A gastric ulcer is a pathological condition that causes lesions of the mucosa of the stomach and eventually affects the innermost layers. 

Whatever the cause, gastric ulcer is always the result of an imbalance between aggressive factors (such as hydrochloric acid and pepsin) and defensive factors (e.g., mucus and bicarbonates) of the gastroduodenal mucosa. 

Men are more frequently affected than women, although peptic ulcers are unlikely to strike before age 20. Such incidence, however, increases over the years and peaks around age 50.

Gastric ulcers, however, should not be underestimated: An ulcerative disease can cause mortality due to the onset of complications, such as bleeding or perforation.

Gastric ulcer: Causes

Among the causes of gastric ulcer:

  • Infection caused by a bacterium, the Helicobacter pylori;
  • A genetic predisposition to the disease;
  • The use of certain medications (such as aspirin and anti-inflammatory drugs);
  • Excessive alcohol consumption;
  • Stress.

Gastric ulcer: Symptoms

The first symptom, which is also the most common, of gastric ulcer is abdominal pain, often located at the mouth of the stomach – in the epigastrium. 

It is a dull pain that tends to occur immediately after eating and sometimes worsens depending on the meal. 

In other cases, the pain may be accompanied or replaced by other symptoms, such as:

  • Sense of fullness;
  • Postprandial bloating;
  • Slow or difficult digestion;
  • Nausea, occasionally accompanied by vomiting;
  • Epigastric and retrosternal heartburn;
  • Poor appetite;
  • Weight loss.

As a condition characterized by scarring and recurrence, the symptomatology is usually intermittent and episodic, alternating periods of well-being lasting a few months and periods of flare-ups, which are mainly seasonal, usually occurring in spring and fall.

Gastric ulcer, stress, and drugs

Intense psychological stress and anxiety are some of the factors that can increase the risk of developing gastric ulcers.

Certain medications, such as NSAIDs, aspirin, and cortisone drugs, can cause similar issues.

NSAIDs are among the most widely used drugs in the world for treating inflammation and pain, and often, their intake is not under medical supervision. Not for nothing are they, after Helicobacter pylori infection, the second leading cause of disease. To prevent gastrointestinal damage, it is preferable to prescribe drugs such as proton pump inhibitors to patients who require long-term NSAID therapy or, in chronic treatment, with aspirin.

Gastric ulcer: Treatment

Before discussing possible remedies, we must underline that proper treatment of gastric ulcers cannot disregard the diagnosis of their triggers. 

In fact, being aware of the causes might mean changing the natural history of ulcerative disease characterized by recurrence in 80% of cases within a year. 

Useful in defining a correct clinical framing is esophagogastroduodenoscopy.

Regarding medications, antisecretory drugs, such as proton pump inhibitors, which significantly inhibit intragastric acid production, and histamine H2 receptor antagonists are used to treat gastric ulcers. 

In addition, in the presence of Helicobacter pylori infection, antibiotics are essential.