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About 1 in 10 Swedes will suffer from stomach ulcers at some point in their lives – a common but often overlooked cause of recurring stomach problems. Because the symptoms are sometimes vague or similar to other stomach problems such as gastritis or IBS, there is an undercount. Many people go around with chronic irritation in the stomach without receiving the right diagnosis or treatment. Behind many cases lies a bacterium called Helicobacter pylori (H. pylori). It can cause inflammation in the stomach or duodenum – which in turn can lead to ulcers that hurt and disrupt digestion.
What is a stomach ulcer?
A stomach ulcer – or ulcer as it is also called – is a sore in the protective lining of the stomach or duodenum. When the lining becomes weakened, stomach acid can begin to attack the tissue and create painful ulcers. Stomach ulcers can be mild or severe and can sometimes lead to bleeding or complications if left untreated.
What do stomach ulcers feel like?
Symptoms of stomach ulcers can vary, but the most common are:
- A dull or burning pain in the upper abdomen
- Acid reflux or heartburn
- Nausea, sometimes combined with vomiting
- Feeling full early during meals
- Unintentional weight loss
In more acute and severe stomach ulcers, you may experience:
- Severe pain in the upper abdomen
- Black or bloody stools
- Bloody or coffee-grounds-like vomit
- Fever and feeling unwell
Why do you get stomach ulcers?
The two most common causes of stomach ulcers are:
- infection with Helicobacter pylori – a bacterium that attacks the stomach lining and causes inflammation.
- Long-term use of medications such as NSAIDs (e.g. ibuprofen) or cortisone, which can weaken the mucosal protection.
Other risk factors include smoking, alcohol, stress, coffee, highly spicy foods and genetic predisposition.
How do you know if you have a stomach ulcer?
It can be difficult to determine for yourself whether the symptoms are due to a stomach ulcer or other stomach problems such as gastritis or IBS. However, stomach ulcers more often cause persistent or worsening symptoms that do not go away over time. If you suspect you have a stomach ulcer, you should have a medical examination – and one of the easiest ways to start is with a blood test for Helicobacter pylori (IgG).
What does the Helicobacter pylori (IgG) blood test show?
The test measures whether you have IgG antibodies to H. pylori in your blood, which indicates that you have or have had an infection. It is a convenient and easily accessible way to find out if the bacteria could be the cause of your symptoms. If the test is positive, the doctor may recommend treatment with antibiotics and drugs that reduce stomach acid.
Treatment of stomach ulcers
The treatment is adapted to the cause of the stomach ulcer:
- In the case of H. pylori infection, so-called triple therapy is given – antibiotics in combination with acid-suppressing drugs.
- In the case of drug-induced ulcers, the drug is often replaced and supplemented with stomach acid-suppressing drugs.
Most people recover completely after treatment, but it is important to follow up with the right tests if symptoms persist.
What can I do myself?
To prevent and relieve stomach ulcers, you can:
- Avoid smoking and alcohol
- Limit coffee and strongly spiced foods
- Take drugs such as NSAIDs only when necessary and in consultation with doctor
- Eat regularly and avoid stressing out at mealtimes
When should I seek medical attention for a stomach ulcer?
You should contact a doctor if you experience any of the following symptoms;
- Have long-term or recurring stomach problems
- Have symptoms that do not go away despite over-the-counter treatment
- Lose weight without explanation
- Have difficulty swallowing or feel weak
Seek emergency medical attention if you experience bloody vomiting, black stools or sudden, severe abdominal pain - these may be signs of a bleeding or ruptured stomach ulcer.
Blood tests that can help diagnose stomach ulcers
If a stomach ulcer is suspected, certain blood tests can provide valuable information about the cause of the symptoms. The most common test is Helicobacter pylori (IgG), which shows whether you have had an infection with the ulcer-causing bacterium H. pylori. But there are also other markers that can be helpful in the investigation:
- Pepsinogen A – a precursor to the enzyme pepsin that is produced in the stomach. Low levels may indicate a thinned stomach lining, which increases the risk of ulcers and inflammation.
- Gastrin – a hormone that stimulates stomach acid production. High values may occur with certain stomach ulcers or with long-term treatment with acid-inhibiting drugs.
- Hemoglobin (Hb) and iron values – are used to detect possible anemia, which can occur with bleeding stomach ulcers.