Abdominal pain after a meal may have a simple cause, such as heartburn, or may be due to something more serious, such as peptic ulcer disease. Acid production causes sores in the lining of the stomach, resulting in the development of ulcers. Severity, cause and treatment of ulcers vary. The Centers for Disease Control and Prevention reports that an estimated 25 million people will have peptic ulcer disease at some point in their lifetime.
Symptoms
Since ulcers tend to relapse after healing, so do the symptoms. Intermittent symptoms vary from asymptomatic to symptomatic, with symptoms such as gnawing, burning chest pain, abdominal pain two to three hours after meals, and pain that awakens you during the night. Milk or antacids can often relieve the pain. Peptic ulcer disease symptoms do not always follow this pattern, however, as both duodenal and gastric disease symptoms may overlap.
Symptoms related to gastric ulcers are less likely to follow any particular pattern. However, food often aggravates the stomach in the case of gastric ulcers. Bloating, nausea and vomiting tend to be more associated with gastric ulcers, according to the Merck Manual.
Signs of peptic ulcers that indicate worsening or severe symptoms include vomiting blood, dark blood, nausea, unexplained weight loss and appetite changes, reports the Mayo Clinic.
Types
Peptic ulcer disease has two types, depending on their location: gastric and duodenal ulcers. Both have different presenting symptoms and complication risks. Duodenal ulcers develop ulcerations in the first part of the small intestine (duodenum); gastric ulcers develop ulcerations in the lining of the stomach.
Cause
Normally, the stomach defends itself from damage with mucus that coats and protects the stomach lining. When damaging substances make it through this barrier and the repair mechanisms in place, this produces the symptoms of peptic ulcer disease. Infection and medication weaken the mucosal layer, allowing acidic fluid in the stomach to irritate and eat away at its lining, which in turn forms ulcers of various sizes in the lining.
Helicobacter pylori bacteria, the most common cause of peptic ulcers, increase acid production in the stomach. Smoking, tobacco, alcohol and stress also increase acid volume and contribute to peptic ulcer disease.
Diagnosis
Typically, a physician will prescribe medications when suspicion of peptic ulcer disease is high. When there is little response to medications, other diagnostic measures can be performed. A small tube, called an endoscope, helps physicians make the diagnosis of peptic ulcer disease. Placed down the throat, the endoscope allows physicians to see the sores on the lining of the stomach and small intestine.
Complications
Complications can happen when ulcers penetrate the lining of the stomach or create a hole in the abdominal cavity. The possibility of bleeding increases in both instances. Obstruction around the passage from the stomach to the small intestine may also occur due to long-standing inflammation in that region. Though not common, all complications from peptic ulcer disease may be life-threatening and require immediate treatment.
Treatments
Treatment is based on the cause. Based on the patient's symptoms and history, the doctor may simply treat with a regimen of antibiotics, an acid reducer and bismuth, or seek more aggressive treatment like surgery. Antibiotics eradicate the bacteria H. pylori, the most common cause peptic ulcer disease. Proton pump inhibitors, histamine blockers, misopristol and antacids can combat damage due to stomach acid. Misopristol works to increase the stomach's ability to resist acid, while antacids buffer acid. Surgery is reserved for complications associated with peptic ulcer disease, and is rarely performed.
