Generally, we know stress often causes unfavourable physical effects and health problems if not properly managed. Recently, our former prime minister, Datuk Seri Najib Razak’s daughter came forward to talk about her father’s recent admission to the hospital that was due to a stress-induced stomach ulcer. While stomach ulcers are fairly common, not many are aware of the risk factors and the complications it can bring. Hence, in this article we hope to give you a better overview on stomach ulcers and how we can prevent them.
Understanding Stomach Ulcers
Stomach ulcers, also sometimes referred to as gastric ulcers, is a type of peptic ulcer disease (PUD). PUD can be further divided into stomach/gastric ulcer and duodenal ulcer, depending on the location of the ulcer. One notable difference between them is that in stomach/gastric ulcers, pain may arise as soon as after eating whereas in duodenal ulcers pain will only be present a few hours after meals.
Though different in location, both ulcers share similar causes and present with almost identical symptoms. They are identified as painful sores that affect the stomach lining when the thick layer of mucus that shields our stomach from acidic digestive juices is reduced. As a result, the digestive acids will eat and erode the tissue of our stomach lining, forming an ulcer. Stomach ulcers are relatively common and can be easily treated but can cause unwanted problems if not treated appropriately.
What Causes Stomach Ulcers?
The two typical causes of stomach ulcers are:
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Helicobacter pylori (H.pylori) infection, a bacterial infection that’s normally found in the stomach damaging the mucus coating that protects our stomach lining and subsequently cause inflammation and ulcers
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Excessive use of Non-steroidal anti-inflammatory Drugs (NSAIDs). NSAIDs are often used as an over-the-counter pain relief medication and these include Ibuprofen, Aspirin, Naproxen etc. They are thought to irritate the stomach lining and interfere with some of the chemicals in our body that defend and repair the mucous lining, thus resulting in painful ulcers.
(https://img.freepik.com/premium-vector/illustration-study-stomach-helicobacter-pylori-bacteria-magnifying-glass_313437-507.jpg?w=740)
Other causes of stomach ulcers that are not as common include:
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Zollinger-Ellison Syndrome, which is a rare condition that stimulates our stomach to produce too much gastric acid
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Physiological stress such as surgery, trauma, infection, burns or injuries that may affect our body’s pH balance, hence increasing the production of stomach acid.
How do I know if I have stomach ulcers?
Stomach ulcers are manifested differently for different individuals with severity of the symptoms depending on the intensity of the ulcer. For instance, smaller ulcers may not cause any symptoms but larger ulcers on the other hand may result in uncomfortable, persistent pain and potentially lead to bleeding or bowel obstruction.
A burning sensation or pain in the upper abdomen between your chest and belly button is thought to be the most common symptom of a stomach ulcer in which the pain can last for a few minutes to several hours.
Other signs and symptoms that may be accompanied by include:
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Stomach pain that may improve after meal or after taking antacids
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Heartburn
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Weight loss
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Indigestion
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Nausea or vomiting
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Bloating
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Burping
When do I know to seek help?
Even though stomach ulcers are rarely life threatening and can be easily treated, they shouldn’t be taken lightly. Appetite changes, unexplained weight loss, vomiting blood, dark black or bloody stools should be the red flags to look out for to call a healthcare professional and seek for immediate medical attention. These could be an indication of internal bleeding or a blockage which may pose danger if left untreated.
How is stomach ulcers treated?
Depending on the cause of your stomach ulcer as mentioned above, your doctor may recommend different treatment options and care plans. Let’s take a look at some of the common treatment options:
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Medications
(a) Proton Pump Inhibitors, PPI (ie: omeprazole, pantoprazole) which is an acid-lowering agents
(b) Histamine Receptor Blockers, H2RA (ie: Ranitidine, Famotidine) that reduces stomach acid by inhibiting histamine, the chemicals that stimulate acid production
(c ) Bismuth subsalicylate tablets that protects and coats our ulcer from acids
(d) Antibiotics (ie: Clarithromycin, Metronidazole) to kill H.pylori bacteria
(e) Panadol (acetaminophen) to replace NSAIDs as pain reliever or anti–fever medication
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Lifestyle modifications
Diet: While studies have found that foods generally won’t cause or cure ulcers, incorporating healthy eating habits can benefit your overall intestinal health. Your doctor may suggest more fruits and vegetables to enhance your daily fibre intake and to avoid fried, spicy foods as well as caffeinated beverages to prevent further damage and keep symptoms under control.
Stress relief: Managing stress effectively such as breathing exercises, meditation, yoga or anything that puts you at ease are highly recommended as a complement to medication and dietary changes.
Healthy habits: Reducing cigarette smoking and alcohol consumption can also aid in symptom relief since they’re found as one of the risk factors to cause stomach ulcers.
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Surgical intervention
In extreme cases where the ulcer keeps coming back, does not heal and bleeds uncontrollably, surgical procedures may be required to repair the perforation or obstruction. Ulcers that are unfortunately malignant will be surgically removed to prevent spreading to the other organs and cause other complications. However, worry not, as in many cases, stomach ulcers can usually be treated with medications and take a few weeks to heal. On that note, it is important to take your medications as instructed by your doctor and attend the follow-ups scheduled to ensure that your ulcer is appropriately treated and healed.
Written by Janelle Leong, Bpharm(Hons); Medically reviewed by Nur Ariffin, MBBS UniSZA
References:
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What Is a Stomach Ulcer? - VeryWellHealth. Accessed 6th September 2022. Available at https://www.verywellhealth.com/stomach-ulcer-5220245#toc-types
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Stomach Ulcers and What You Can Do About Them - Healthline. Accessed 6th September 2022. Available at https://www.healthline.com/health/stomach-ulcer
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Stomach Ulcer - Cleveland Clinic. Accessed 6th September 2022. Available at https://my.clevelandclinic.org/health/diseases/22314-stomach-peptic-ulcer#symptoms-and-causes
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Stomach Ulcer - NHS UK. Accessed 7th September 2022. Available at https://www.nhs.uk/conditions/stomach-ulcer/treatment/
