Gastric Ulcer: Causes, Symptoms and Treatment

A gastric ulcer, also known as a stomach ulcer, is a type of peptic ulcer that results from the erosion of the stomach lining, more specifically, the gastric mucosa. This condition often presents as a rounded erosion, typically resulting from the corrosive action of acidic gastric juices produced by the stomach. Gastric ulcers might manifest as a simple erosion of the mucosa, leading to a dull, burning pain in the upper abdominal region following meals. However, complications such as hemorrhages, perforations, and occlusions due to tissue scarring can also occur.

Causes and Risk Factors

The exact cause of gastric ulcers is not entirely understood, but several contributing factors have been identified. These ulcers are thought to occur due to a decrease in the resistance of the gastric mucosal barrier to the aggressive action of peptic-acid secretion.

The stomach produces gastric juices, which have both digestive and defensive functions against pathogens. These juices are highly corrosive, and thus the stomach has specialized cells that produce a protective mucus layer. This layer contains proteins and bicarbonates, which maintain a higher pH value to protect the gastric mucosa from the acidic gastric secretion. Any factors that alter this protective barrier, increase gastric acidity, or obstruct the natural repair processes of the mucosa can potentially contribute to the onset of a gastric ulcer.

Inflammation of the stomach mucosa, or gastritis, is always found in patients suffering from gastric ulcers. This inflammation precedes the ulcer and reduces the mucosa's ability to secrete bicarbonate into the mucus, thus explaining the onset of the ulcer.

Helicobacter Pylori and Other Factors

In a significant number of patients with gastric ulcers, the presence of a bacterium called Helicobacter pylori is found beneath the mucosa. This bacterium is capable of inducing a local inflammatory reaction, which triggers an immune response that makes the mucous lining vulnerable to attack by gastric juices.

Other factors such as diet, medications, and behavioral factors can also contribute to the onset of gastric ulcers. Non-steroidal anti-inflammatory drugs (NSAIDs) and corticosteroids, for instance, can exert a harmful action on the mucosa. Alcohol and caffeine can also affect the stomach lining, as can certain dietary fats and smoking.

Genetic predisposition and psychological factors also play a role in the development of gastric ulcers. Individuals with certain personality traits or who are exposed to high stress and conflict situations are more likely to develop gastric ulcers.

Symptoms and Diagnosis of Gastric Ulcers

Gastric ulcers typically present as a dull, cramp-like pain or burning sensation in the upper and central region of the abdomen. This pain often appears within the first 30 minutes after a meal. Other symptoms may include nausea, vomiting, and weight loss due to aversion to food.

The diagnosis of a gastric ulcer is typically based on symptoms and confirmed through instrumental tests such as gastroscopy and radiographic examination with contrast medium. Gastroscopy allows for direct visualization of the ulcer, evaluation of its size and shape, and the collection of biopsy samples.

Treatment and Prevention

The treatment of gastric ulcers primarily involves the use of drugs that reduce the acidity of gastric juices, such as proton pump inhibitors and histamine H2 receptor antagonists. If the ulcer is associated with a Helicobacter pylori infection, antibiotic therapy is also employed. In severe cases, surgical intervention may be necessary.

Preventive measures include adopting a diet that excludes foods and drinks that increase acid secretion, minimizing alcohol consumption, and being cautious with the use of anti-inflammatory drugs. Quitting smoking is also highly advisable, as it can alter the normal vascularization and repair of the gastric mucosa.

In conclusion, understanding the causes, symptoms, and treatment options for gastric ulcers can greatly assist in managing this condition. While further research is needed to fully understand the mechanisms behind gastric ulcer formation, current knowledge provides valuable insights into prevention and treatment strategies.