It’s estimated that 10 per cent of people will develop a peptic ulcer in their lifetime.
Gastritis is the medical name for when the protective lining of the stomach tract (the mucosa) is damaged and inflamed. If the layer that protects the stomach lining from stomach acid breaks down, an ulcer can develop.
Helicobacter pylori (H. pylori) infection is a common cause of gastritis, with 80 per cent of ulcers resulting from it. It inflames and infects the stomach and duodenum lining and interferes with a mechanism that normally switches off stomach acid production.
Other causes include regular use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, which can lead to irritation and swelling of the stomach if taken for a long time at high doses. Bile reflux, where the fluids which digest fats, wash back into the stomach and irritate the lining is also a common cause of gastritis.
Heavy alcohol consumption, smoking and stress may all increase stomach acid and cause inflammation. Less common causes include an autoimmune reaction, such as Crohn’s disease, where the immune system attacks healthy cells and tissue in the stomach lining, and allergies to foods.
Many people with gastritis have no symptoms. Acute gastritis, where symptoms come on quickly over a short period of time can cause burning abdominal pain, indigestion, feeling full after meals, nausea and vomiting. Chronic gastritis takes longer to develop, and may only cause mild symptoms, such as loss of appetite, but if it’s left untreated, it can lead to ulcers.
Peptic ulcer symptoms may include a sharp knife-like pain just below the breast bone, which lasts anything from a few minutes to a few hours and starts 1-2 hours after eating. Internal bleeding is the most common complication of stomach ulcers, where an ulcer develops at the site of a blood vessel.
Symptoms include weight loss, red blood in vomit and black stools. If you have these symptoms, you should speak to your GP right away. Other complications include iron-deficiency anaemia, where a lack of iron in the body leads to a reduction in the number of red blood cells, typically causing tiredness, pale skin, breathlessness and heart palpitations.
Your doctor may diagnose gastritis and an ulcer from your symptoms. Tests for H.pylori might be carried out, including a blood test, a stool sample and a urea breath test, where you’ll drink a liquid sample containing a chemical broken down by H.pylori.
An endoscopy may also be performed, which involves examining the lining of the stomach and duodenum with a tiny fibre-optic camera on the end of a thin flexible tube that can be swallowed. You may also be given some barium solution if your doctor wants to take X-rays, as it shows up on X-rays as it passes through your digestive system.
Who gets gastritis and ulcers?
Both men and women of all ages can get gastritis and peptic ulcers. However, peptic ulcers are more common in people over the age of 65, as well as people who are taking NSAIDs and smokers.
Gastritis can be treated with drugs to relieve symptoms including antacids to neutralise stomach acids and H2-receptor antagonists such as ranitidine, which blocks histamine the chemical in your body that signals your stomach to produce acid. Proton pump inhibitors (PPIs) such as omeprazole, also reduce stomach acid. You may also be tested for H.pylori infection and given antibiotics if infected.
H.pylori infection can be treated with a course of antibiotics to eradicate the infection and H2 receptor-antagonists or PPIs to reduce acid production.
If your ulcer is due to NSAIDs, the usual treatment is to stop the NSAIDs and take acid- suppressing drugs for four to eight weeks. If the NSAIDs can't be stopped, the acid suppressing drugs will still work but the ulcer will take longer to heal.