provoke an exacerbation. If such medicines are needed for a long time, the doctor discusses gastric protection in advance in order to reduce this risk. Smoking worsens the blood supply to the mucosa and prevents it from recovering after damage. Alcohol irritates the stomach walls directly and also slows down healing. Giving up cigarettes and limiting alcohol noticeably improve the conditions for tissue recovery. Many people notice the changes by how less often heaviness and discomfort occur after eating. If complaints from the stomach appear, a visit to a gastroenterologist should not be put off for long.
What should be kept under control
- Taking painkillers: any such medicines are taken only as prescribed by a doctor, because uncontrolled use increases the risk of an exacerbation of a gastric ulcer.
- Gastric protection: with long-term use of medicines this issue is discussed with the doctor in advance, so that the mucosa does not suffer from constant strain.
- Smoking: giving up cigarettes helps the mucosa recover, since smoking worsens its nutrition and slows down the healing of damaged areas.
- Alcohol: limiting alcohol reduces irritation of the stomach walls and creates calmer conditions for healing.
- Complaints from the stomach: if they appear, one should promptly consult a gastroenterologist, without waiting for the condition to worsen.
How often to see the doctor
A regular examination by a gastroenterologist is needed even when one's wellbeing remains good and nothing is troubling them. An exacerbation of a gastric ulcer often develops gradually, and outward wellbeing does not always reflect the state of the mucosa. The doctor assesses the complaints, monitors the course of the condition and, if necessary, adjusts the recommendations. Such monitoring allows changes to be noticed in time and prevents a pronounced exacerbation. If heaviness, discomfort or other complaints appear, the visit should not be put off for long. Planned consultations help to maintain the usual rhythm of life and avoid sudden deteriorations. It is sensible to discuss a convenient frequency of such visits with the doctor in advance.
What is worth remembering
A gastric ulcer is a condition in which a defect in the wall of the organ requires a doctor's supervision, rather than independent attempts to cope with the pain. Below is what is important to keep in mind after becoming familiar with the topic.
Key takeaways
A gastric ulcer often follows a wave-like course: calm periods give way to flare-ups, and feeling well on good days does not cancel out the defect in the wall itself. Pain or discomfort in the upper abdomen, a link between the complaints and eating, and night pain are a reason not to wait until it gets better on its own. The danger of a gastric ulcer lies not only in the unpleasant sensations: complications develop suddenly and sometimes without pronounced preceding pain. That is precisely why, when black stools, vomiting with blood or severe weakness appear, help is needed immediately, not according to a plan. The examination for a gastric ulcer is prescribed by a doctor, and it is needed in order to see the whole picture, rather than guess from sensations. Treatment is selected individually, and it should not be interrupted when things improve: outward well-being outpaces healing. It is more sensible to rely on regular supervision and an honest conversation with the doctor than on one-off measures at the moment of pain.
