Treatment of stomach (gastric) ulcer at the Sachsenhausen Clinic, Germany, Frankfurt

Treatment of stomach (gastric) ulcer

A gastric ulcer is a deep wound in the gastric mucosa. It is typically noticeable by upper abdominal pain. Gastric ulcers are mainly caused by an excess of stomach acid. Often a colonization of the gastric mucosa is responsible for the bacterium Helicobacter pylori. With medication, a gastric ulcer can usually be completely cured. Find out, among other things, which risk factors favor a stomach ulcer, which warning signs you should look out for and how the treatment and prognosis look like.

Gastric ulcer: symptoms

Gastric ulcers are among the most common gastrointestinal diseases. Even more often, only the duodenal ulcer (medicalulcer duodeni) occurs. Both gastric and duodenal ulcer typically cause oppressive or burning upper abdominal pain. The complaints often occur in connection with eating or drinking. However, people with a duodenal ulcer often have pain with an empty stomach (fastingpain) and at night. In contrast, an increase in pain shortly after eatingis a typical ulcer. In addition, loss of appetite, bloating, nausea and vomiting and weightloss may indicate gastric ulcer. Some patients also develop signs of anemiaas a result of bleeding gastric ulcer.

Gastric ulcer: complications

Certain analgesics and anti-inflammatories such asacetylsalicylicacid (ASA), ibuprofenordiclofenac can cause stomach ulcers on theonehand. On the other hand, if taken regularly, they can suppress the pain stimulus so that sufferers do not notice the typical gastric ulcer symptoms. As a result, unnoticed (severe) complications may develop. The most common complication of gastric ulcers (and duodenal ulcers) is a bleeding from the ulcer. One possible sign of this is a black-colored stool. The black color develops when the blood from the ulcer is decomposed by the acid gastric juice.

Sometimes the bleeding from the gastric ulcer is so small that the stool does not discolor. However, persistent bloodloss is reflected in a decreased hemoglobin level in the blood.

Gastric ulcer: treatment and prevention

How our doctors treat a gastric ulcer depends mainly on the cause. A particularly important factor is whether the gastric bacterium Helicobacter pylori was detected in the stomach in the patient. If this is the case, the doctor primarily uses antibiotics for gastric ulcer therapy to eliminate the infection. To do this, the person takes two different antibiotics (clarithromycin and amoxicillinormetronidazole) daily for seven days. In addition, the doctor will prescribe an acid-reducingdrug (forexample, a so-called "proton pump inhibitor"). As a "stomach protection" they inhibit the production of stomach acid, so that the attacked mucous membrane can recover.

If the bacterium Helicobacter pylori can not be detected, no antibiotics are used, only acid-reducing drugs, especially "proton pump inhibitors". The therapy is symptomatic. This means that it only alleviates the symptoms. Without the damaging effect of stomach acid, the gastric ulcer usually heals by itself. In addition, however, it must been sured that the person concerned completely avoids stomach-irritating substances and foods (alcohol, coffee, nicotine) until the gastric ulcer has healed.

Gastric ulcer treatment: gastroscopy

After completion of the medical gastric ulcer treatment, gastroscopy is performed within about six to eight weeks (gastroscopy). It is checked if the ulcer is really completely healed.

In addition, a gastroscopy can be performed to treat complications: If the ulcer bleeds, the doctor can inject a special protein glue (fibrin glue) into the wound in the context of gastroscopy to so stop the bleeding.

Gastric ulcer treatment: surgery

Gastric ulcers are rarely operated on today. Forexample, with a very stubborn boil, it may be useful to remove part of the stomach. As a rule, the vagus nerve is also severed (vagotomy) in order to reduce gastric acid production.

Complications of a gastric ulcer may also require surgery. For example, a stomach opening must always be surgically treated.

Gastroscopy

The gastroscopy serves to ensure the diagnosis "gastric ulcer". It helps a flexible hose, at the front end of a light source and a small optics are installed. This endoscope is gently advanced over the mouth and esophagus into the stomach and to the duodenum. This allows the doctor to directly assess any changes in the mucous membrane.

Tissue removal

During gastroscopy, the doctor can take tissue samples (biopsies) from suspicious mucosalsites via the endoscope. They are examined microscopically in the laboratory. In this way, it can be as certained whether the mucosallesions really are a stomach ulcer and not stoma chcancer. In addition, a colonization with the gastric germ Helicobacter pylori can be detected on the basis of the tissue samples.

Prof., Dr. med. Plamen Staikov

Prof., Dr. med. Plamen Staikov

Medical Director, Head physician

Holger Bahn

Holger Bahn

Senior physician

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