Stomach Issues: Causes and Solutions for Ulcers - Gastroenterology and Hepatology

Stomach

Hello Doctor: My father is currently around 65 years old.
After meals, he often feels a sense of heaviness in his stomach, experiences a burning sensation in his chest, and has the urge to vomit sour liquid.
He previously underwent an endoscopy, and the doctor mentioned that there was a hole in the stomach wall, suspected to be a gastric ulcer.
He was prescribed medication for treatment, which seemed to improve his condition.
However, I am unsure why the old ailment has recurred.
What could be the reason, and are there any methods for a complete cure? Susan 2001 07 29

Susan, 20~29 year old female. Ask Date: 2002/07/29

Dr. Yang Peizhen reply Gastroenterology and Hepatology

There are many causes of gastric ulcers, including Helicobacter pylori, medications (especially nonsteroidal anti-inflammatory drugs), alcohol, stress, corrosive chemicals (such as hydrochloric acid and strong bases), and severe illnesses (such as stroke or brain surgery).
Gastric ulcers can be classified as benign or malignant; therefore, if a gastric ulcer is found during an endoscopy, a biopsy is usually required to determine the possibility of malignancy.
If it is confirmed to be benign, medication must be taken regularly for eight to twelve weeks for complete healing, and a follow-up endoscopy is necessary to check if the gastric ulcer has fully healed.
If it has not healed, there must be a suspicion of malignant tissue potentially lurking beneath the ulcer.
To prevent the recurrence of gastric ulcers, it is essential to avoid the aforementioned causes, as this is the only way to achieve a complete cure.

Reply Date: 2002/07/29

More Info

Dear Susan,
Thank you for reaching out regarding your father's stomach issues. It sounds like he has been experiencing significant discomfort, and I appreciate your concern for his health. Based on the symptoms you've described—post-meal discomfort, a sensation of heat in the chest, and acid reflux—it is indeed possible that he is dealing with a peptic ulcer, which can manifest as a "hole" in the stomach lining.
Peptic ulcers can be caused by several factors, the most common being infection with Helicobacter pylori (H. pylori), excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), and lifestyle factors such as smoking and excessive alcohol consumption. Stress and dietary habits can exacerbate symptoms but are not direct causes of ulcers.
The recurrence of ulcers after treatment can be attributed to several reasons:
1. Incomplete Eradication of H. pylori: If the underlying cause of the ulcer is an H. pylori infection, it is crucial that the bacteria be completely eradicated. This typically involves a combination of antibiotics and proton pump inhibitors (PPIs) over a course of 10 to 14 days. If the infection persists, the ulcer may return.

2. Medication Adherence: It is essential that your father follows the prescribed medication regimen closely. If he stops taking the medication prematurely or does not take it as directed, this could lead to a resurgence of symptoms.

3. Lifestyle Factors: Factors such as diet, smoking, and alcohol consumption can significantly impact ulcer healing. A diet high in spicy foods, caffeine, or acidic foods may irritate the stomach lining and exacerbate symptoms. Encouraging a balanced diet and avoiding irritants can be beneficial.

4. Stress Management: While stress does not directly cause ulcers, it can worsen symptoms. Encouraging stress-reducing activities such as exercise, meditation, or counseling may help improve his overall well-being and potentially alleviate some symptoms.

5. Other Gastrointestinal Conditions: Sometimes, other conditions such as gastroesophageal reflux disease (GERD) or gastritis can mimic ulcer symptoms. If the ulcer is healing but symptoms persist, it may be worth investigating these other possibilities.

To address your question about a potential "cure," while many ulcers can heal completely with appropriate treatment, the key is to address the underlying causes. This often requires a multifaceted approach, including medication, lifestyle changes, and possibly further testing to ensure that there are no other underlying issues.

In terms of follow-up, it is advisable for your father to have regular check-ups with his gastroenterologist. They may recommend repeat endoscopy to assess the healing of the ulcer and to ensure that there are no complications. Additionally, if H. pylori was not previously tested, it may be beneficial to conduct a breath, stool, or biopsy test to confirm its presence.

In summary, while peptic ulcers can be challenging to manage, with the right treatment plan and lifestyle modifications, many patients can achieve significant relief and prevent recurrence. I encourage you to discuss these points with your father's healthcare provider to develop a comprehensive management plan tailored to his needs.

Best wishes for your father's health,
Doctor Q&A Teams

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