Peptic Ulcers
Intro
A peptic ulcer is a loss of tissue lining the lower esophagus, stomach, and duodenum. It is commonly caused from an infection in the lining of the stomach, from the bacteria Helicobacter pylori (H. pylori). H. pylori causes peptic ulcers by damaging the acid-tolerant lining of the inner stomach or duodenum. Therefore, the stomach acid can reach the tissues underneath and cause further damage and irritation. Although an infection is common in older adults, not everyone will develop an ulcer. Peptic ulcers may also be caused by the use of anti-inflammatory pain medications, such as ibuprofen, naproxen, and celecoxib. These medications can cause irritation and inflammation of the stomach lining which can lead to developing an ulcer. Although lifestyle factors aren't primary causes of peptic ulcers, smoking, excessive alcohol consumption, and stress can contribute to worsening symptoms, interfere with healing, or increase the risk of recurrence.
Signs and Symptoms
Referral Pattern
Symptoms vary widely and can be tricky to distinguish from other problems, such as heartburn. A burning, gnawing pain anywhere from your navel to your breastbone is the predominant symptom. The pain often lasts from a few minutes to several hours, is worse when your stomach is empty, flares up at night, can be temporarily relieved by eating food or taking a medication that reduces stomach acid. In some cases pain may be brought on by eating. Some individuals may experience more vague abdominal pain or cramping and it is not uncommon for an older adult to have an ulcer that causes no pain.
Yellow Flags
Red Flags
A peptic ulcer is a loss of tissue lining the lower esophagus, stomach, and duodenum. It is commonly caused from an infection in the lining of the stomach, from the bacteria Helicobacter pylori (H. pylori). H. pylori causes peptic ulcers by damaging the acid-tolerant lining of the inner stomach or duodenum. Therefore, the stomach acid can reach the tissues underneath and cause further damage and irritation. Although an infection is common in older adults, not everyone will develop an ulcer. Peptic ulcers may also be caused by the use of anti-inflammatory pain medications, such as ibuprofen, naproxen, and celecoxib. These medications can cause irritation and inflammation of the stomach lining which can lead to developing an ulcer. Although lifestyle factors aren't primary causes of peptic ulcers, smoking, excessive alcohol consumption, and stress can contribute to worsening symptoms, interfere with healing, or increase the risk of recurrence.
Signs and Symptoms
- Epigastric pain
- Heartburn
- Burning, gnawing, cramping, or aching pain
- Nausea
- Vomiting
- Weight loss/gain
- Loss of appetite
- Anemia
- Bloating or belching
Referral Pattern
Symptoms vary widely and can be tricky to distinguish from other problems, such as heartburn. A burning, gnawing pain anywhere from your navel to your breastbone is the predominant symptom. The pain often lasts from a few minutes to several hours, is worse when your stomach is empty, flares up at night, can be temporarily relieved by eating food or taking a medication that reduces stomach acid. In some cases pain may be brought on by eating. Some individuals may experience more vague abdominal pain or cramping and it is not uncommon for an older adult to have an ulcer that causes no pain.
Yellow Flags
- If you feel abdominal discomfort or if you're controlling what you think is heartburn on your own with non-presciption medications for more than a few days talk to your doctor.
Red Flags
- Untreated, peptic ulcers can cause life threatening problems (internal bleeding or a perforation that creates a hole in the wall of the stomach or small intestine)
- Seek emergency care if you experience: a sudden, sharp abdominal pain that may feel like it is radiating toward your back and won't go away, black or bloody stool, or bloody vomit or vomit that looks like coffee grounds.
References:
Goodman, MBA, PT, C. C., & Snyder, MN, RN, OCN, T. E. (2007). Differential Diagnosis PHYSICAL THERAPISTS Screening for Referral (4thth ed.). St. Louis, MO: Saunders Elsevier
Mayo Clinic. (2011, March). Peptic Ulcers. Consumer Health, 29(3), 1-3.
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