It often starts as a burning or gnawing ache in the upper belly, worse when the stomach is empty, easing for a while after eating, then returning. Many people reach for antacids, blame something they ate, and carry on for months. Some of them have a stomach ulcer that is being quietly ignored.
Ulcers are common and very treatable, but they are worth understanding, because the popular ideas about what causes them are mostly wrong, and a small number of ulcers can become dangerous.
What an ulcer actually is
A peptic ulcer is an open sore in the lining of the stomach or in the first part of the small intestine just beyond it, called the duodenum. The stomach produces strong acid to digest food, and normally a protective layer keeps that acid from harming the lining. When that protection breaks down, the acid eats into the wall and forms an ulcer.
The real causes
A bacterial infection. A germ called Helicobacter pylori, often shortened to H. pylori, lives in the stomach lining of many people and is the single most common cause of ulcers. It can be picked up years earlier and cause no trouble until it damages the protective layer. The good news is that it can be detected with a simple test and cleared with a course of treatment.
Regular painkillers. Anti inflammatory medicines known as NSAIDs, which many people take for arthritis, headaches or back pain, can wear down the stomach's protective lining when used often or in high doses. This is a very common and often overlooked cause.
Smoking and heavy alcohol use make ulcers more likely and slow their healing. Spicy food and stress, contrary to popular belief, do not create ulcers, although they can certainly aggravate the discomfort of one that already exists.
The symptoms to notice
The classic sign is a burning or gnawing pain in the upper abdomen. It often comes when the stomach is empty, including at night, and may ease briefly after eating or after an antacid.
Other symptoms include bloating, frequent burping, nausea, feeling full quickly, and in some cases a loss of appetite or weight. Some ulcers, though, cause few symptoms until they bleed, which is why the warning signs below matter so much.
How ulcers are diagnosed
Because ulcer symptoms overlap with ordinary acid reflux and other conditions, diagnosis is about finding the cause rather than guessing.
We can test for H. pylori through our laboratory. The most direct way to confirm an ulcer, though, is an endoscopy, a procedure in which a thin, flexible tube with a tiny camera is passed through the mouth to look directly at the lining of the stomach and duodenum. This lets the doctor see the ulcer, check for the bacteria, and take small samples if needed. We offer endoscopy on site.
Endoscopy is particularly important for anyone over a certain age with new symptoms, or with warning signs such as weight loss, difficulty swallowing or bleeding, because it also helps rule out more serious conditions.
How ulcers are treated
Treatment is usually straightforward and very effective. Medicines that strongly reduce stomach acid, a class known as proton pump inhibitors, give the ulcer a chance to heal. If H. pylori is found, a specific combination of antibiotics alongside acid reducing medicine clears the infection, which both heals the ulcer and stops it coming back.
Where NSAIDs are the cause, stopping or changing them is key, and your doctor can advise on safer options for your pain. Cutting out smoking and reducing alcohol help the lining recover. Most ulcers heal well with this approach, and a follow up may be arranged to confirm healing. In the uncommon event of a complication such as heavy bleeding or a perforation, surgery may be needed, and our operating theatre is on site.
The honest bottom line
Persistent upper stomach pain is not something to manage forever with a shelf full of antacids. It usually has a specific, treatable cause, and finding that cause is simpler than most people expect.
If stomach pain, burning or reflux has been part of your daily life, book a consultation. Getting the right test and the right treatment can settle it properly, and it can catch the rare problem that should not be missed.
Persistent stomach pain or heartburn? Get to the cause at Newtown.
Consultation, laboratory testing and endoscopy are all available under one roof at 55 Woodford Street, Port of Spain, so the cause of your stomach pain can be found and treated properly. Our doctors can test for the common causes of ulcers and look directly at the stomach lining when needed. Our Accident and Emergency department is open 24 hours for the bleeding warning signs below.
This article is for general education only and is not a substitute for personal medical advice, diagnosis or treatment. Always consult a qualified healthcare provider about your own health. If you believe you have a medical emergency, call or visit our 24-hour Accident and Emergency department immediately.