The cause of the sensation could be what’s known as a peptic ulcer. Sometimes described as a hole in the stomach or a sore in the lining of the stomach, duodenum or esophagus, an ulcer can cause hours of misery for those who are unlucky enough to have them.
Many people have ulcers, but the good news is that the condition is on the decline. U.S. News & World Report estimates that a half-million new peptic ulcer cases are diagnosed each year, with about 5 million people having symptoms at any one time. An estimated 25 million people will suffer from an ulcer at some point, most between the ages of 25 to 64 years old.
Thanks to the increased efficacy of over-the-counter medications, the bacteria that causes peptic ulcers is slowly being eradicated.
Why Do Ulcers Happen?
The common perception that stress or spicy food causes ulcers has been disproven. While those items can aggravate the condition, they do not cause ulcers.
Instead, ulcers can be traced to an infection of the Helicobacter pylori, a bacterium that will throw off the digestive fluids in the stomach and the duodenum, located in the first part of the small intestine.
No one knows how this bacterium is acquired. H. pylori lives in the mucous layer that covers the tissue that lines the stomach and small intestines. Normally, the bacteria causes no issues. But when it does react, it causes inflammation of the lining of the stomach, esophagus or duodenum, causing an ulcer. There is some speculation by the medical community that contact like kissing may cause its transmission, while other think it is spread by food or is water-borne.
When they kick in, the bacteria create havoc. Instead of doing their normal job of digesting food, the acids instead attack the walls of the stomach, the esophagus or the duodenum.
In addition to the bacteria, long-term users of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin or ibuprofen are also at risk of creating an ulcer by using too much of the product.
Eight Signs of Ulcers
Most ulcer sufferers know instantly that something is seriously wrong. Here are eight signs of ulcers.
1) Burning pain that interrupts sleep
2) Pain in the stomach region that lasts for hours
3) Pain that comes and goes in the stomach region
4) Vomiting black or red blood
5) Excreting dark or tar-like stools
6) Extreme nausea
7) Change in appetite
8) Unexplained weight loss
The danger with ulcers beyond the pain is the misery generated by sleepless nights, which can cause accidents, inattention, inability to concentrate and mistakes, all leading to productivity loss. A loss of blood may lead to anemia in some cases.
Because stomach burning can come and go, sometimes for weeks on end, it is easy for patients to dismiss initial problems as just momentary issues. They may be just fine at first using antacids or dairy to coat the stomach. But these will not heal the issue; they only mask the symptoms, and a continued problem can only get worse.
Three Types of Ulcers
There are three types of peptic ulcers:
1) Gastric ulcers – Found on the inside of the stomach
2) Esophageal ulcers – Located in the tube that carries food from the throat to the stomach
3) Duodenal ulcers – Sores located in the upper portion of the small intestine
When stomach acid touches the ulcerated location, pain ensues. The burning sensation can radiate upward to the breastbone, and when the condition becomes severe, bleeding and other problems can happen.
It is important to see a doctor rather than self-medicate if you suspect an ulcer is at work. As noted, over-the-counter pain medications can cause problems -- many people take more than the recommended dose of aspirin, ibuprofen and other medications.
The side effects of medication include irritating or inflaming the stomach lining. Other prescription medications like Actonel, Fosamax and potassium supplements used to combat osteoporosis also can exacerbate stomach issues.
Of course, smoking and drinking can aggravate the ulcer by increasing stomach acid.
Diagnosis and Treatment
Those who wait to get medical attention for a potential stomach ulcer run the risk of complications. The problems include internal bleeding, with severe blood loss that may require hospitalization; an infection that spreads to other parts of the body; an abdominal cavity infection called peritonitis, which is potentially life-threatening; and the potential for creating scar tissue that can block the digestive tract, causing vomiting and weight loss.
To determine if stomach pain is an ulcer or some other condition, doctors will perform a physical and run blood, breath and stool tests.
The breath test uses radioactive carbon, which the patient swallows. The H. pylori bacteria will break it down in the stomach, and then the patient will blow into a sealed bag. The radioactive breath sample will be measured for carbon dioxide, an indication of H. pylori’s presence.
Doctors will examine the digestive tract to determine if the pain is something other than an ulcer, such as a tumor or blockage.
In an endoscopic examination, a thin tube equipped with a lens is guided down the throat to look at the esophagus, stomach and small intestine. The tool can grab small tissue samples to determine the presence of H. pylori.
Another potential test is the barium upper gastrointestinal series. This requires ingesting a white liquid containing barium. The liquid coats the digestive tract and makes an ulcer visible to X-rays or other scans.
If an ulcer is diagnosed, treatments can include two weeks of antibiotics to kill H. pylori and acid blockers like proton pump inhibitors to reduce stomach acid by blocking the cells that produce acid.
The proton pump inhibitors are particularly effective and credited with the decline in ulcers. The medications include Prilosec, Prevacid, Nexium and Protonix. These are short-term solutions because they may weaken bones and increase fracture risks.
The good news is that relief is readily accessible for ulcer sufferers – it just takes a quick visit to the doctor.