Gastric Ulcer

What is a gastric ulcer?

Gastric ulcer, also known as peptic ulcer, is a localized area of erosion in the stomach lining, resulting in abdominal pain, possible bleeding, and other gastrointestinal symptoms. The most common cause of gastric ulcer is a stomach infection associated with the Helicobacter pylori (H pylori) bacteria. The spread of H pylori among humans is not completely understood; it may spread through contaminated food and water. Many people become infected with H pylori at a young age, but symptoms most commonly occur in adulthood.

In some people, the H pylori bacteria cause an infection in the lining of the stomach, which may lead to gastric ulcers. Damage to the stomach lining from stomach acid increases the likelihood that H pylori infection will result in a gastric ulcer. Other risk factors for gastric ulcer include alcohol use, tobacco use, and prolonged use of medications such nonsteroidal anti-inflammatory drugs (NSAIDs). Severe illness has also been associated with developing a gastric ulcer.

The signs and symptoms of gastric ulcer can be constant or sporadic, and the disease course varies among individuals. If H pylori is the cause, the symptoms will remain as long as the infection is untreated. Some people with gastric ulcers have no symptoms at all, while others may have burning pain, severe nausea, and vomiting.

In the case of H pylori-related gastric ulcers, the infection can be treated successfully with antibiotics. For gastric ulcer not related to H pylori, antacids or other medications are an effective treatment. You can reduce your risk of H pylori bacteria infection by following commonsense hygiene practices such as washing your hands with soap and water prior to preparing food and after handling dirty diapers or using the bathroom.

Seek immediate medical care (call 911) for serious symptoms such as severe abdominal pain, bloody or black tarry stools, or bloody or black vomit.

Seek prompt medical care if you are being treated for gastric ulcer but mild symptoms recur or are persistent.

What are the symptoms of a gastric ulcer?

Gastric ulcer causes inflammation and damage to the stomach lining that may result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of a gastric ulcer

You may experience gastric ulcer symptoms daily or just once in a while. At times any of these common symptoms can be severe:

    * Abdominal bloating
    * Abdominal burning
    * Abdominal pain
    * Belching
    * Feeling of fullness
    * Loss of appetite
    * Nausea with or without vomiting
    * Unexplained weight loss

Serious symptoms that might indicate a life-threatening condition

In some cases, gastric ulcer can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

    * Bloody stool (blood may be red, black, or tarry in texture)
    * Severe abdominal pain
    * Vomiting blood or black material (resembling coffee grounds)

What causes a gastric ulcer?

Other causes of gastric ulcer include agents that can cause inflammation of the stomach lining, including alcohol, tobacco, and medications such as nonsteroidal anti-inflammatory drugs (NSAIDs). Severe illness and radiation therapy have also been associated with gastric ulcers.

What are the risk factors for a gastric ulcer?

A number of factors increase the risk of developing a gastric ulcer. Not all people with risk factors will get gastric ulcer. Risk factors for gastric ulcers include:

    * Alcohol abuse
    * H pylori infection
    * History of radiation therapy
    * Regularly taking NSAIDs, such as ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin
    * Stress or severe illness
    * Tobacco use
    * How is a gastric ulcer treated?

Treatment for gastric ulcer begins with seeking medical care from your health care provider. To determine if you have a gastric ulcer, your health care provider may ask you to undergo diagnostic tests.
Antibiotic treatments for a gastric ulcer

If your gastric ulcer is caused by H pylori infection, antibiotic therapy is the mainstay of treatment. It is important to follow your antibiotic regimen precisely to avoid re-infection or recurrence. Most commonly, two antibiotics are given for 14 days. Examples of antibiotic treatments include:

    * Amoxicillin
    * Clarithromycin (Biaxin)
    * Metronidazole (Flagyl)
    * Tetracycline

Other medications for treating a gastric ulcer

Medications such as proton pump inhibitors and histamine H2-receptor antagonists, which decrease the amount of acid in the stomach, can also be effective treatments for gastric ulcers.

Proton pump inhibitors that are effective in the treatment of gastric ulcer include:

    * Esomeprazole (Nexium)
    * Lansoprazole (Prevacid)
    * Omeprazole (Prilosec)
    * Pantoprazole (Protonix)
    * Rabeprazole (Aciphex)

Histamine H2-receptor antagonists that are effective in the treatment of gastric ulcers include:

    * Cimetidine (Tagamet)
    * Famotidine (Pepcid)
    * Nizatidine (Axid)
    * Ranitidine (Zantac)

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

What are the potential complications of a gastric ulcer?

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of gastric ulcer include:

    * Internal hemorrhaging
    * Perforated gastric ulcer, which can lead to bleeding
    * Severe discomfort or pain
    * Spread of infection


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