What are ulcers?
An ulcer is an open sore that can either form in your stomach, small intestine, esophagus, or duodenum. These are all called peptic ulcers and they are actually a common phenomenon in America. However, this doesn’t mean that they should be taken lightly as ulcers can lead to other serious problems if left untreated.

What are the symptoms of an ulcer?
Symptoms of an ulcer vary for each individual, but the most prominent complaint is a dull, burning pain in the upper abdomen.

Other symptoms include:
  • dark, black stools
  • bloating
  • heartburn
  • nausea
  • frequent burping
  • sharp stomach pains
  • loss of appetite
  • vomiting
  • pain while eating
Normally, the pain is temporarily relieved with an acid-reducing medication such as Zantac or Tums. Some note that pain tends to worsen at nighttime or when the stomach is empty.

What causes ulcers to form?
Doctors previously believed that ulcers were caused by various factors such as stress, acidic fruits, spicy foods and alcohol. But today doctors have proof that a certain bacterium called H. Pylori is a major culprit in the formation of ulcers. H. Pylori is responsible for roughly two-thirds of all peptic ulcers.

Stomach acid is another major factor in the formation of an ulcer since acid can erode the lining of the digestive tract.

Unlike stomach and intestinal ulcers, ulcers found in the esophagus mainly form due to effect of stomach acid and not due to H. Pylori infection.

Lastly, anti-inflammatory medications, such as Aspirin or Ibuprofen are another important cause of ulcer formation in the upper digestive tract, especially when used often.

How are ulcers diagnosed?
Dr. Khorrami may ask you to thoroughly describe and detail your symptoms as well as check your medical history. After your initial evaluation, he may advise you to have certain testing procedures such as:
    Upper Endoscopy
    This procedure allows Dr. Khorrami to view your esophagus, stomach, and duodenum with a camera. If necessary, a small tissue sample of your stomach may be taken for further testing (known as a biopsy).

    Upper GI series
    This is a test in which x-rays are used to reveal your esophagus, stomach, and intestine. You will be asked to drink a liquid that contains barium. The barium will allow your stomach to clearly show up on the x-rays taken.

    Blood tests
    Blood tests can help detect anemia due to blood loss or detect infection with H. pylori. They can also spot other problems or abnormalities that may exist within the digestive system.

    Stool tests
    These are commonly done to rule out other causes of GI diseases, such as infection. Stool tests can also show if there is bleeding in the intestines. They can also help detection of H. pylori.
How are ulcers treated?
Ulcers can be treated successfully with the use of acid-suppressing medication such as:
  • Antacids (e.g. Tums, Rolaids)
  • Histamine “H2” blockers (e.g. Zantac)
  • Proton pump inhibitors (e.g. Nexium)
  • Ulcers are also treated by using antibiotics to eliminate H. pylori bacteria.
Treatment is relatively easy for ulcers but it is important to understand that ulcers can take weeks to heal and they can also recur at a later date.

Surgery is only performed in severe cases where ulcers fail to heal through the use of medication therapy, often come back after treatment, or perforate your stomach.

Ulcer surgery is only performed in severe cases where ulcers fail to heal through the use of medication therapy or if the ulcer is deep enough to have perforated the wall of the bowel.

How can I prevent ulcers?
You can prevent ulcers by avoiding smoking, drinking alcohol, or taking non-steroidal anti-inflammatory drugs (e.g. Aspirin, Ibuprofen, Aleve). While spicy foods do not cause ulcers, they can certainly worsen your symptoms by direct irritation and by causing your stomach to produce more acid. Foods that increase stomach production such as fried or fatty foods should be avoided.

Discuss Your Options with Dr. Khorrami
Dr. Khorrami has been in practice since 1996 as a double-board certified gastroenterologist, has experienced a variety of patient cases, and is well trained to solve your digestive problems. Contact us to learn more about ulcers and how you can successfully treat and prevent them.

Source contains material from the National Digestive Diseases Information Clearinghouse (NDDIC).


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About Dr. Khorrami

Dr. Payman Khorrami is a UCLA graduate, has been in practice since 1996, and is double board certified. Undergraduate Education at University of California, Berkeley, Medical School at University of California, San Francisco, Internal Medicine Training at University of California, San Diego Read Full Bio