Stomach ulcers, also known as peptic ulcers, are open sores that develop on the inner lining of the stomach or the upper part of the small intestine. They can cause discomfort and lead to serious health issues if untreated. This article explores diagnostic methods, particularly whether ultrasound can detect them.
Can Ultrasound Detect Them?
Traditional transabdominal ultrasound is generally not the primary method for detecting stomach ulcers. This limitation arises because the stomach contains gas, which scatters sound waves and makes it challenging to visualize the stomach lining clearly. The relatively small size of most ulcers also makes them difficult to discern with this imaging technique.
Transabdominal ultrasound struggles to detect superficial ulcers and differentiate them from other stomach abnormalities. However, it can identify very large ulcers, significant stomach wall thickening, or complications like a perforation. It may also guide biopsies in complex cases.
Endoscopic ultrasound (EUS) can visualize ulcers more effectively. This involves guiding a thin, flexible tube with an ultrasound transducer down the throat and into the stomach. The transducer’s close proximity to the stomach lining allows for clearer, more detailed images of the ulcer and stomach wall layers. Still, EUS is not typically the first-line diagnostic tool for routine ulcer detection.
Other Ways to Diagnose Stomach Ulcers
Upper gastrointestinal endoscopy is the most accurate and preferred method for diagnosing stomach ulcers. This procedure involves inserting a thin, flexible tube with a camera into the esophagus, stomach, and the first part of the small intestine. It allows direct visualization of the ulcer, assessment of its size and location, and taking tissue samples (biopsies) for Helicobacter pylori testing or malignancy.
A barium swallow is another imaging technique to identify ulcers. During this procedure, the patient drinks a liquid containing barium, which coats the digestive tract lining and makes it visible on X-rays. While it can show an ulcer’s outline, it is less precise than endoscopy and cannot provide tissue samples.
Several non-invasive tests detect Helicobacter pylori. These include blood tests for antibodies, stool tests for bacterial antigens, and breath tests identifying carbon dioxide after a special solution. These tests confirm infection, guiding treatment decisions.
Understanding Stomach Ulcers
Stomach ulcers are open sores that form on the protective lining of the stomach (gastric ulcers) or the upper part of the small intestine (duodenal ulcers). The most frequent causes are Helicobacter pylori infection and prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen. These factors can disrupt the stomach’s protective mucus layer, allowing stomach acid to damage the underlying tissue.
Less common factors contributing to ulcers include excessive alcohol consumption and smoking. While stress was once thought to be a primary cause, it is now understood that psychological stress can exacerbate symptoms but does not directly cause ulcers. A rare condition called Zollinger-Ellison syndrome can also lead to ulcers by causing the stomach to produce too much acid.
Symptoms of stomach ulcers often include a burning pain in the abdomen, typically felt between the breastbone and the navel. This pain may be worse when the stomach is empty, often occurring between meals or at night, and can be temporarily relieved by eating or taking antacids. Other common symptoms include bloating, heartburn, nausea, and occasional vomiting. In some cases, ulcers can bleed, leading to dark, tarry stools or vomiting blood, which requires immediate medical attention.
Treatment Approaches
Treating stomach ulcers typically depends on their underlying cause. If the ulcer is due to a Helicobacter pylori infection, a combination of antibiotics is prescribed to eliminate the bacteria, usually alongside proton pump inhibitors (PPIs). PPIs reduce stomach acid, allowing the ulcer to heal. This combination therapy is often given for 10 to 14 days.
For ulcers caused by long-term NSAID use, the primary treatment involves discontinuing the NSAID if possible. PPIs or H2 blockers, medications that reduce stomach acid, are then prescribed to promote ulcer healing. These acid-suppressing medications are typically taken for several weeks for recovery.
Lifestyle modifications also play a supportive role in ulcer management. Avoiding irritants like excessive alcohol and smoking is generally recommended. While specific dietary restrictions are often not necessary, some individuals find relief by limiting spicy foods or other items that trigger their symptoms. Following the prescribed treatment plan and attending follow-up appointments are important for proper healing and monitoring complications.