Ulcer Disease

A peptic ulcer is a sore or break in the lining of any part Bleeding may be the first and only symptom of an ulcer.
within the digestive tract that contains concentrated gastric Bleeding ulcers can cause vomiting of acidified blood that looks
juice. The main components of gastric juice are water, mucus, like ‘old coffee grounds’ and/or bowel movements that appear
hydrochloric acid, enzymes, and electrolytes. Ulcers most black. When an ulcer bleeds and continues to bleed without
commonly occur in the first part of the small intestine below the treatment, a person might become anemic.
stomach (duodenum) and can also occur at the lower end of the Perforation can occur when ulcers go untreated, as gastric
esophagus or in the stomach. juices can make a hole through (perforate) the stomach and/or
Most ulcers result from infection with Helicobacter pylori duodenal lining, requiring surgery to close the opening.
(H. pylori) bacteria. Contrary to old beliefs, neither eating spicy Obstruction is a complication that can occur when chronic
food nor living a stressful life cause ulcers. H. pylori bacteria inflammation from the ulcer causes swelling and scarring. Over
weaken the protective mucous coating of the esophagus, time, this scarring may close (obstruct) the outlet of the stomach,
stomach, or duodenum, which then allows acid to get through preventing the passage of food and causing vomiting and weight
to the sensitive lining beneath. Once the protective coat is loss. Surgery is required to repair obstructions.
weakened, then both acid and H. pylori irritate this lining and It is important to contact a physician immediately if your
cause a sore (ulcer) to form. ulcer symptoms worsen.
It is unclear how these bacteria spread from person to person
and why only a small percentage of those who have H. pylori Diagnosis
within the stomach develop peptic ulcers. Just because you have The most common tests used to check for the presence of an
H. pylori bacteria populating your stomach does not mean you ulcer are:
will get an ulcer, although most diagnosed with ulcers also have Upper GI series: You will swallow a liquid that contains
an H. pylori infection. barium and then a technician will take X-rays. Barium coats
Another cause of ulcers is the regular use of pain medications the esophagus, stomach, and upper part of the small intestine,
called non-steroidal anti-inflammatory drugs (NSAIDs), which which makes their outline visible on the X-ray images.
include aspirin, ibuprofen (Advil®, Motrin®), and naproxen Gastroscopy: A physician passes a long flexible tube with
(Aleve®, Naprosyn®). Frequent or long-time use of NSAIDs, a tiny video camera on the end (endoscope) through the mouth
especially among the elderly population, can increase the risk of and down the esophagus to the stomach to look for the presence
developing an ulcer. of inflammation or ulcers. If necessary, the physician removes a
About 10% of Canadians will experience peptic ulcers at small sample of tissue (biopsy) for further testing.
some point throughout their lives. Tests for H. pylori: There are several tests available to detect
Helicobacter pylori infection. These include a simple breath test,
Symptoms/Complications checking the blood for antibodies to the bacteria, or examination
The most common symptom of an ulcer is a burning pain of stomach biopsies.
in the upper abdomen, somewhere between the breastbone and
the navel. The pain can last anywhere from a few minutes to Management
several hours, often occurs between meals, and can wake you Dietary and Lifestyle Modifications
from sleep. Food or antacids might temporarily relieve the Your physician might recommend lifestyle and dietary
discomfort. Less common symptoms of an ulcer include nausea, changes in addition to medications until the ulcers completely
vomiting, lack of appetite, and weight loss. heal. It is best to avoid certain foods and beverages such as
There are three main complications of peptic ulcers: bleeding, chocolate, coffee, alcohol, fatty foods, peppermint, citrus fruits
perforation, and obstruction. and juices, tomato products, pepper, mustard, and vinegar

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during healing. Eating smaller meals more frequently About the Gastrointestinal Society
may also help control symptoms. Smoking cessation is The GI (Gastrointestinal) Society is a registered Canadian charity
committed to improving the lives of people with gastrointestinal and
important, as smoking inhibits ulcer healing. You should
liver conditions, supporting research, advocating for appropriate patient
also avoid NSAIDs (non-steroidal anti-inflammatories), access to healthcare, and promoting gastrointestinal and liver health.
such as aspirin, ibuprofen, or naproxen because they can
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cause further damage to stomach tissue. Your physician
quarterly newsletter, provides the latest on digestive and liver research,
will probably lift any dietary restrictions once your ulcers disease and disorder treatments (e.g., medications, nutrition), and a
have healed. whole lot more. If you have any kind of digestive problem, then you will
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Medications This pamphlet was produced in partnership with the Canadian Society
The cause of your ulcer will determine the type of of Intestinal Research under the guidance of affiliated healthcare
medical treatment that your physician recommends. If professionals. This document is not intended to replace the knowledge,
diagnosis,orcareofyourphysician.©GlSociety2023.Allrightsreserved.
caused by NSAID use, then your doctor may discontinue
prescribing NSAID medication, suggest a different pain Subscription/Donation Form
medication, or continue NSAID use and add another Purchase Information
medication to protect your stomach and duodenum, such I enclose a donation of $ (Eligible for a Canadian tax receipt)

as a proton pump inhibitor (PPI), which reduces stomach I enclose a $20 annual subscription fee ($30 outside Canada)
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If H. pylori infection is the cause, then your doctor
may prescribe a treatment plan to kill the infection
while reducing the acid in your stomach. Usually, this Name (Mr./Mrs./Ms./Dr./Other Please circle one)
is a combination of one or more antibiotics (to kill the
bacteria) plus a PPI. It is important to follow the treatment Company Name (Optional)
plan exactly as your doctor prescribes.
Some of the common antibiotic medications prescribed
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for treatment of ulcers caused by H. pylori infection
include amoxicillin, clarithromycin, tetracycline,
and metronidazole. It is important to take antibiotic City, Province, Postal Code

prescriptions until they are complete. This helps prevent

the growth of superbugs (more resistant bacteria) that Daytime Phone Email
might make subsequent infections more difficult to treat. Patient Friend/Family Member Professional
Along with the antibiotic, your physician will likely
prescribe a PPI. PPIs work by blocking an enzyme
necessary for acid secretion. These include omeprazole Diagnosis/Area of Interest (This optional information helps us to
determine which topics might be of interest to you and is kept strictly
(Losec®), lansoprazole (Prevacid®), pantoprazole confidential.Weneversellourlists.)
sodium (Pantoloc®), esomeprazole (Nexium®),
rabeprazole (Pariet®), pantoprazole magnesium
Would you like more information? Please list your topics.
(Tecta®), and dexlansoprazole (Dexilant®).
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Outlook
Acquiring H. pylori infection during childhood is
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often without consequence. Transmission within a family
is very rare, so indiscriminate screening for H. pylori is Gastrointestinal Society
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To help ensure that you remain ulcer-free, it is
important to take all of your medication exactly as your Phone:604-873-4876
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way through treatment. Re-infection after successful Email: info@badgut.org
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