Gastric Ulcer

A gastric ulcer, also known as a stomach ulcer, is a lesion that forms in the mucosal lining of the stomach and, in some cases, may progress to rupture or bleeding. These lesions arise when the protective mucus layer of the stomach is reduced, allowing digestive acids to damage the underlying tissues. Ulcers may be asymptomatic in their early stages; however, if left untreated, they can cause intense abdominal pain, discomfort and serious complications. The term peptic ulcer disease includes both gastric ulcers and ulcers that occur in the first part of the small intestine, the duodenum.

Symptoms of a gastric ulcer include abdominal pain, weight loss, loss of appetite, nausea, vomiting (sometimes with blood), acid reflux–related belching, heartburn, anaemia, and dark stools (melena) or fresh blood in the stool in more severe cases.

The main causes of gastric ulcers include:

• Helicobacter pylori infection: may inflame the gastric and duodenal mucosa, increasing the risk of gastric cancer;
• Non-steroidal anti-inflammatory drugs (NSAIDs): such as aspirin or ibuprofen, which can damage the stomach lining;
• Zollinger–Ellison syndrome: a rare condition that increases gastric acid production, promoting ulcer formation.

Diagnosis is performed by a gastroenterologist through upper gastrointestinal endoscopy. The most serious complications of untreated ulcers include bleeding, perforation of the stomach wall, obstruction of food passage and an increased risk of cancer.

Treatment depends on the cause of the ulcer and the severity of the condition:

• Medical treatment: includes antibiotics to eradicate H. pylori, proton pump inhibitors or H2-receptor blockers to reduce acid secretion, antacids for rapid symptom relief, and gastric protectants such as sucralfate;
• Endoscopic treatment: control of bleeding from a bleeding ulcer, endoscopic dilation in cases of narrowing or obstruction;
• Surgical treatment: indicated in severe cases, such as recurrent, bleeding, perforated ulcers or those causing gastric outlet obstruction. Surgery may include ulcer removal, cauterisation of bleeding vessels and reduction of gastric acid production.
• Prevention

To reduce the risk of gastric ulcers, the following measures are recommended:

• Screening for and treating H. pylori infection;
• Maintaining a balanced diet, avoiding acidic or irritating foods, alcohol and tobacco;
• Avoiding prolonged periods of fasting;
• Adhering strictly to the treatment plan prescribed by the physician, including acid-suppressing medication when indicated.

With early diagnosis and appropriate treatment, prognosis is favourable, and the adoption of healthy lifestyle habits helps prevent recurrence and associated complications.