“Doctor, I have this pain behind my chest bone?”

This happens to be a common presentation in the general practice clinic these days prompting us to write this piece. Peptic ulcers are ulcers in the lining of either the stomach wall or in the duodenum or both. The duodenum is the first part of the small intestine.

Stomach ulcers and duodenal ulcers (sometimes called peptic ulcers) cause the same symptoms and treatment for both is the same.

Signs and symptoms

The most common symptom of peptic ulcer is a burning pain in the center of the tummy (abdomen), sometimes, it is up there between the chest bone and the umbilicus (navel).

The pain is sometimes severe and may you up at night and cause you to scamper for analgesics at odd times of the day. Some people feel slightly better after a glass of water, or milk, but shortly afterwards, the pain is back again.

Stomach ulcers may not even cause you pain. Some people may experience other symptoms such as bloating, acid taste in the mouth, feeling of a mass behind the throat, indigestion and just out rightly feeling sick.

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Causes of ulcers

Peptic ulcers are caused by a damage to the layer that protects the stomach and/or duodenal lining from the acids in your stomach.

This is commonly seen as a result of:

• an infection with Helicobacter pylori (H. pylori) bacteria
• taking anti-inflammatory medicines (NSAIDs), such as ibuprofen or aspirin – particularly if they’re taken for a long time or at high doses
• taking steroid medications such as dexamethasone or prednisolone

 

It is street knowledge that peppery foods, starvation and stress can cause peptic ulcer but there’s little evidence to suggest these are the primary causes.

Studies have shown that peptic ulcers can affect anyone but are more common in middle-aged men.

When to seek medical advice

If you think, you might have these symptoms, speak to us and we can clarify.

If you are:

• you are passing black, dark, sticky, tar-like stools
• you have a sudden, sharp pain in your tummy that gets steadily worse

Go to your nearest hospital accident and emergency (A&E) department if:

• you are vomiting blood – this is a sign of an acutely bleeding ulcer. It can range from little trickles to an outrageous bleed. The blood can appear bright red or have a dark brown, grainy appearance, similar to coffee grounds. These could be a sign of a serious complication, such as internal bleeding.

How peptic ulcers are treated

Like most ailments, treatment will depend on what caused the ulcer.

Firstly, we aim to identify what has caused your ulcer, and offer you specific medical advise while we relieve the symptoms.

Peptic ulcers can come back after treatment, although this is less likely to happen if treatment starts early and if the underlying cause is addressed.