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Gastric ulcers

Condition Overview:

A stomach ulcer, also called a gastric ulcer, is a raw area or open sore in the lining of the stomach.

The stomach's lining has a protective layer of cells that produce mucus. The mucus prevents the stomach from being injured by stomach acids and digestive juices. When this protective layer is damaged, an ulcer may occur.

Stomach ulcers may develop from:

• the presence of bacteria called Helicobacter pylori (H. pylori), the most common cause of stomach ulcers
• decreased resistance of the lining of the stomach to stomach acid
• increased production of stomach acid.

Stomach ulcers are more likely to occur in people who:

• regularly take nonsteroidal anti-inflammatory drugs (NSAIDS), such as aspirin, ibuprofen, and naproxen
• smoke cigarettes.

Substances that increase the production of stomach acids, such as caffeine, may increase the risk of ulcers and are known to worsen the pain. Stress has been thought to contribute to ulcers, but its role in causing ulcers is not clear.

Symptoms include:

• gnawing or burning abdominal pain, especially in the middle of the upper abdomen
• heartburn
• nausea
• pain that may get better with eating or taking antacids
• pain that may get worse a couple of hours after meals or sometimes may be worse before meals
• pain that awakens you during the night.

If an ulcer is bleeding, you may have:

• vomit containing bright red blood or digested blood that looks like brown coffee grounds
• black, tarry bowel movements.

It is possible, though unusual, to have an ulcer without any symptoms.

Your health care provider will review your symptoms, ask about your medical history, and examine you. You may have one or more of these tests:

• upper GI x-ray (for this test you swallow liquid barium, which may allow your health care provider to see the ulcer on an x-ray)
• blood tests to look for H. pylori bacteria
• tests of a sample of your bowel movement to check for blood (which might come from a bleeding ulcer)
• blood test for anemia (which may be a sign of internal bleeding)
• an upper endoscopy, which may allow your provider to see the ulcer with a thin flexible tube and tiny camera inserted through your mouth down into your stomach
• a biopsy, which involves taking a piece of tissue during an endoscopy and sending it to the lab for testing (this is another way to test for H. pylori).