A stomach ulcer, also known as a gastric ulcer, is a painful sore that develops on the lining of the stomach. These ulcers are part of a group of peptic ulcers, which also include ulcers found in the small intestine (duodenal ulcers). Stomach ulcers can cause significant discomfort and, if left untreated, can lead to severe complications. Fortunately, with proper diagnosis and treatment by ranitidine 150 mg, most stomach ulcers can heal completely. In this blog, we’ll explore how stomach ulcers are diagnosed and the most effective treatment options available.

What Is a Stomach Ulcer?

A stomach ulcer occurs when the protective mucus lining of the stomach is eroded, allowing stomach acid to damage the underlying tissue. This erosion can be caused by various factors, the most common being:

Helicobacter pylori (H. pylori) infection: A bacteria that damages the stomach’s mucous layer.

Nonsteroidal anti-inflammatory drugs (NSAIDs): Prolonged use of medications like ibuprofen, aspirin, and naproxen can weaken the stomach lining.

Smoking and alcohol: These can irritate and damage the stomach lining, worsening ulcer conditions.

Stress and spicy food: While not direct causes, they can exacerbate the symptoms of an ulcer.

Common Symptoms of Stomach Ulcers

Stomach ulcers can vary in severity, but the most common symptoms include:

Burning stomach pain: This pain often occurs between meals or at night.

Bloating: A feeling of fullness, even without eating much.

Nausea: An unsettled feeling in the stomach, which may sometimes lead to vomiting.

Heartburn: A burning sensation in the chest caused by acid reflux.

Unexplained weight loss: Some people lose weight unintentionally due to a loss of appetite.

Blood in stool or vomit: In severe cases, bleeding ulcers can cause tar-like stool or bloody vomit.

If any of these symptoms persist for more than a few days or worsen, it’s essential to seek medical attention to determine the underlying cause and appropriate treatment.

How Are Stomach Ulcers Diagnosed?

1. Medical History and Physical Exam

The first step in diagnosing a stomach ulcer is a thorough review of the patient's medical history and a physical examination. A doctor will ask about:

Symptoms, such as stomach pain, nausea, and changes in appetite.

Medication use, especially NSAIDs.

Personal habits, such as smoking or alcohol consumption.

During the physical exam, the doctor may press on the abdomen to check for tenderness or pain. If symptoms and history suggest a stomach ulcer, further diagnostic tests will be recommended.

2. Diagnostic Tests

a. Endoscopy

An upper endoscopy is one of the most effective ways to diagnose a stomach ulcer. During this procedure:

A thin, flexible tube with a camera (endoscope) is inserted through the mouth into the esophagus, stomach, and small intestine.

The doctor can directly view the stomach lining to look for ulcers.

If necessary, a biopsy may be taken to test for H. pylori bacteria or to rule out stomach cancer.

Endoscopy is usually recommended for patients with severe or persistent symptoms, especially if there is concern about bleeding or malignancy.

b. H. pylori Testing

Testing for H. pylori infection is a critical part of diagnosing stomach ulcers, as this bacterium is responsible for most cases. Several tests can be used to detect H. pylori:

Breath test: The patient drinks a special solution containing urea, and if H. pylori is present, the bacteria break down the urea, releasing carbon dioxide, which is then detected in the breath.

Blood test: A blood sample can detect antibodies against H. pylori, although this test is less commonly used because it cannot determine an active infection.

Stool antigen test: This test checks for H. pylori antigens in the stool, which indicates an active infection.

c. Upper GI Series (Barium Swallow)

In some cases, an upper gastrointestinal (GI) series may be recommended. This involves drinking a liquid containing barium, which coats the stomach and makes ulcers visible on X-rays. While less accurate than endoscopy, it is a less invasive way to check for ulcers.

d. Blood and Stool Tests for Anemia or Bleeding

If a stomach ulcer is causing bleeding, tests may be ordered to check for anemia (low red blood cell count). Additionally, stool samples may be analyzed to detect hidden blood.

Treatment Options for Stomach Ulcers

Once a stomach ulcer has been diagnosed, the treatment plan will depend on the cause and severity of the ulcer. The primary goals of treatment are to reduce stomach acid, eradicate H. pylori (if present), promote healing of the ulcer, and prevent complications.

1. Medications

a. Proton Pump Inhibitors (PPIs)

PPIs are the most commonly prescribed medications for treating stomach ulcers. They work by significantly reducing the production of stomach acid, giving the ulcer time to heal. Common PPIs include:

Omeprazole (Prilosec)

Esomeprazole (Nexium)

Lansoprazole (Prevacid)

These medications are typically taken for 4 to 8 weeks, depending on the severity of the ulcer. 

b. H. pylori Eradication Therapy

If H. pylori infection is confirmed, a combination of antibiotics and acid-suppressing medications will be prescribed to eliminate the bacteria and heal the ulcer. This is known as triple therapy and includes:

Two antibiotics (such as amoxicillin and clarithromycin) to kill the bacteria.

A PPI to reduce stomach acid and promote healing.

In some cases, a quadruple therapy with the addition of bismuth subsalicylate (Pepto-Bismol) may be recommended.

c. Antacids and H2-Receptor Blockers

Antacids can provide quick relief from ulcer pain by neutralizing stomach acid. H2-receptor blockers, such as ranitidine (Zantac) or famotidine (Pepcid), reduce acid production and help heal the ulcer, though they are less potent than PPIs. Ranitidine is available at online pharmacy. 

d. Protective Medications

Drugs like sucralfate (Carafate) or misoprostol (Cytotec) may be prescribed to coat the stomach lining and protect it from acid. These medications can be particularly useful for people who need to continue using NSAIDs for other conditions.

2. Lifestyle Changes

In addition to medication, making certain lifestyle changes can help prevent ulcer recurrence and improve healing:

Avoid NSAIDs: If NSAIDs are contributing to the ulcer, discontinuing their use is crucial. Alternative pain relievers like acetaminophen (Tylenol) may be recommended.

Limit Alcohol and Smoking: Both alcohol and smoking can interfere with ulcer healing and increase acid production. Quitting smoking and reducing alcohol intake are essential steps.

Stress Management: While stress alone doesn’t cause ulcers, it can exacerbate symptoms. Relaxation techniques, such as meditation, yoga, or deep breathing exercises, can help reduce stress levels.

Follow a Healthy Diet: Although no specific diet can cure ulcers, eating a balanced diet rich in fruits, vegetables, and whole grains can support overall health. It’s best to avoid spicy, acidic, or fatty foods that might aggravate the stomach lining.

3. Surgical Treatment (Rare Cases)

Surgery is rarely required for stomach ulcers today due to the effectiveness of medication. However, if the ulcer causes complications like severe bleeding, perforation (a hole in the stomach), or obstruction, surgery may be necessary. Surgical options include:

Vagotomy: Cutting the vagus nerve to reduce acid production.

Partial gastrectomy: Removing part of the stomach that contains the ulcer.

Pyloroplasty: Widening the opening of the stomach to the small intestine to improve food passage.

4. Natural Remedies (Supportive)

Some people seek natural remedies to complement their treatment, though these should not replace medical therapy. Popular natural remedies include:

Probiotics: Beneficial bacteria that support gut health, which may assist in healing ulcers.

Honey: Raw honey has antibacterial properties and may soothe the stomach lining.

Licorice Root: Deglycyrrhizinated licorice (DGL) may help protect the stomach lining and reduce symptoms.

Always consult with a healthcare provider before trying any natural remedies to ensure they are safe and appropriate for your condition.

Conclusion

Stomach ulcers are a painful but treatable condition. Accurate diagnosis through medical history, physical exams, and diagnostic tests like endoscopy and H. pylori testing is crucial to determining the cause of the ulcer. With the right combination of medications, lifestyle changes, and in rare cases, surgery, most ulcers can heal fully.

If you experience symptoms of a stomach ulcer, it’s important to seek medical advice to prevent complications and begin treatment as soon as possible.