Ulcer Stomach and Duodenum

General Information

An ulcer in the stomach or duodenum means that a hole has appeared in the lining membrane. This hole extends deep enough into the wall of the organ so that healing produces a scar. Lesser degrees of inflammation of the lining, those that heal without the formation of a scar, are gastritis or gastric erosions. In younger patients, peptic ulcers are more commonly located in the duodenum, the first portion of the small intestine just beyond the stomach. In older patients, ulceration in the stomach itself becomes more common.

Typically ulcers present with burning pain that occurs in the front of the abdomen between the sternum (breastbone) and the navel. It is worse when the stomach is empty and is made better by eating or taking an antacid. Many patients do not have typical pain. A few may have no pain at all. Gastric (stomach) ulcers, those most common in elderly patients, are a little less typical in their presentation. The pain may not be burning, the location not so precise, and relief with food less consistent.

Gastritis seems to render the lining of the stomach vulnerable to the development of ulcers. Gastritis can increase steadily in frequency with age as a result of an infection in the stomach. It is also particularly common in people taking aspirin-like anti-inflammatory drugs. This is a likely explanation for the increased occurrence of gastric ulcers in elderly patients.

Confirmation of the presence of an ulcer is important. This is particularly true if it is a gastric ulcer. Cancers of the stomach can often mimic gastric ulcers, and they require different treatment. Although gastric ulcers may appear to be simple ulcers, a biopsy is usually performed to ensure that a tumor is not present. Often a biopsy is done to look for a type of infection that is often associated with peptic ulcers and gastritis. The treatment includes antibiotics if this infection is present.

Important Points in Treatment
The treatment of ulceration in the stomach or duodenum involves the use of drugs. These may be drugs to suppress the production of acid, to neutralize acid, to treat infection in the stomach, or to protect the lining membrane from the effects of acid. The use of these drugs, either alone or in combination, has been highly effective, and surgery for ulcers, which used to be common, is now kept for the treatment of complications.

Once they occur, ulcers are likely to recur after healing. To prevent this, one takes lower doses of acid-suppressing drugs nightly after the ulcer heals. Treating the infection associated with peptic ulcers and gastritis also helps prevent recurrence.

Complications
The complications of peptic ulcers are bleeding, perforation through the wall of the stomach or duodenum, scarring, and failure to respond to treatment. Because some people feel no pain or discomfort with an ulcer, they may have a complication as their first symptom.

Notify Our Office If ...

• You experience onset of pain or burning in the stomach.
• You have any evidence of bleeding from the stomach. Blood in vomitus may be red but may also resemble coffee grounds. Blood in the stool often changes the feces so that they appear black and tarry.