Ulcer

Ulcer

Peptic ulcers are ulcers in the lining of the stomach or in the upper part of the duodenum caused by the bacterium Helicobacter pylori. Ulcers can in some cases also be caused by long-term use of anti-inflammatory medicines. About 1 in 10 will develop a stomach ulcer at some point in their life.

What causes stomach ulcers?

Peptic ulcers are today considered an infectious disease caused by the bacterium Helicobacter pylori (H. pylori). It is believed that 99% of duodenal ulcers and 75% of gastric ulcers are due to infection with this bacterium. The remaining cases of stomach ulcers are due to the use of an anti-inflammatory drug called NSAIDs. Examples of active substances included in this drug group are ibuprofen, naproxen and acetylsalicylic acid.

Symptoms of peptic ulcer

The symptoms of stomach ulcers often come periodically, and vary in strength. The most common symptom is abdominal pain that disappears or decreases in strength when eating food or antacid/acid-inhibiting medicines. Symptoms of peptic ulcer:

• Hunger pains (typical of duodenal ulcers)

• Abdominal pain that wakes you up at night

• Acid reflux or heartburn

• Nausea and vomiting

• Early satiety and reduced appetite. Most pronounced with ulcers in the stomach

• If the wound bleeds, you may experience symptoms of anemia (pale, lethargic and dizzy)

Self-treatment

In the case of a stomach ulcer, you usually have to be careful with strongly spicy food, smoked food, very fatty food, coffee and acidic drinks for a long time. Some people have to avoid such foods for life. Smoking increases the risk of new ulcers.

Anyone with a stomach ulcer must avoid using medications that are classified as NSAIDs, both over-the-counter and prescription.

There are over-the-counter medicines that reduce the acid content in the stomach. If you have a stomach ulcer or stomach catarrh, such remedies should only be taken after consultation with a doctor.

Treatment

Ulcers must always be examined and treated by a doctor.

Stomach ulcers caused by the bacteria H.pylori are treated with a so-called triple cure. This triple regimen usually consists of two types of antibiotics and a medicine that inhibits acid production (usually a proton pump inhibitor). It is important to take the triple regimen correctly. Correct use of the medicines increases the chance of getting rid of the bacteria. The course lasts 7-10 days.

If stomach ulcers are caused by the use of NSAIDs, treatment with this medication must be discontinued. The stomach ulcer is additionally treated with an antacid for 4-8 weeks. Maintenance treatment is also considered.

Bleeding ulcers and ulcers with a risk of a hole in the stomach must be operated on.

When should you contact a doctor for stomach ulcers?

• In case of suspected stomach ulcer

• If you have severe stomach pain, vomiting or black faeces/dark blood in the faeces

Sources: Norwegian drug handbook for health personnel.