What is an ulcer?
“Erosion of the tissue lining, usually in the stomach (gastric ulcer) or the upper small intestine (duodenal ulcer). These are generally referred to as peptic ulcers” [1] From glossary G-19
Why does an ulcer develop?
Ulcers can occur either because there is excessive acid which erodes the stomach tissue and/or because the protective mucus layer of the stomach has deteriorated.
Some possible causes of this happening are:
· Acid-resistant bacterial infection (Helibacter pylori [H.pylori)
· Heavy use of aspirin and related NSAIDS medications
· Stress
· Disorders that cause excessive acid production in the stomach
· Smoking and alcohol
· Genetics [1]
Symptoms:
· Pain after eating – “Stomach acid acting on a meal irritates the ulcer after most of the meal has moved from the site of the ulcer” p93 [1]
Less common symptoms:
· Nausea and vomiting
· Loss of appetite/weight [1]
More on pain – burning or gnawing abdominal pain
“This is a typical symptom of duodenal ulcer, although many people with duodenal ulcers don’t have the typical symptoms. The pain can occur one to 2 hours after meals, or sometimes in the middle of the night or early morning. It usually occurs when the stomach is empty. You may feel pain in the area between your navel and your breastbone. The pain may last from between a few minutes to several hours, and can often be relieved by eating, drinking milk or taking antacid medicines. With stomach ulcers, pain can be caused by eating rather than relieved by it.” [2]
Risks:
· The ulcer could erode all the way through the stomach wall, leading to an infection
· If a blood vessel is eroded there could be massive blood loss [1]
If you suspect you have an ulcer, see your doctor for diagnosis and treatment. Do not ignore the symptoms.
Treatments:
“In the past, milk and cream therapy – the so called Sippy diet – was used to help cure ulcers…milk and cream are two of the worst foods a person with an ulcer could eat. The calcium in these foods stimulates stomach acid secretion and actually inhibits ulcer healing.” p93 [1]
Medications:
· Antibiotics –to treat H.pylori infection if its present
· Acid blocking medications e.g. omeprazole
· Antacids e.g. Zantac
Both antacids and acid blocking medications block acid secretions in the stomach but work in different ways. [1]
Lifestyle changes:
· Stop smoking or at least keep it to a minimum
· Avoid aspirin and related NSAIDS where possible (discuss alternatives with your GP)
· Avoid foods that cause pain – this might include foods like curries and spicy foods, acidic fruit like tomatoes pineapple and oranges, dairy foods. Keep a diary to work out what aggravates your symptom’s, it could be 2hrs after eating before you react.
· Avoid alcohol, coffee and tea
· Eat enough fiber
· Chew food thoroughly (improves digestion)
· Lose weight if overweight [1]
· Take Probiotics to improve digestive health, dairy free supplements are more appropriate than yoghurt until the ulcer/s are healed. Probiotics will also replace the lost bacteria if on antibiotics, and can help reduce H.pylori bacteria by providing a better balance of good bacteria.
Diet changes are considered of minor importance in relation to ulcers, however individuals may find improvements avoiding trigger foods and taking probiotics.
References:
1. Wardlaw G & Hampl J. Perspectives In Nutrition. 7th ed. 2007. McGraw-Hill, New York.
2. mydr.com.au
Peptic ulcers: What are the symptoms?
http://www.mydr.com.au/gastrointestinal-health/peptic-ulcers-what-are-the-symptoms
