An ulcer is a break in the inner lining of the esophagus, stomach, duodenum, or other areas of the gastrointestinal tract. According to WebMD, about 1 out of every 10 Americans will suffer from abdominal pain of an ulcer at some point in life. There are different ulcer types, and it is essential to get our ulcer info straight and define the causes, symptoms, and treatments.
A peptic ulcer is an open sore located on the inside lining of the stomach and upper portion of the small intestine that causes stomach pain—one of the most common symptoms. A peptic ulcer occurs when acid in the digestive tract consumes the inner surface of the stomach or small intestine, creating painful open sores. If the mucous layer that normally protects against acid decreases and the amount of acid increases, you can develop an ulcer. Ulcer causes include:
- Helicobacter: The bacterium helicobacter pylori lives in the mucous layer that covers and protects tissues in the stomach and small intestine. The helicobacter does not create problems in most cases, but it might cause inflammation of the stomach’s inner layer, producing an ulcer. Scientists do not have a clear explanation for this, but the inflammation may be transmitted from person to person by close contact, such as kissing, or through food and water.
- Pain relievers: Certain over-the-counter pain relievers and prescription anti-inflammatory drugs that include ibuprofen and naproxen sodium such as Advil and Aleve can irritate the lining of the stomach and small intestine if used frequently.
- Other medications: Medications taken along with NSAIDs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax), and risedronate (Actonel), can cause a peptic ulcer.
- Smoke, alcohol, stress: People who are infected with helicobacter are more likely to develop a peptic ulcer if they smoke. Alcohol can also irritate the mucous lining of your stomach and increase the amount of acid. Untreated stress can also cause a peptic ulcer.
Common ulcer symptoms include stomach pain, bloating, fatty food intolerance, heartburn, and nausea. Stomach acid and having an empty stomach make the pain worse, and the discomfort is more intense between meals and at night. Another sign of peptic ulcer is a gnawing hunger, occurring shortly after eating. This hunger may be accompanied by a burning pain in the area between the belly and breastbone.
It is important to mention that, according to Mayo Clinic, nearly three-quarters of people with peptic ulcers do not have symptoms, while in some rare cases ulcers may cause severe signs or symptoms such as vomiting, dark blood in stools, trouble breathing, appetite changes, and unexplained weight loss.
A gastric ulcer occurs when a peptic ulcer is located in the stomach. The causes are similar to the ones mentioned for the peptic ulcer, but the symptoms of a stomach ulcer are more specific. The most common symptom is a burning sensation or pain in the middle of the abdomen right between the chest and belly button—the discomfort is more intense when the stomach is empty, and it can last for a few minutes to several hours. Other symptoms include dull pain in the stomach, weight loss, appetite loss, nausea, bloating, acid reflux, heartburn, anemia, and vomiting.
A duodenal ulcer occurs when a peptic ulcer is located in the duodenum, the first part of the small intestine. The causes are similar to the ones mentioned for the peptic ulcer, but some of the symptoms of a duodenal ulcer are different than those of a gastric ulcer. The most common symptom is pain in the upper abdomen that usually comes and goes; it occurs before meals, or when you are hungry. Other symptoms include bloating, retching, and feeling sick.
An esophageal ulcer is a type of peptic ulcer that occurs in the lower end of your esophagus (the tube connecting your throat to your stomach). The causes are similar to the ones mentioned for the peptic ulcer, but a chronic condition known as gastroesophageal reflux disease (GERD) may also lead to an esophageal ulcer.
People who have GERD have frequent acid reflux, which occurs when stomach contents move backward into the esophagus. In people who have compromised immune systems, esophageal ulcers may be caused by other bacterial, fungal, or viral infections, including HIV, Candida overgrowth, and herpes simplex virus. The most common symptom of an esophageal ulcer is burning mild or severe pain in the chest. Other symptoms of an esophageal ulcer include nausea, indigestion, acid reflux, vomiting, bloating, lack of appetite, pain when swallowing, dry cough, sour taste in the mouth.
The most dangerous type of ulcer, a bleeding ulcer is caused by a peptic ulcer that has been left untreated. An ulcer can bleed so slowly that you do not notice it. The first signs of a slow-bleeding ulcer are symptoms of anemia, which include pale skin color, shortness of breath with physical activity, lack of energy, fatigue, and lightheadedness. An ulcer that is bleeding heavily, instead, may cause stool that is black and sticky, dark red or maroon colored blood in the stool, and bloody vomit with the consistency of coffee grounds. Keep in mind that rapid bleeding from an ulcer can be life-threatening—seek immediate medical attention.
A stress ulcer is a group of lacerations located in the esophagus, stomach, or duodenum. The type of ulcer is triggered by physical stress that may come in different forms including serious long-term illness, surgical procedure, trauma that occurs to the brain or body, severe burns, or injury to the central nervous system. A peptic ulcer may also be a cause of stress, aggravating the symptoms, which include a burning sensation, pain to the touch, and extreme sensitivity.
To diagnose an ulcer, the doctor may take the medical history of the patient and do a physical exam. If the results suggest the possibility of an ulcer, the patient will undergo more specific testing including:
- Laboratory tests: Laboratory tests are used to determine whether the helicobacter is present in the body, using a blood, stool, or breath test—the latter is the most accurate. This test invovles drinking or eating something containing radioactive carbon. If there is an infection, the breath sample contains the radioactive carbon in the form of carbon dioxide.
- Endoscopy: The doctor may use a scope to examine the upper digestive system. If an ulcer is detected, small tissue samples (biopsy) may be removed for examination in a lab. Endoscopy is usually recommended for older patients who have signs of bleeding or have experienced recent weight loss or difficulty eating and swallowing.
- Upper gastrointestinal series: This is a series of X-rays of the upper digestive system that create images of the esophagus, stomach, and small intestine. During the X-ray, the patient swallows a white liquid that coats the digestive tract and makes an ulcer more visible.
Ulcer treatments depend on the cause. Usually, the main objective is to kill the helicobacter, if present, and eliminate or reduce pain medications, if possible. Ulcer treatments include:
- Antibiotics: Antibiotics such as Amoxil and Biaxin are used to kill the helicobacter—the type of antibiotic is usually determined by where you live and current antibiotic resistance rates. The treatments with antibiotics usually last around two weeks—additional medications are used to reduce stomach acid.
- Medications: These medications, which include proton pump inhibitors (PPIs), block acid production and promote healing—side effects of long-term use include risk of hip, wrist, and spine fractures. Acid blockers such as Zantac and Pepcid also reduce stomach acid and encourage healing. Other medications, called cytoprotective agents, may be used to protect the lining of your stomach and small intestine.
How to Treat Stomach Ulcers with Amino Acids
A study conducted by scientists at Beth Israel Deaconess Medical Center (BIDMC) and the Massachusetts Institute of Technology shows that additional supplementation with the amino acid glutamine may be beneficial in treating gastric damage caused by helicobacter. This is a natural and less invasive alternative to antibiotics for ulcer treatment.
Glutamine is a nonessential amino acid that can be used to reduce inflammation. To prove that glutamine can help treat an ulcer, scientists divided 105 mice into two groups, which were fed either a standardized diet (containing 1.9% glutamine) or the same diet with supplemental L-glutamine (containing 6.9% glutamine). After two weeks, the mice were subdivided into two more groups, with one group receiving a dose containing helicobacter. By week 20 the study results showed that, among the infected animals, the mice that were fed the L-glutamine diet exhibited lower levels of inflammation than did the mice that received the standard control diet.
Another study also demonstrated the benefits of L-glutamine on various gastric lesions.