A gastric ulcer is a sore found in the lining of the stomach that is caused by bacterial infection or drugs. According to the University of Maryland Medical Center, bacteria like Helicobacter pylori (H. pylori) cause 80 percent of gastric ulcers. Bacteria cause ulcers by releasing chemicals that weaken the mucus lining of the stomach, making it more susceptible to stomach acid and digestive juices. The second major cause for ulcers is irritation of the stomach arising from regular use of drugs like NSAIDs (nonsteroidal anti-inflammatory drugs) like ibuprofen and aspirin, which have been known to erode the lining of the stomach after prolonged use, notes the American College of Gastroenterology.
Transmission
According to the National Digestive Diseases Information Clearinghouse (NDDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), researchers are not certain how H. pylori is transmitted, although they think it may be spread by not washing or cooking food properly, and by drinking contaminated water. The bacteria may also be spread through the saliva, stool or vomit of an infected person. Therefore, it is important to practice good hygiene.
Symptoms
Abdominal discomfort is the main symptom of a gastric ulcer and could be in the form of a dull or burning pain. It may last from minutes to hours, or even days or weeks. Eating food or taking antacids may temporarily relieve the discomfort. Discomfort occurs often when the stomach is empty, usually at night. Other symptoms include nausea, vomiting, bloating, poor appetite, burping and weight loss. It is important to get medical assistance if there is sudden, severe pain, blood in the stool or vomit, and if the stool is black. Bleeding could indicate that the ulcer has broken a blood vessel.
Diagnosis
Medication history helps rule out the use of NSAIDS as the cause of the ulcer. There are three tests performed to detect the presence of Helicobacter bacteria. A blood test is used to detect antibodies against the bacteria. If antibodies are present, then H. pylori bacteria are present. A stool antigen test uses a stool sample provided by the patient to detect the presence of bacteria, and works similarly to the blood test. The urea breath test involves swallowing a capsule, food or liquid containing the chemical urea, which is tagged with a special carbon tag. When the patient breathes out into a container, a measurement is done to detect any carbon, indicating the presence of H. pylori bacteria. According to National Digestive Diseases Information Clearinghouse, another method to diagnose an ulcer is using an endoscope--a thin, lighted tube with a camera. The patient is sedated and the tube is inserted through the mouth and down into the stomach. This allows the doctor to view any abnormalities in the stomach. X-rays may also be done using a chemical called barium. The patient drinks the barium liquid and it helps show the stomach and any ulcers present on the x-ray.
Treatment
Antibiotic combinations are used to kill the Helicobacter bacteria to avoid resistance. Drugs include amoxicillin (Amoxil), clarithromycin (Biaxin) and metronidazole (Flagyl). Acid blockers are also used to reduce the amount of hydrochloric acid produced in the stomach, and include ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet) and nizatidine (Axid). Proton pump inhibitors may be used to shut down acid-secreting cells, and include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex) and esomeprazole (Nexium). Cytoprotective drugs like sucralfate (Carafate), misoprostol (Cytotec) and bismuth subsalicylate (Pepto-Bismol) may be prescribed to help coat and protect the stomach, according to the Mayo Clinic.
Prevention
Prevention of Helicobacter bacteria starts with good hygiene and includes washing the hands with soap and water before eating and after using the restroom. Drink water from a clean source and eat food that has been properly cooked and washed.
