Presentation
Abdominal pain is the most common symptom of gastric ulcer. The pain subsides with antacid drugs. In addition, the following are some of the other symptoms:
- Bloating
- Feeling of fullness after meals
- Retching
- Abdominal pain that usually gets worse after meals.
In more severe cases, individuals with gastric ulcer may experience the following:
- A sudden and sharp pain in the stomach that gets worse
- Vomiting blood
- Passing blood in stools
Such signs could signal ulcer bleeding and individuals should receive quick medical attention.
Entire Body System
- Pain
The purpose of this article is to report on the evaluation of vague abdominal pain and anemia in the deployed military environment resulting in the diagnosis of a giant gastric ulcer. [ncbi.nlm.nih.gov]
Epigastric pain which occurs after meals is the most common symptom of gastric ulcers. Abdominal pain is the most common symptom of gastric ulcer. The pain subsides with antacid drugs. [symptoma.com]
The most common complaint is a burning pain in the stomach. Duodenal ulcers may also cause abdominal pain a few hours after eating. [medicalnewstoday.com]
When peptic ulcer occurs, the life become painful. The patient survives for how long without eating food. When patient eats food, the severe pain starts in his/her stomach. [alhakeemshifakhana.com]
- Inflammation
H. pylori-associated severe inflammation can lead to neoplastic changes in histiocytes. [ncbi.nlm.nih.gov]
When the bacteria H. pylori gains entry into the human system, it causes inflammation of the lining of the stomach. Inflammation in turn damages the mucosal barrier causing some amount of acid to be released. [symptoma.com]
This causes inflammation through the entire body. In addition, more recent discoveries also confirm that inflammation is present in cells that form the lining of the gut. [obesityaction.org]
Long-standing inflammation can lead to chronic inflammation of the stomach and even stomach cancer. The damaged gastric tissue is replaced by intestinal or fibrous tissue naturally. [oncnursingnews.com]
- Weight Loss
We present the case of a 30-year old female with a history of abdominal pain, fever, poor oral tolerance and weight loss for 6 months. [ncbi.nlm.nih.gov]
Symptoms of a gastric ulcer can include abdominal pain that occurs after a meal, nausea, vomiting, weight loss, and fatigue. Some gastric ulcers can be caused by infection with a bacterium called Helicobacter pylori. [merckmanuals.com]
- Weakness
Author information 1 General Internal Medicine, Ohta-Nishinouchi Hospital, Japan. [email protected] Abstract A 67-year-old woman presented with melena and general weakness. [ncbi.nlm.nih.gov]
The symptoms of anemia are tiredness (fatigue), lack of energy (lethargy), weakness, rapid heartbeat (tachycardia), and pale skin (pallor). QUESTION Pancreatitis is inflammation of an organ in the abdomen called the pancreas. [emedicinehealth.com]
Bleeding symptoms may include: Bloody or black, tarry stools Vomiting what looks like coffee grounds or blood Weakness Lightheadedness A perforated ulcer is a break through the wall of the stomach. It causes sudden and severe pain. [health.cvs.com]
This is especially important as this inflammation may lead to weakness of gut cells and make them prone to ulcer formation. 2. Gut bacteria are different in individuals affected by obesity compared to individuals with a weight in the normal range. [obesityaction.org]
Anemia from bleeding can cause weakness and faintness or fainting. Ulcers can get progressively deeper and penetrate through the wall of the stomach or duodenum, producing sudden and severe pain and shock. This is a medical emergency. [health.harvard.edu]
- Fever
We present the case of a 30-year old female with a history of abdominal pain, fever, poor oral tolerance and weight loss for 6 months. [ncbi.nlm.nih.gov]
Patients can present non-specific symptoms such as epigastric pain, vomiting, fever, weight loss, anorexia, upper GI bleeding among others, so a high index of suspicion is required (5,10). [scielo.org.pe]
Tick-borne Rickettsia rickettsii Rocky Mountain spotted fever Rickettsia conorii Boutonneuse fever Rickettsia japonica Japanese spotted fever Rickettsia sibirica North Asian tick typhus Rickettsia australis Queensland tick typhus Rickettsia honei Flinders [en.wikipedia.org]
Gastrointestinal
- Vomiting
The most common symptoms of stomach ulcers are abdominal pain and vomiting. [emedicinehealth.com]
A 61-year-old male had osmotic demyelination syndrome caused by rapid correction of gastric ulcer bleeding and vomiting related hyponatraemia with normal saline. It is rare to see severe hyponatraemia caused by gastric ulcer bleeding and vomiting. [ncbi.nlm.nih.gov]
Symptoms can include: repeated episodes of vomiting, with large amounts of vomit that contain undigested food a persistent feeling of bloating or fullness feeling very full after eating less food than usual unexplained weight loss An endoscopy can be [nhs.uk]
For example, the irritation of the ulcer may cause vomiting, sometimes with blood in the vomit. Vomited blood may be dark red, but may also be black. [livestrong.com]
- Nausea
Sometimes there are no signs or symptoms of stomach cancer or duodenal or gastric ulcers, and when they do occur, they may include nausea and loss of appetite with no clear cause. [emedicinehealth.com]
We report a 77-year old woman who presented with diffuse abdominal pain, weight loss, malaise, nausea, and occasional dark stools. Laboratory tests showed extreme hyposideremic anemia with inflammatory syndrome. [ncbi.nlm.nih.gov]
Symptoms of a gastric ulcer can include abdominal pain that occurs after a meal, nausea, vomiting, weight loss, and fatigue. Some gastric ulcers can be caused by infection with a bacterium called Helicobacter pylori. [merckmanuals.com]
For patients with stomachache, nausea, or vomiting, it's always better to get checked by a doctor as soon as possible. All these may possibly be the symptoms of stomach cancer. [oncnursingnews.com]
- Abdominal Pain
The purpose of this article is to report on the evaluation of vague abdominal pain and anemia in the deployed military environment resulting in the diagnosis of a giant gastric ulcer. [ncbi.nlm.nih.gov]
Usually, this type of abdominal pain does not occur in stomach cancer. The most common symptoms of stomach ulcers are abdominal pain and vomiting. [emedicinehealth.com]
- Loss of Appetite
[…] of appetite Loss of weight Severe ulcers may cause bleeding in the stomach or duodenum. [emedicinehealth.com]
Other less common symptoms include: indigestion (heartburn) loss of appetite vomiting feeling full and bloated, or belching not being able to tolerate fatty foods nausea. [healthdirect.gov.au]
It presents with diarrhoea mixed with blood and mucous, abdominal pain, loss of appetite, fatigue and weight loss. The disease pattern is such that rectum is always involved and accordingly classified based on the area affected. [ejpmr.com]
Symptoms may include: Gnawing pain: May awaken you from sleep May change when you eat May last for a few minutes or several hours Feels like unusually strong hunger pangs May be relieved by taking antacids Nausea Vomiting Loss of appetite Bloating Burping [health.cvs.com]
Patients with peptic ulcers typically feel a burning pain in their abdomen or may experience nausea, vomiting, weight loss, or loss of appetite. [news-medical.net]
- Dyspepsia
However NICE guidelines now suggest that a referral for urgent OGD should be done for patients presenting with either: New-onset dysphagia Aged >55 years with weight loss and either upper abdominal pain, reflux, or dyspepsia New onset dyspepsia not responding [teachmesurgery.com]
Print this page Dyspepsia Dyspepsia is a term covering a group of symptoms including poor digestion, pain, and discomfort in the upper digestive tract. Research to date does not show any relationship between coffee consumption and dyspepsia. [coffeeandhealth.org]
Updated 09/21/2018 Category: Diet A diet that avoids stomach irritants is for those patients who suffer from symptoms of peptic ulcer disease or non-ulcer dyspepsia. [gicare.com]
The most common symptom in patients with peptic ulcer disease is dyspepsia, which is a technical term for indigestion. [courses.washington.edu]
Symptoms were limited to dyspepsia (indigestion). Endoscopy demonstrated a 1 cm ulcer in the gastric antrum. The ulcer crater is fairly superficial and has a benign appearance, with smooth margins. [endoatlas.com]
Cardiovascular
- Hypertension
A 65-year-old male with a history of type 2 diabetes mellitus, hypertension, pulmonary tuberculosis, and end-stage renal disease was previously treated with hemodialysis (HD). [ncbi.nlm.nih.gov]
Gastroesophageal Reflux Disease (GERD) Hepatitis B Hepatitis C Inflammatory Bowel Disease (IBD) Irritable Bowel Syndrome Islet Cell Transplant Liver Cancer Liver & Biliary Diseases Pancreatic Diseases Pancreatic Cancer Pancreatitis Peptic Ulcer Disease Portal Hypertension [nyp.org]
While chelated bismuthate and carbenoxolone works quite similar to sucralfate, appreciable incidence of aldosterone-like adverse effects (sodium and fluid retention, hypertension etc) have hampered their use. 2.4. [intechopen.com]
[…] diabetes, as evidenced by a high hemoglobin A1c and a high fasting glucose Poorly functioning kidney, as evidenced by increased BUN (blood urea nitrogen) and blood creatinine Poorly functioning liver, as evidenced by increased blood liver function tests Hypertension [dovemed.com]
Skin
- Ulcer
ulcer without mention of hemorrhage or perforation, with obstruction acute gastric ulcer with hemorrhage, with perforation AND with obstruction gastric ulcer stomach peptic ulcer disease edit English gastric ulcer An ulcerated lesion in the mucosal surface [wikidata.org]
Esophagogastroduodenoscopy revealed an ulcerated gastric mass. Pathologic examination revealed squamous cell carcinoma in both the gastric ulcer margin and the cutaneous mass. The patient was transfused 2 units of packed erythrocytes. [ncbi.nlm.nih.gov]
- Skin Rash
Side effects of H2-receptor antagonists are uncommon but may include: diarrhoea, headaches, dizziness, skin rashes, and tiredness. [hse.ie]
Psychiatrical
- Hunger
[…] tral·gia del es·tó·ma·go va·cí·o que es sín·to·ma ca·rac·te·rís·ti·co de la úl·ce·ra gás·tri·ca o duo·de·nal Feminine - Noun - Singular Translate "gastralgia del estómago vacío que es síntoma característico de la úlcera gástrica o duodenal" to English: hunger [wordmagicsoft.com]
But the downside of hunger was nausea — and an empty stomach can be doubly painful. Without any food in there, the ulcer is bathed in stomach acid all the time, said Dr. [nytimes.com]
Symptoms may include: Gnawing pain: May awaken you from sleep May change when you eat May last for a few minutes or several hours Feels like unusually strong hunger pangs May be relieved by taking antacids Nausea Vomiting Loss of appetite Bloating Burping [health.cvs.com]
Neurologic
- Dizziness
A 50-year-old female was admitted to our hospital with dizziness and tarry stools. Upper gastrointestinal endoscopy revealed bleeding from a gastric ulcer, and endoscopic hemostasis by endoscopic clipping was carried out. [ncbi.nlm.nih.gov]
Side effects of these are usually mild, but can include: headaches diarrhoea or constipation feeling sick tummy (abdominal) pain dizziness rashes These should pass once treatment has been completed. [nhs.uk]
Side effects of H2-receptor antagonists are uncommon but may include: diarrhoea, headaches, dizziness, skin rashes, and tiredness. [hse.ie]
Side effects Side effects of these are usually mild, but can include: headaches diarrhoea or constipation feeling sick abdominal (tummy) pain dizziness rashes These should pass once treatment has been completed. [nhsinform.scot]
- Burning Sensation
The most common symptom is a burning sensation or pain in the middle of your abdomen between your chest and belly button. Typically, the pain will be more intense when your stomach is empty, and it can last for a few minutes to several hours. [healthline.com]
Symptoms of Ulcer The most common symptoms of a peptic ulcer are the following: Burning sensation Avoiding food due to discomfort Pain that improves upon food intake or by antacids Feeling of fullness Bloating or belching Vomiting Dark stools Blood in [marham.pk]
The burning sensation can occur during the night and be so extreme as to wake the patient. Instead of pain, some patients experience intense hunger or bloating. Antacids and milk usually give temporary relief. [starpoli.com]
This causes a burning, painful sensation, sometimes one that’s very strong. [draxe.com]
Workup
Diagnosis of gastric ulcer is made based on the symptoms experienced by the individual. If the symptoms point towards development of ulcers in the stomach then the following procedures are done to confirm the diagnosis:
- Endoscopy: With the help of endoscopy, inflammation and ulcers in the stomach can be detected.
- Breath test, blood test or stool test is done to look for the presence of H. pylori bacteria.
- Gastric acid assays using basal acid output (BAO) and maximal aid output as parameters may be a helpful predictor of gastric ulcer propensity in patients [5].
- Biopsy is also done to confirm the condition. Small samples of the tissues are analyzed for signs of cancer.
Microbiology
- Helicobacter Pylori
We describe a 77-year-old man with refractory gastric ulcer that worsened after Helicobacter pylori eradication therapy. [ncbi.nlm.nih.gov]
You’re also likely to have tests to check for Helicobacter pylori infection. Usually this involves a breath test, or a test of the stomach lining during endoscopy. [healthdirect.gov.au]
- Candida
Though cured of the lesion, she developed another ulcer in a different position, in which Candida was demonstrated but H. pylori was undetectable. This is the first case of recurrent Candida-associated gastric ulcer in the world. [ncbi.nlm.nih.gov]
This is because fungi like Candida feed off glucose -- the blood sugar your body uses as a source of energy. If you have diabetes, you have too much glucose in your blood. Extra glucose can create a breeding ground for fungus. [webmd.com]
Other causes of chapped lips (cheilitis) Angular Cheilitis Bacterial Infection Candida Infection Chronic Lip Licking or Biting Drug Reactions Fungal Infection Hypervitaminosis A Medications Pemphigus Vulgaris Wind Exposure SLIDESHOW Rosacea, Acne, Shingles [medicinenet.com]
Gastroscopy
- Gastric Lesion
Pathology showed marked infiltration of IgG4-positive plasma cells in the gastric lesions, which led us to suspect IgG4-related sclerosing disease. [ncbi.nlm.nih.gov]
Treatment
Treatment is geared towards managing the symptoms by suppressing the excessive production of acid and eradicating the infection if the ulcer has occurred due to bacterial infection. The following methods are employed to treat gastric ulcers:
- Medications: Medications such as antibiotics are administered if bacteria are the source of infection. In addition, acid suppressing medications are also given to suppress the acid produced in the stomach. Therefore, a proper course of antibiotic along with acid suppressing medications (triple therapy) is given to treat gastric ulcers [6].
- Surgery is usually the last resort. It is done only when complications develop and medications are of no help. In cases of ulcer bleeding and perforation, surgical intervention is carried out.
Prognosis
The prognosis of the condition is very favorable if timely treatment is initiated. Failure to diagnose the condition and appropriately treat it can pave way for complications to set in.
Acute gastric perforation due to gastric ulceration carries a mortality rate of up to 30% [4]. In severe cases, the ulcers can bleed and cause other secondary complications. It is necessary that ulcers be promptly treated to avoid the condition from taking a severe form.
Complications
Complications of gastric ulcer include the following:
- Perforation: Untreated ulcers can even penetrate the wall of the stomach. Such a kind of development causes the food and acid to leak into the abdominal cavity leading to severe pain. Perforation as a result of ulcers is a medical emergency requiring prompt intervention.
- Bleeding: Ulcers that are left untreated for long can cause them to bleed giving rise to life threatening complications. Symptoms of bleeding ulcers include passing of blood in stools and vomiting blood.
- Gastric obstruction: In this condition, ulcers block the passage of the food through the digestive tract.
Etiology
Infections by Helicobacter pylori (H. pylori) are known to trigger the development of sores in the stomach. Majority of individuals develop such bacterial infections at least once in their lifetime. Appropriate antibiotic drugs are necessary to treat the infection; otherwise the infection would persist for the rest of their life.
Various drugs such as non–steroidal anti-inflammatory drugs (NSAIDs) can also lead to gastric ulcers [1]. In addition, the disorder is also known to occur as a secondary condition to other medical illnesses such as Crohn disease and stomach cancer.
Diuretic medications like spironolactone has been found to cause gastric ulcers and gastric bleeding in patients taking long term maintenance with spironolactone [2].
Epidemiology
Gastric ulcer is a common condition affecting about 1 in every 10 individuals in England. It has also been estimated that infections are the major cause of gastric ulcers that account for every 8 in 10 cases [3].
Pathophysiology
Bacterial infections and certain class of medications are known to trigger the development of gastric ulcers. When the bacteria H. pylori gains entry into the human system, it causes inflammation of the lining of the stomach. Inflammation in turn damages the mucosal barrier causing some amount of acid to be released. This acid gives rise to open sores on the stomach lining. In similar fashion, some over the counter drugs taken for common ailments can also lead to release of acid causing open sores to develop on the lining.
Prevention
Development of gastric ulcers can be prevented by following certain simple practices:
- Washing hands frequently to avoid infections.
- Certain medications such as NSAIDs and anti-inflammatory drugs can cause gastric ulcers; use of such medications should be limited. For those who need to continue their NSAIDs therapy, a maintenance of a daily proton pump inhibitor may prevent recurrence of gastric ulcer [7].
- Avoiding use of high spicy foods that can worsen the already existing ulcers.
- The active control of H. pylori infection in the stomach and intestine with triple therapy has a cure rate of 85-90% in gastric ulcer cases [8].
- Patients diagnosed with gastric ulcer or duodenal ulcer triggered by H. pylori may experience relapse with continued smoking [9]. Although, smoking has already been proven to be directly harmful to the gastroduodenal mucosa [10].
Summary
Gastric ulcers, also commonly known as stomach ulcers, are characterized by development of open sores in the mucosal lining of the stomach. It is a common condition affecting millions of individuals across the globe.
Bacterial infection is the major cause of gastric ulcer. An appropriate treatment regime with antibiotics is successful in treating such a condition. Certain preventive measures can also be taken to keep bacterial infections at bay.
Patient Information
Definition
Gastric ulcers are characterized by development of open sores in the lining of the stomach. It is a common condition affecting several individuals across the globe. Infections and certain class of drugs cause inflammation of the stomach lining which in turn disrupts the mucosal cells. As a result of this, acid is released by the cells giving rise to development of open sores.
Cause
Infections by bacteria known as Helicobacter pylori is one of the major causes of gastric ulcer. In addition, medications such as anti-inflammatory drugs and NSAIDs are also known to trigger development of ulcers.
Symptoms
Symptoms of gastric ulcer include abdominal pain, bloating, retching and feeling of fullness after meals. In addition, more serious symptoms include passing of blood in stools, vomiting blood and sharp and sudden pain in the abdomen that persists for long duration.
Diagnosis
Diagnosis of gastric ulcer is done through endoscopy that makes use of a flexible tube inserted through the mouth to study the presence of inflammation and ulcers in the stomach. In addition, blood test is also required to detect the presence of bacteria in the body.
Treatment
Treatment includes administration of medications such as antibiotics and acid suppressing drugs. Surgery is employed only when the condition turns severe and medications do not seem to work.
References
- Laine L, Curtis SP, Cryer B, Kaur A, Cannon CP. Risk factors for NSAID-associated upper GI clinical events in a long-term prospective study of 34 701 arthritis patients. Aliment Pharmacol Ther. Nov 2010; 32(10):1240-8.
- Gulmez SE, Lassen AT, Aalykke C, Dall M, Andries A, Andersen BS, et al. Spironolactone use and the risk of upper gastrointestinal bleeding: a population-based case-control study. Br J Clin Pharmacol. Aug 2008; 66(2):294-9.
- Cai S, García Rodríguez LA, Massó-González EL, Hernández-Díaz S. Uncomplicated peptic ulcer in the UK: trends from 1997 to 2005. Aliment Pharmacol Ther. Nov 15 2009; 30(10):1039-48.
- Svanes C, Lie RT, Svanes K, Lie SA, Søreide O. Adverse effects of delayed treatment for perforated peptic ulcer. Ann Surg. Aug 1994; 220(2):168-75.
- Schubert ML, Peura DA. Control of gastric acid secretion in health and disease. Gastroenterology. Jun 2008; 134(7):1842-60.
- Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. Aug 2007; 102(8):1808-25.
- Lai KC, Lam SK, Chu KM, Hui WM, Kwok KF, Wong BC, et al. Lansoprazole reduces ulcer relapse after eradication of Helicobacter pylori in nonsteroidal anti-inflammatory drug users--a randomized trial. Aliment Pharmacol Ther. Oct 15 2003; 18(8):829-36.
- Javid G, Zargar SA, U-Saif R, Khan BA, Yatoo GN, Shah AH, et al. Comparison of p.o. or i.v. proton pump inhibitors on 72-h intragastric pH in bleeding peptic ulcer. J Gastroenterol Hepatol. Jul 2009; 24(7):1236-43.
- Sonnenberg A, Müller-Lissner SA, Vogel E, Schmid P, Gonvers JJ, Peter P, et al. Predictors of duodenal ulcer healing and relapse. Gastroenterology. Dec 1981; 81(6):1061-7
- Koivisto TT, Voutilainen ME, Färkkilä MA. Effect of smoking on gastric histology in Helicobacter pylori-positive gastritis. Scand J Gastroenterol. 2008; 43(10):1177-83.