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Stomach Ulcer - Medical Malpractice
Stomach ulcer, also known as peptic ulcer, is an open sore or lesion of the lining of the stomach, where the stomach acid comes in contact with stomach tissue. Similar ulcers also occur in the oesophagus and in the upper portion of the small intestine. The primary symptom is epigastric abdominal pain, associated with indigestion and gas. The most common type of stomach ulcer is due to a bacterial infection known as Helicobacter pylori. Stomach ulcers affect up to ten percent of all people in developed countries but not all are treated properly.
The most common symptoms of gastric ulcers are burning abdominal pain, particularly in the upper stomach, breast bone or just above the navel, indigestion and gassiness. The pain is generally worse at night and worse on an empty stomach. Certain foods buffer the acid in the stomach so the symptoms tend to go away. TUMS and antacids buffer the acid in the stomach so that there is temporary relief of pain. Gastric ulcers can last for several weeks, pass for awhile and then recur for several weeks more. Related symptoms to stomach ulcers include vomiting, sometimes of tarry liquid or fresh blood, dark tarry stools from blood passing through the digestive tract, nausea and weight loss that is unintended. Some people can gain weight from continually eating to buffer the stomach acid.
Peptic ulcers used to be believed to be caused by spicy foods and stress. This is just not the case. Doctors now relate the ulcerations to infections with H. pylori. The bacteria survive in the mucosa of the lining of the stomach and can be asymptomatic in some people. The bacteria can also inflame the lining of the stomach, duodenum or oesophagus so that an ulceration or erosion in the stomach lining occurs. About 20 percent of all people under age 30 have H. pylori; this number increases to 50 percent in those who are 60 years or more. No one actually knows how H. pylori spreads from one person to another. Direct contact with an infected person may cause passage of the infection or it may be sharing food or liquids with an infected individual.
People who take nonsteroidal anti-inflammatory medications like aspirin, ibuprofen, ketoprofen, or naproxen are at an increased risk of getting stomach ulcers. These medications should be taken with food and you shouldn't take the medications with a known ulcer. Smoking makes stomach acid worse as does the drinking of alcohol to excess. Stress doesn't relate at all to stomach ulcer formation but you will get a worsened ulcer with stress if you already have one. Stress can be a physical trauma or surgery or an emotional trauma.
There are several complications of stomach ulcers. You can get internal bleeding which leads to anaemia and the need for blood transfusions. The infection can perforate the stomach lining, leading to peritonitis. Large amounts of scar tissue can form, blocking the outlet or pylorus of the stomach so that there is an inability to pass food through the stomach and nausea and vomiting as a result.
The tests for stomach ulcers include a test for an H. pylori infection. It is a blood test for the antibodies to the H. pylori infection. A breath test can check for the presence of H. pylori organisms. You take a slightly radioactive liquid that is broken down by H. pylori into a gaseous form. It shows up on a breath test for radioactivity. It can tell if the H. pylori infection is being treated properly by antibiotics; once the blood test for H. pylori infection is positive, it remains positive and is not a good test for reinfection or lack of treatment of the infection by antibiotics. A stool tests exists for H. pylori as well that is a good test for the presence of active H. pylori infection.
Doctors can also do an upper GI endoscopy of the stomach to look directly at the ulcers, take biopsies and culture for H. pylori. The upper GI endoscopy looks at the oesophagus, stomach and the first part of the duodenum. A dye study with an x-ray can also be done to look for blockages and ulcerations.
The treatment of peptic ulcers involves the use of antibiotics to kill the H. pylori infection. The most common treatments include amoxicillin, Flagyl, Biaxin and bismuth. Combination medications contain antibiotics and antacids, such as Helidac and Prevpac. Antibiotics are taken for a couple of weeks and then the person remains on anti-acid medications or acid blockers like Prevacid, Axid, Tagamet or Prilosec for an indefinite period of time.LEGAL HELPLINE: ☎ 855 804 7125
The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here