Gasric Ulcer

Gastric ulcers are a descriptive term for damage to the lining of the stomach that leads to destruction of the delicate epithelium (lining) of the stomach wall. An ulcer is conventionally a descriptive term for a hole in this epithelium which is larger than 3mm. The term erosion is used for holes which are less than 3mm. The process leading to both these events is often similar.

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Ulcers may arise as a result of damage to or dysfunction the protective layer of mucous that covers the epithelium, or as a consequence of noxious substances, such as excess gastric acid, alcohol or chemicals that cause damage to the epithelium in spite of the protective barrier, or a failure of the normal processes of repair. Sometimes damage arises as a result of a combination of these factors.

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Common causes of gastric ulceration include H.pylori infection, which may disrupt the mucosal barrier or lead to excess acid production, Non steroidal anti-inflammatory (NSAIDs include brufen and diclofenac) use, which disrupts the mucosal barrier or exposure to infection or excess alcohol.

Ulcers are often asymptomatic (cause no symptoms) unless they bleed, in which case they may cause haematemesis or melaena or both. On occasion they may cause epigastric pain, nausea, or weight loss and early satiety.

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Gastric ulcers are usually treated by avoidance of precipitating drugs or treatment of the underlying causes such as H.pylori, with eradication therapy and proton pump inhibitors.