What are the symptoms of stomach ulcers – and how is it treated?

What is a stomach ulcer?

A stomach ulcer is an ulcer that occurs in the lining of the stomach or duodenum, which in the vast majority of cases occurs due to the stomach ulcer bacterium Helicobacter Pylori, the intake of non-steroidal anti-inflammatory drugs of the NSAID type (e.g. Ibuprofen), or both. Smoking is also a risk factor.

The stomach contains stomach acid, which makes the environment acidic, and therefore the mucous membrane is protected by a natural layer of mucus. If the mucus disappears due to infection with the Helicobacter Pylori bacteria or side effects from NSAID preparations, the mucous membrane is exposed to the acidic stomach acid and the enzyme pepsin, which are naturally found in the stomach. This can cause ulcers to form. (Source: Sundhed.dk)​.

Epidemiology and prevalence

The incidence of duodenal ulcers is approximately five times more common than gastric ulcers, but has generally been decreasing over the past 30 years due to a decreasing incidence of Helicobacter Pylori in the population. On the other hand, gastric ulcers have been slightly increasing, probably due to increased consumption of NSAIDs. The incidence of gastric ulcers generally increases with age and approximately 10% of the population will develop a gastric ulcer during their lifetime.

The incidence of stomach ulcers increases with age, and is particularly high in people over 65 years of age.

(Sources: Sundhed.dk & Medicin.dk)​

Symptoms of stomach ulcers

The symptoms of stomach ulcers include:

• Pain in the stomach, often described as a burning or gurgling sensation.
• Bloating and food cravings
• Nausea and vomiting.
• Weight loss

Approximately 1/4 of people with stomach ulcers, especially older people and people who take painkillers in the form of NSAIDs, develop complications such as bleeding from the stomach ulcer, perforation of the stomach or narrowing between the stomach and duodenum. (Source: BMJ)​.

Diagnosis and treatment

The diagnosis of a stomach ulcer is most reliably made by gastroscopy, where a thin, flexible tube with a camera is passed into the stomach and duodenum via the mouth or nose. This allows a stomach ulcer to be visualized and tissue samples (biopsies) to be taken.

Since Helicobacter Pylori is still widespread in the population and is the most common cause of stomach ulcers, the doctor may order a breath test or stool test to detect the bacteria.

Treatment of stomach ulcers without the aforementioned complications depends on the cause:

• Stomach ulcers caused by Helicobacter Pylori are treated with a so-called triple regimen consisting of medication that reduces the production of stomach acid and two types of antibiotics.
• Gastric ulcers where Helicobacter Pylori is not present are treated with proton pump inhibitors alone and NSAID medications must be discontinued.

Prevention and lifestyle changes

To reduce the risk of stomach ulcers and prevent recurrence, it is recommended that:

• Avoid long-term use of NSAIDs. If necessary, use them in low doses and together with stomach acid-protecting medications (proton pump inhibitors).
• Avoid smoking.

Osteopathic relief of discomfort related to stomach ulcers

Osteopathy can be a useful adjunct treatment or prevention for ulcer-related discomfort. Osteopaths use manual manipulation to improve the body’s structural balance and function, which can help reduce stress and improve blood circulation.

Studies have also found that osteopathic manipulative therapy can reduce edema and improve healing times in patients with ulcers, which could potentially be used for peptic ulcer patients as a supplement to medical treatment. (Journal of Osteopathic Medicine & Naturopath Osteopath Clinic)​.