Stomach Ulcers - What Are The Most Common Causes?

The stomach has a smooth mucosal lining, which also provides a protective layer for the stomach tissue. There are various acids and chemicals that flow through the stomach, and this protective layer provides the stomach tissue adequate protection. However, due to various conditions, this lining can develop ulcers or sores or breaks which disrupts the continuity of the mucosal lining. This can allow the acids and chemicals access to further degrade the mucosal lining.

Some of common causes include -

1. Infection with Helicobacter pylori.
2. Prolonged use of non-steroidal anti-inflammatory drugs like aspirin and ibuprofen.

The stomach ulcers can be symptomless in the initial stages but over a period of time, they can cause the following:

1. Constant, nagging pain which is relieved with eating and antacids.
2. Weight loss
3. Loss of appetite
4. The feeling of fullness in the stomach.
5. Constant burping
6. Heartburn
7. Bleeding which can cause bloody vomiting or dark, tarry stools.

These symptoms could point to the presence of a stomach ulcer. This can lead to further investigations as below to confirm the diagnosis:

1. H. pylori infection via a breath, blood, or stool test.
2. Barium swallow followed by x-ray of the stomach.
3. Endoscopy of the stomach lining to identify ulcers (location, size, shape, etc.). This is used when multiple ulcers are suspected.
4. Biopsy of the mucosal lining.

Treatment: If identified early on, non-surgical treatment would suffice.

1. Stop the use of NSAIDs like aspirin.
2. Antibiotics may be prescribed if H. pylori infection is present.
3. Proton pump inhibitors and H2 receptor blockers: These control the production of acid so that further mucosal lining breakdown is prevented.
4. Bismuth supplements.
5. Probiotics which are believed to control H. pylori infection.
6. Surgical treatment as a last resort may be required to treat ulcers which continue to return and do not heal. This could range from removal of a single ulcer to removal of a part of the stomach which is prone for ulcers. Lining from another part of the intestine is usually then patched to cover the removed part.

In addition to the above treatment, diet and lifestyle changes also help in managing ulcers.

1. Foods like broccoli, cabbage, spinach, apples, yogurt, berries, olive oil, etc. help in fighting H. pylori infection.
2. Honey, glutamine, and probiotics are considered good for people with stomach ulcer.
3. Smoking worsens ulcers, so quitting smoking is suggested.
4. Food needs to be cooked after thoroughly cleaning the ingredients as the bacteria get into the system often via food.
5. NSAIDs should be used only when absolutely necessary.
6. Do not ignore regular acidity attacks, as they could be the first symptom of underlying ulcers.

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