Stomach Ulcer (Peptic Ulcer Disease)

A stomach ulcer is a break in the lining of the stomach that is deeper than a surface erosion. Together with ulcers in the first part of the small intestine (duodenal ulcers) it is called peptic ulcer disease.

Two causes explain nearly all ulcers: infection with the bacterium Helicobacter pylori and regular use of anti-inflammatory painkillers. Both can be dealt with, so ulcers today are curable with tablets and rarely need surgery. Stomach ulcers are re-examined after treatment because a small number turn out to be cancers.

Symptome

• Burning or gnawing pain in the upper abdomen, often related to meals
• Indigestion, bloating and feeling full quickly
• Nausea, sometimes with vomiting
• Loss of appetite and weight
• No symptoms until a complication, especially in older people on painkillers
• Black, tarry stools or vomiting blood or coffee-ground material if the ulcer bleeds
• Tiredness from iron deficiency anaemia

Ursachen und Risikofaktoren

Helicobacter pylori is usually acquired in childhood and infects about half of the world's population, most of whom never develop an ulcer. It weakens the protective mucus layer and provokes inflammation. Non-steroidal anti-inflammatory drugs such as ibuprofen, diclofenac and naproxen, and even low-dose aspirin, reduce the prostaglandins that protect the lining. Risk climbs with age, higher doses, combination with steroids, anticoagulants or SSRIs, smoking and heavy alcohol. Stress and spicy food do not cause ulcers, although severe physical illness in intensive care can. Rare causes include Zollinger-Ellison syndrome and Crohn's disease.

Wie es diagnostiziert wird

• Gastroscopy: The definitive test. It shows the ulcer and allows biopsies from its edge, which are taken from every stomach ulcer to exclude cancer.
• Helicobacter pylori testing: Biopsy urease test, urea breath test or stool antigen. Acid-suppressing tablets should be stopped two weeks beforehand to avoid a false negative.
• Blood tests: Blood count and iron for anaemia.
• Repeat gastroscopy at 6 to 8 weeks: Confirms that a stomach ulcer has healed completely.

Behandlungsmöglichkeiten

• Proton pump inhibitor: Omeprazole or a similar drug for four to eight weeks heals most ulcers.
• Helicobacter eradication: A 10 to 14 day combination of a proton pump inhibitor with two or three antibiotics, or bismuth quadruple therapy where resistance is common, followed by a breath or stool test at least four weeks later to confirm cure.
• Stopping or replacing NSAIDs: Using paracetamol instead, or continuing with stomach protection when an anti-inflammatory or aspirin is essential.
• Endoscopic treatment of bleeding: Clips, heat or adrenaline injection control most bleeding ulcers without surgery.
• Surgery or interventional radiology: For a perforated ulcer, or bleeding that endoscopy cannot stop.
• Lifestyle: Stopping smoking speeds healing, and limiting alcohol helps.

Wenn es dringend ist

Vomiting blood, black tarry stools, dizziness or fainting mean a bleeding ulcer. Sudden, severe, constant abdominal pain with a rigid abdomen suggests perforation. Both are emergencies requiring an ambulance and treatment at the nearest hospital.

Reisen nach Türkiye zur Behandlung

Ulcers are diagnosed and cured with standard care available almost everywhere, so they are not a reason to travel. If you are in Istanbul for a check-up or another procedure, a gastroscopy with Helicobacter testing fits into a single morning, and treatment can start the same day. The confirmation test after eradication and any repeat endoscopy can be done at home. Bring a list of your medicines, especially painkillers and blood thinners.

Senden Sie Ihre Berichte, Scans und eine kurze Geschichte und eine Clinic-Y Koordinator Antworten innerhalb von 24 Stunden mit geeigneten Teams und schriftlich, All-inclusive Vorschläge nebeneinander. Die Überprüfung Ihres Falls ist kostenlos.

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