A stomach ulcer can be considered an infectious disease, since the role of the bacterium Helicobacter pylori (Helicobacter pylori ) in its development has been proven , transmission routes and preventive measures are known. However, not only Helicobacter is involved in the formation of ulcers on the gastric mucosa. The pathological processes that lead to this are complex, but, oddly enough, they boil down to the boring expression “all diseases are from the nerves.” Indeed, the state of the mucous membrane is strongly influenced by stresses – if there are many of them, and they occur often or last for a long time, the stomach responds with inflammation and the production of excess acid, which eats away at the mucous membrane. Especially in those places that have already been “prepared” by Helicobacter .

How does a stomach ulcer arise?

There are two types of factors acting in the stomach – aggressive and protective, or protective . The aggressive ones include hydrochloric acid, the enzyme pepsin, with the help of which food is digested, bile acids – if bile is accidentally thrown into the stomach from the duodenum. Protective factors are the production of mucus and special substances, the growth of new epithelium in place of the worn out one, good blood supply to the stomach, rich innervation. These factors are normally balanced and the stomach remains healthy. But if the balance shifts towards aggressive factors: Helicobacter secretes its toxins, acidity rises, mucus production decreases, then inflammation occurs, and an ulcer may develop.

Stomach ulcers are more often found in men than in women, and in general 10% of the working population suffers from an ulcer. This is a lot, and this makes stomach ulcers a socially significant pathology. Among the reasons, in addition to Helicobacter and stress, there are malnutrition, smoking and hobby for alcoholic beverages, frequent use of non-steroidal anti-inflammatory drugs (these are pain relievers, like Nise or Ibuprofen) and steroid hormones, as well as hereditary factors.

Ulcer symptoms: pain, heartburn, vomiting

Most often, the first symptoms of an ulcer appear suddenly – there is severe pain in the stomach. In general, this disease is characterized by a wave-like course with a worsening and improvement of the condition until the complete cessation of symptoms. If an exacerbation can last for several weeks, then remission, at times, occurs for years. Gross malnutrition, severe stress, taking the above drugs, infection can lead to an exacerbation of ulcer symptoms.

Pain can be of a different nature – aching, dull, sharp, cramping – and can occur at different times in relation to food. This latter depends on which part of the stomach the ulcer is located in. An ulcer in the upper part of the stomach gives early pain – ulcer symptoms appear as soon as the patient eats. If the stomach ulcer is located in its lower section, the pain will occur a couple of hours after eating. If the pain occurs on an empty stomach, often at night, and subside after eating, it is most likely a duodenal ulcer.

An increase in the acidity of the contents of the stomach causes another symptom of an ulcer – heartburn. It can appear before or during pain. Patients often complain of belching, nausea and vomiting. Vomiting often occurs at the peak of pain and is followed by relief, so some people purposely induce vomiting to relieve pain. Appetite in patients with stomach ulcers may not change, but with an exacerbation it is reduced. Sometimes patients are afraid to eat, knowing that the food will be followed by pain, and they lose a lot of weight. 

How is ulcer diagnosed

The diagnosis of stomach ulcers is based on gastroscopy. In this procedure, the doctor examines the walls of the esophagus, stomach, and duodenum. If necessary, you can do a biopsy, that is, remove a piece of stomach tissue and examine it under a microscope. This is done to prove the presence of Helicobacter or if an ulcer is suspected of degenerating into cancer.

Ulcer treatment: surgery or medication?

In the 1970s, when the arsenal of doctors was poor – diet and drugs that reduce the acidity of the stomach for a short time, stomach ulcers often reappeared after treatment and often gave complications. It was during this period that the surgical treatment of ulcers was given an important place. Today gastroenterologists have a huge selection of effective medicines. These are, first of all, antibiotics to combat H. pylori and hydrogen pump inhibitors to reduce acidity. The drugs have become more accessible, and doctors use them in the early stages of ulcer formation, thereby preventing complications.   

Medical treatment of the ulcer usually leads to its healing. The ulcer is scarred, as doctors say, that is, a scar remains in the stomach in its place, a reminder of former problems. However, if the diet is not followed or re-infection with Helicobacter pylori, the ulcer may open in the old place or a new ulcer may form. That is why in case of a stomach ulcer it is necessary to be observed by a gastroenterologist and adhere to his recommendations for nutrition and treatment.

Indications for surgery: bleeding, etc.

Surgical treatment of stomach ulcers today is used only with a complicated course of the disease. For example, when an ulcer is perforated, when in this place the wall of the stomach breaks through, and all of its acidic contents enters the abdominal cavity. This is a very difficult and painful condition that requires emergency surgery. Another indication for surgery is bleeding from an ulcer, which cannot be stopped endoscopically . That is, a gastroscope is introduced to the patient through the mouth, an ulcer is found and a bleeding vessel is cauterized.  

But if this does not help, and the bleeding continues, you have to go for surgery. Also, a stomach ulcer can eat away at the wall of the stomach and spread to the pancreas. This condition is called penetration and is also the reason for surgical treatment. Finally, sometimes the ulcer becomes the cause of stomach cancer, the treatment of which, of course, surgical. In most other cases, the treatment of stomach ulcers is conservative.

Diet for stomach ulcers

The nutrition of a stomach ulcer patient should be complete and thoughtful. It is better to eat fractionally – four to six times a day. The amount of food at the reception is small. It’s easy to get used to this rule, knowing that three hours later you can eat again.

A diet for stomach ulcers excludes all fried, cold and hot food, mushrooms, fatty meat or lard, sausage and canned food, smoked products, bran and muesli, cereals from coarse cereals, for example, barley, fresh vegetables, sour fruits and berries, fermented milk products, hot sauces, chocolate, black bread, legumes, soda, strong tea and coffee and, of course, alcohol.

But low-fat milk and dairy products are allowed. An ulcer diet involves eating foods that do not increase acidity. Low-fat milk is one of them. Food can be stewed, boiled, steamed. Soups, mashed potatoes, soft cereals, soft-boiled eggs or scrambled eggs are allowed. You can eat dried white bread, non-yeast baked goods, broth and soups in secondary broth (that is, the first broth is drained, the meat is poured with clean water and then the soup is prepared), lean meat and fish. Berries and fruits need to be peeled and mashed. From sweets, marmalade, marshmallow, honey, jam are acceptable. And from drinks – diluted juices, weak tea, rosehip broth.

Diet with an ulcer should be adhered to all the time of exacerbation, and it is better not to break it later. Although at the stage of recovery, it is possible to use a zigzag diet under the supervision of a doctor: the patient is allowed to eat prohibited food from time to time, and then again transferred to a diet. It is believed to exercise the stomach lining.