Peptic ulcers are sores that develop when stomach acid or digestive juices erode weak areas of the lining of the stomach or first part of the small intestine.
We talked to Carin Jensen, Pharmacy Manager at South Country Co-op in Taber, Alta., about what you can do to minimize your ulcer risk and how to treat them if they occur.
What causes peptic ulcers?
Jensen told us that when the normal defense and repair system in the stomach and small intestine is reduced or inhibited, acids or digestive juices can damage the lining. Peptic ulcers can result from bacteria known as Helicobacter pylori (H. pylori) causing an infection.
Medications may also weaken or irritate the lining of the stomach or small intestine. The most common medications known to cause peptic ulcers are non-steroidal anti-inflammatory drugs (NSAIDS), including over-the-counter preparations such as ibuprofen or naproxen.
“Patients who happen to use NSAIDS and have an infection of H. pylori have a very high risk of ulceration,” Jensen explained.
Some rare conditions can cause a peptic ulcer including a type of cancer causing a syndrome of excess acid production (Zollinger-Ellison Syndrome).
What are the symptoms of peptic ulcers?
Symptoms will vary depending on the location of the ulcer, age and other factors. Some people don’t notice any symptoms while others may experience a gnawing or burning pain in the abdomen especially between meals or at night, pain that disappears temporarily when eating or using an antacid, or bloating, heartburn, nausea or vomiting.
Jensen told us to watch for more serious signs including dark or black stool caused by bleeding in the stomach or small intestine, vomiting, weight loss and severe pain in the mid to upper abdomen.
Severe ulcers may have life-threatening complications, including these:
- Bleeding and chronic blood loss.
- Penetration or perforation which may affect other organs within the abdominal cavity that causes sudden, intense and piercing pain.
- Obstruction or a blockage caused by swelling of the inflamed tissues.
- Vomiting, feeling unusually full after eating and lack of appetite.
What are the risk factors for developing peptic ulcers?
One in 10 people will develop a peptic ulcer, but some people are more at risk, including:
- People who use NSAID medications often, especially in high doses.
- Those with a family history of ulcers.
- Those who have a chronic illness such as liver, kidney or lung disease.
- Women, people over the age of 70, and those who have already experienced an ulcer have a higher risk of damage leading to an ulcer when taking an NSAID.
“Some risk factors can be controlled or managed to reduce the risk of developing peptic ulcers,” said Jensen, noting that regularly drinking alcohol and smoking will increase your risk. Take caution when using NSAIDs and take precautions when using them long-term. Always take NSAIDs with food to reduce irritation.
How are peptic ulcers diagnosed?
Your doctor will review your symptoms and may determine treatment or order tests. H. Pylori bacteria can be found with a breath test, and endoscopy, x-rays or CT scans are sometimes used to visualize the damaged area. Blood tests may be used to determine if anemia or electrolyte imbalances have developed.
How are peptic ulcers treated?
Jensen told us that treatment for ulcers will remove the cause of the ulcer and allow the lining of the stomach or small intestine to heal. H. pylori infections are treated with antibiotics and medication to reduce the production of stomach acid. Severe or complicated situations may require surgery to repair damage.
How can my pharmacist help me manage peptic ulcers?
Your pharmacist can discuss any symptoms or concerns you have and determine if you should see your doctor for further investigation.
Your pharmacist can help you identify peptic ulcer risk factors, and help monitor your current treatment and any side effects you might be experiencing.
If you’re concerned about a peptic ulcer, your Co-op pharmacist is here to help.