Overuse of painkillers can cause stomach ulcers
One big misconception about stomach ulcers, also called peptic ulcers, is that spicy food is to blame. Actually, most ulcers occur owing to bacterial infection or the overuse of painkillers.
Stomach ulcers, though common, remain poorly understood. Mrudul Dharod, consultant, gastroenterology, hepatology and endoscopy, at Wockhardt Hospitals, Mumbai, says he sees almost 20-30 cases of peptic ulcer disease every week. Ajay Kumar Sachdev, senior consultant gastrointestinal surgeon at the Sri Balaji Action Medical Institute, New Delhi, says he sees around 14-15 cases every week.
According to Dr Dharod, changing dietary habits, increased consumption of junk food and fizzy drinks, reduced physical activity, high stress levels, smoking and alcohol intake are leading to an increasing number of gastrointestinal issues.
Stomach ulcers are sores in the stomach lining or the small intestine. They occur when the protective mucus that lines the stomach becomes ineffective. The stomach produces a hydrochloric acid to help digest food and protect against harmful microbes. To protect the body’s tissues from this acid, it also secretes a thick layer of mucus. “If the mucus layer is worn away and stops functioning effectively, the acid can damage the stomach tissue, causing an ulcer,” explains Chandra Soni, head of department, gastroenterology, at the Asian Institute of Medical Sciences in Faridabad, adjoining Delhi.
Most stomach ulcers are caused by Helicobacter pylori, a common bacterium that grows in the digestive tract and tends to attack the stomach lining. “This bacteria gets into the mucosal lining in the stomach, creating holes and exposing more sensitive tissue to stomach acid,” explains Dr Sachdev.
According to Mehul Choksi, consultant gastroenterologist at the Dr LH Hiranandani Hospital in Mumbai, the regular intake of painkillers (e.g. Ibuprofen, Diclofenac, etc.) or use of blood thinners like aspirin for heart disease and stroke can also lead to ulcers.
Unsupervised use of these for headaches, backaches, joint pains, especially for a long period, can irritate the stomach and bowel and lead to ulcers. “It is advisable to look for the root cause of pain rather than popping painkillers. Intake of blood thinners like aspirin should be supervised by a physician and taken only if the clinical situation warrants their use,” says Dr Choksi.
Sometimes, though, an ulcer could be an indication of cancer, tuberculosis or inflammatory bowel disease (Crohn’s disease).
“Common symptoms are abdominal discomfort after having a meal, extreme burning sensation or pain in the abdomen (often pain from a stomach ulcer can travel, radiating to the back or chest), chronic heartburn and regurgitation (that icky feeling of acid backing up into your throat), loss of appetite, unexplained weight loss, and feeling faint and weak. Other symptoms include bloating, lots of burping, or feeling permanently full,” lists Dr Sachdev. If you vomit blood and have black stools, you require medical attention urgently,” he warns. An endoscopy is usually performed to look at the gut lining, and a biopsy (tissue sample) may be taken for further investigation.
According to Dr Choksi, if it is a bacterial infection, the doctor may prescribe a course of antibiotics and acid suppressants. The most effective medications used commonly to treat gastric ulcers are PPIs (proton pump inhibitors), which block acid production by stomach cells, thereby helping in the healing of ulcers, explains Dr Dharod. They are usually prescribed for 6-12 weeks, depending on the severity of the ulcers and surrounding gastritis (inflammation of the internal stomach lining).
Occasionally, antacid syrups with/without coating agents may be prescribed to protect the tissues of the stomach, and for immediate symptomatic relief. Surgical treatment is rare. Only a complicated stomach ulcer that continues to return, refuses to heal, has torn through the stomach wall, or has caused signs of obstruction due to the narrowing of the tract, may require surgery.
According to Dr Soni, foods that may help fight off H. pylori or boost the body’s own healthy bacteria include broccoli, cauliflower, cabbage, radish, leafy greens such as spinach, probiotic-rich foods, yogurt, apples, blueberries, raspberries, strawberries and blackberries.
Dr Dharod says some natural home remedies may be useful in managing stomach ulcers. He suggests a healthy diet full of fruits, especially with vitamins A and C, vegetables and whole grains. Soybean, legumes, red grapes, broccoli, apples, berries, and teas, especially green tea, contain naturally occurring compounds called flavonoids, which may be an affective additional treatment for peptic ulcer.
Not eating vitamin-rich foods may make it difficult for the body to heal the ulcer. “Refrain from smoking and alcohol consumption as they erode the protective lining of the stomach, making the stomach more susceptible to the development of an ulcer. Smoking also increases stomach acid. Try to get enough sleep. Spicy foods irritate the ulcer and hence need to be avoided, as should caffeinated carbonated beverages and deep-fried foods. Sleep can help your immune system, and therefore counter stress. Also, avoid eating shortly before bedtime,” he says.
Traditionally turmeric, garlic, cabbage and neem bark extract were recommended to treat gastric ulcers. These may be helpful, says Dr Dharod, but evidence on effectiveness is lacking and these cannot be recommended as the primary treatment for peptic ulcers.
If stomach ulcers remain untreated or are not treated in time, it can lead to bleeding. This in turn can lead to anaemia, and severe blood loss may even require hospitalization or a blood transfusion. “Peptic ulcers can even eat a hole through (perforate) the wall of your stomach or small intestine, putting you at risk of serious infection of your abdominal cavity (peritonitis),” adds Dr Dharod. They can lead to swelling, inflammation or scarring that may block passage of food through the digestive tract, and may lead to a person losing a lot of weight and becoming weak. Also, an internal ulcer can develop into cancerous cells if it’s not treated well or in time.
So, treat the symptoms in time.