Highlights
- Internal ulcers are breaks in the mucous membrane or other membranes inside the body, usually in the gastrointestinal system.
- Of these, gastric, duodenal, and esophageal ulcers are the three most common types.
- The most common causes of internal ulcers are nonsteroidal anti-inflammatory drug (NSAID) use, H. pylori infections, and excess stomach acid.
- Medication and lifestyle changes can help you prevent and manage internal ulcers.
This article is part two of our series on ulcers. Read part one, Understanding Ulcers: Types and Causes.
Internal ulcers, or breaks in the membranes of organs, are usually found along the gastrointestinal tract. In our previous article, we discussed the types and causes of all types of ulcers. Here, we discuss how to manage and treat internal, or peptic, ulcers.
Prevention and management against internal ulcers improves your quality of life, reduces pain, and drives down the risk of more serious problems, such as cancer. Learn how internal ulcers form, the difference between types of internal ulcers, treatment and prevention, and getting the lowest price on ulcer medication.
Types of Internal Ulcers
The most common internal ulcers, also known as peptic ulcers, are gastric, duodenal, and esophageal. Contrary to popular belief, duodenal ulcers are actually the most frequently occurring type and are found in the upper part of the small intestine, just below the stomach. Gastric ulcers, while also common, are located in the stomach. Esophageal ulcers develop in the esophagus, usually closer to the stomach.
Causes and Risk Factors
While there are a few rarer causes, most common internal ulcers are triggered by one of three problems:
- Helicobacter pylori infection: The bacterium H. pylori weakens the protective membranes of the gastric system, making it susceptible to the acids and enzymes it produces, thereby leading to ulcers.
- Non-steroidal anti-inflammatory drugs (NSAIDs): These drugs inhibit the enzyme COX-1, which is essential for maintaining a strong mucus lining in the stomach and intestine. A compromised lining increases the likelihood of an ulcer forming, especially as we age.
- Excess stomach acid production: While less common, the stomach can produce acid at levels that overwhelm its protective mechanisms, resulting in an ulcer. Conditions like acid reflux, or GERD, are particular risk factors for esophageal ulcers.
Each of these factors can interact in complex ways, making everyone’s risk profile unique.
Internal Ulcer Symptoms
Internal ulcers can often be elusive and silent, especially among the elderly. However, they can manifest through a variety of symptoms that differ based on their location within the digestive system. Early recognition of these symptoms is vital for prompt diagnosis and effective treatment.
Symptoms that you may have an ulcer include:
- Pain in or around the stomach, often described as a burning or dull ache
- Bloating or other forms of discomfort
- Heartburn
- Nausea and vomiting
- Presence of blood in vomit or feces
Specific Symptoms for Different Types of Ulcers
- Weight loss: Particularly associated with gastric ulcers, as eating may exacerbate the pain.
- Weight gain: More common in duodenal ulcers, as eating can temporarily alleviate the pain.
- Pain after eating: Both duodenal and gastric ulcers can cause pain a few hours after a meal, sometimes disrupting sleep.
- Sour taste in the mouth: A hallmark of esophageal ulcers, often caused by acid reflux into the esophagus.
Diagnosing Internal Ulcers
Initial diagnosis of an ulcer often relies on symptoms, a brief physical examination, and medical history. However, definitive diagnosis typically involves more specialized tests. Your healthcare provider may recommend blood or stool tests to check for antibodies that would confirm an infection. If there’s no indication that the ulcer is a symptom of a more severe issue, your provider may start treatment on the presumption of an ulcer.
However, if symptoms like bleeding are present, expect a more comprehensive diagnostic approach. These usually include differential tests to rule out severe conditions such as cancer.
Breath Testing
Should your doctor suspect an H. pylori infection, they may order a breath test. You’ll ingest a capsule containing a special form of urea marked with a carbon atom. The H. pylori bacteria will metabolize the urea into carbon dioxide (CO2), which you’ll exhale. The presence of the marked carbon atom in your breath confirms the infection.
Barium Swallow Fluoroscopy
For this diagnostic test, you’ll drink a barium solution to coat your gastrointestinal system. You’ll then undergo a fluoroscopy, a real-time x-ray, to visualize any ulcers or other abnormalities. This test also provides insights into your swallowing mechanics and how your stomach and duodenum function during digestion.
Upper Endoscopy
In certain cases, an endoscopy may be necessary for a conclusive diagnosis. While you’re sedated, a camera will be inserted through your throat to examine the affected area. Your doctor may order a follow-up endoscopy after treatment to ensure complete healing. This procedure is also used if a biopsy is needed.
Treatment and Management of Internal (Peptic) Ulcers
Managing peptic ulcers can be challenging, but a variety of treatment options are available. Medication is often the first line of defense, reducing stomach acid to promote healing. Lifestyle changes can also play a significant role, particularly in managing symptoms. In extreme cases where other treatments have failed or complications have arisen, surgical intervention may be necessary.
Medication
The cornerstone of ulcer treatment usually involves medications to reduce stomach acid. Proton pump inhibitors (PPIs) are commonly prescribed and are also available over the counter. These include:
- Omeprazole (Prilosec)
- Lansoprazole (Prevacid)
- Rabeprazole (Aciphex)
- Esomeprazole (Nexium)
- Pantoprazole (Protonix)
For ulcers caused by H. pylori infections, a combination of antibiotics is typically prescribed alongside PPIs to eradicate the bacteria.
Lifestyle Changes
While lifestyle modifications primarily focus on symptom management and overall well-being, they can also contribute to ulcer healing. Recommended changes include:
- Dietary adjustments
- Engaging in regular exercise
- Quitting smoking
- Limiting alcohol consumption
- Stress management techniques
Surgical Options
In severe cases where ulcers are unresponsive to medication or have led to complications like bleeding or perforation, surgical intervention may be considered as a last resort.
Internal Ulcer Prevention
While it’s impossible to completely eliminate the risk of developing internal ulcers, you can significantly mitigate that risk with some straightforward habits. Alongside the lifestyle changes mentioned earlier, consider the following:
- Get regular check-ups. Early detection makes ulcers easier to treat. Keep up with your scheduled medical appointments and don’t hesitate to discuss any new symptoms or concerns with your healthcare provider.
- Monitor NSAID Use. Over-the-counter NSAIDs like aspirin, ibuprofen (Motrin and Advil), and naproxen sodium (Aleve) can increase the risk of gastrointestinal bleeding and ulcers. While occasional use is generally low-risk, frequent or prolonged use should be discussed with your doctor.
- Practice good kitchen hygiene. While H. pylori can be contracted through contaminated food, it’s also commonly spread through person-to-person contact. Standard food preparation and kitchen sanitation practices are usually sufficient for prevention.
Incorporating these habits with lifestyle changes can substantially reduce your risk of developing an ulcer.
When paired with lifestyle interventions, these habits can cut back heavily on your ulcer risk.
Living with Internal (Peptic) Ulcers
The key takeaway about internal ulcers is that they are treatable and often heal with proper care. Although they can cause discomfort, they usually don’t lead to severe complications if managed effectively. Support groups can offer emotional support and practical advice for managing your condition.
If stress is a significant factor in your ulcer symptoms, consider consulting a mental health professional. They can provide strategies for stress management, offer a confidential setting to discuss your concerns, and work with you on coping mechanisms.
Final Thoughts
Ulcers are neither inevitable nor hereditary. Proactive measures and awareness of symptoms can help you minimize your risk. Moreover, effective risk management can improve not just your gastrointestinal health but your overall quality of life.
Get the Lowest Price for Your Ulcer Medication
Don’t let the cost of ulcer medication add to your stress level. At BidRx, the pharmacies come to you, bidding on your prescription with their best price. Choose the offer that works best for your budget, and it’ll be shipped right to your door, or available for pickup at a pharmacy if it’s local.
See how you can save on all your medications by visiting our medications page.
