Gastric ulcer

What is it?

The stomach secretes acid and digestive enzymes that help with the digestion of the food. The food and gastric juices are kneaded into a mash and then gradually pushed further into the small intestine.

An ulcer is an interruption or opening (of varying depth and size) in the wall of the stomach or duodenum.

Causes

Stomach ulcers are caused by an infection. Sometimes, ulcers are caused by medication (anti-inflammatory drugs or NSAID of which aspirin is the oldest and best known).

Symptoms and complaints

• Gnawing pain in the abdominal area
• Pain for several days and weeks
• Pain decreases with a light meal
• Pain increases two to three hours after meals and possibly at night
• Other symptoms include emaciation, loss of appetite, swollen stomach, nausea and vomiting.

Malignant stomach and pancreas tumours can mimic the symptoms of a peptic ulcer

Warning symptoms include:

• Severe, sudden, persistent pain (such as a knife stab)
• Red blood or coffee ground vomit
• Black or red stool

Complications

• Gastric perforation (the ulcer drills a hole in the stomach wall)
• Stomach haemorrhage (the ulcer attacks a blood vessel)
• Stomach obstruction (the ulcer shuts off the stomach exit)

Diagnosis

A flexible hose, equipped with a video camera, is threaded through the mouth into the stomach during a gastroscopy. This examination is more accurate than radiology and also allows a biopsy to be taken to detect Helicobacter Pylori and confirm the benign nature of an ulcer. The Helicobacter infection can be detected by:

• The microscopic examination of a tissue fragment (i.e. a biopsy) taken during a gastroscopy.
• Performing a chemical test (rapid urease or HUT test) on a tissue fragment (biopsy) taken during a gastroscopy.
• Examination of a blood sample (serology). This test is only useful for epidemiological research. The test may remain abnormal even after effective treatment.

Latest publication date: 11/12/2023
Supervising author: Dr Monsaert Els