How Do You Know if You Have a Stomach Ulcer?

And when they can be potentially dangerous.

Photo: PBS

Stomach ulcers can be potentially dangerous, and very painful. We asked our contributing medical editor, gastroenterologist Roshini Rajapaksa, MD, for the need-to-know facts on stomach ulcers.

The crater-like sores form when acid in the digestive tract eats away at the lining of the stomach or the duodenum (the first section of the small intestine), said Dr. Rajapaksa. "They're potentially very dangerous if left untreated."

"If the ulcer erodes deep enough into the lining of your stomach, two things can happen," said Dr. Rajapaksa. "It can erode into a blood vessel, which then can start bleeding very profusely. Or, it can actually erode a hole all the way through your stomach, and stomach contents can then leak into the abdominal cavity," a rare but potentially deadly scenario.

How Do You Get a Stomach Ulcer?

The primary cause is a bacteria known as Helicobacter pylori (H. pylori), which was just discovered in 1982. "Many people have the bacteria in their bodies, but may not realize it until later in life, if and when they develop gastritis, which is inflammation of the stomach, or an actual stomach ulcer," said Dr. Rajapaksa. (An estimated two-thirds of the world's population carries H. pylori.) Another possible cause of stomach ulcers is the long-term use of nonsteroidal anti-inflammatories, or NSAIDs, like ibuprofen and aspirin, she added.

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How Do You Know if You Have an Ulcer?

You may not if the sore is just opening and you're symptom-free, said Dr. Rajapaksa. But when an ulcer forms and deepens into the stomach lining, you'll feel it, she says. Common symptoms include burning pain and nausea, even vomiting in some cases. "You may also feel a gnawing feeling of hunger," said Dr. Rajapaksa. "People with ulcers tend to feel a little bit better after they eat because food almost helps coat the stomach."

If you notice these signs, Dr. Rajapaksa recommends seeing your healthcare provider a.s.a.p. "Certainly if you're vomiting blood, I would hope that everyone knows to immediately go to the hospital," said Dr. Rajapaksa. "But even if you're having other symptoms at home and you suspect you have an ulcer, I would suggest you get it diagnosed instead of trying to wait it out, or seeing if the pain goes away."

According to the National Library of Medicine, your health care provider can check if you have an H. pylori infection by testing your blood, breath, or stool. Your provider also may look inside your stomach and duodenum by doing an endoscopy (a non-surgical procedure that involves inserting a flexible tube with a light and mini-camera through your mouth to look inside your digestive tract) or x-ray. Though ulcers cannot be diagnosed with an x-ray test, the test may detect perforation due to an ulcer.

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Can You Prevent Stomach Ulcers?

Unfortunately, if you have H. pylori in your body, there are a few precautions you can take to avoid getting a stomach ulcer. Some people believe that avoiding spicy foods can help, or that stress triggers stomach ulcers—but those are myths, said Dr. Rajapaksa. She advises limiting your intake of NSAIDs (and not popping more than the recommended dose per day).

The key is to get checked out early, said Dr. Rajapaksa. "As soon as the ulcer is diagnosed, you can take an acid-blocking medication that will treat the erosion and prevent it from getting any worse in most cases. In more extreme cases, surgery may be required to repair the damage."

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