Don’t Let Ulcers Get So Bad You Need Surgery

A few weeks ago, a friend of mine called me complaining of pain in his abdomen that had lasted several days. His first thought was that it was probably gas, but I became suspicious because the pain was persistent. Sure enough, a few days after he called me, he saw his doctor, who diagnosed the pain as peptic ulcers.

Ulcers can afflict both men and women and can occur at any age, but some studies have shown that ulcers mostly affect men 25 to 50 years old.

Some researchers are seeing more ulcers in men today than in the past, and one guess is that the source is chronic aspirin use. It’s important to be aware of the warning signs of ulcers to prevent further complications, because letting an ulcer go untreated can be uncomfortable if not downright dangerous.

*

There are several types of ulcers. Those that occur in the stomach and the duodenum (the first part of the small intestine leading from the stomach) are called peptic ulcers; those occurring just in the stomach are called gastric ulcers; and ulcers occurring just in the duodenum are called duodenal ulcers.

The most common type of ulcer is a peptic ulcer. Ulcers occur when the protective lining of the stomach or small intestine is destroyed by excess stomach acid. A sore or lesion forms in the lining and, if untreated, can lead to increased pain and bleeding.

Some common initial symptoms include a burning or gnawing pain in the abdomen or lower chest, a bloated feeling after eating, nausea and vomiting, and constipation.

Oftentimes, the pain is not relieved simply by taking over-the-counter antacids such as Rolaids or Mylanta. If symptoms last for several days after self-treatment, it is important to see a doctor. Furthermore, if symptoms return after treatment under a physician’s care, it is imperative that you go back to your doctor.

Many men will continue to ignore the symptoms, hoping that they will simply go away. But this decision could be dangerous. As the stomach lining continues to erode, bleeding can occur. Also, if the ulcer completely erodes the stomach wall--this is a perforated ulcer--severe infection can occur, and this will require emergency surgery.

*

It has not yet been determined what exactly causes ulcers, however, so there are several risk factors to keep in mind. Studies have shown that smoking increases your risk for ulcers; it can also worsen the symptoms of an ulcer if you already have one. Also, chronic use of aspirin and other nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen) puts you at risk for developing ulcers because these medications irritate the stomach’s lining and can cause gastrointestinal bleeding.

Other risk factors include having a family history of ulcers. Some health care professionals say leading a stressful lifestyle can contribute.

It used to be that ulcers were treated with a simple change in diet, which would consist largely of bland, nonspicy food. The idea was to decrease acid production by avoiding foods that brought on symptoms. More recent studies have shown that diet, although associated with worsening the symptoms, does not necessarily cause ulcers. If caught early enough, the ulcer can be treated with antacids that neutralize stomach acid and allow the ulcer to heal.

Your physician will determine the best regimen to treat your condition. In severe cases of perforated ulcers or bleeding ulcers, surgery is the only option to repair the stomach or duodenal wall. If the H. pylori bacterium is the cause of the ulcer, antibiotics will be prescribed.

Kristl I. Buluran has a graduate degree from the UCLA School of Public Health and is a laboratory researcher in Los Angeles.