Acid reflux or ulcer

How Do I Know If I Have Heartburn?

Frequent heartburn – defined as occurring two or more days a week – is a burning discomfort in the chest or throat that occurs when harsh stomach acid comes into contact with the delicate lining of the esophagus, irritating it.

Heartburn affects different people in different ways. But the symptoms of heartburn are generally described as:

  • A burning pain that begins in the chest or at the breastbone and moves up toward the throat

  • A feeling that food is coming back into the mouth

  • An acidic or bitter taste at the back of the throat

  • An increase in severity of pain when you’re lying down or bending over

  • Pain that usually comes after meals

Important note: There are some similarities between heartburn and heart attack symptoms. If you have any chest pain that lasts for more than a few minutes or any warning signs of a heart attack (for example, pain spreading to arms, neck or shoulders with shortness of breath; sweating; light-headedness), seek immediate medical attention.

What causes heartburn?

Your stomach produces juices to help your body break down food. These juices contain hydrochloric acid. While your stomach is naturally protected from this potent acid, your esophagus is not. Heartburn’s fiery sensation can occur when this stomach acid refluxes—or flows backward—into the esophagus.

Normally, a valve called the lower esophageal sphincter (LES) keeps stomach acid in the stomach and out of the esophagus. When functioning properly, the LES acts as a door, allowing food to go down into the stomach but not for stomach acids to come back up. If the LES is “relaxing”—or failing to function properly—reflux and heartburn can occur.

Why do you get heartburn?

There may be many reasons why you get heartburn—some of which you can control and some of which you cannot. Dietary and lifestyle habits can increase your risk of developing heartburn, as can certain medications. Individually or in combination, these factors can cause the LES to relax, increase the amount of acid produced in the stomach, raise stomach pressure and/or make the esophagus more sensitive to acid.

Sound complicated? It can be—but a thoughtful review of your diet, lifestyle and medication regimen can help you get to the bottom of the problem. Follow the links below to learn about common factors that contribute to heartburn.

  • What and how much you eat

    Spicy and greasy foods are common culprits. So are coffee, citrus juices and alcoholic beverages. Eating too much and too quickly are heartburn factors, as is being overweight.

  • Smoking

    Smoking cigarettes, cigars or pipes inhibits saliva, one of the body’s natural protective barriers against damage to the esophagus. Smoking may also weaken the LES and stimulate acid production.

Note: Talk to your healthcare professional if you think your medications may be contributing to your heartburn. Ask about alternatives, but never stop taking any prescription medication before checking with your doctor.

What does heartburn have to do with your heart? Nothing, actually!

Despite its name, heartburn — or acid indigestion — is related to your esophagus. But because the esophagus and heart are located near each other, either one can cause chest pain which is why many people mistake heart burn for angina and vice versa.

So what is heartburn?

Heartburn is a common condition that’s caused by stomach acids rising up into your esophagus. This can cause chest pain that sometimes radiates to your neck, throat or jaw.
“Our stomach is made for acid and can handle it, but our esophagus is not,” said Mary Ann Bauman, M.D., author, practicing physician and medical director of women’s health at INTEGRIS Health Systems.

Not sure if what you’re feeling is a heart attack or heartburn?

“I tell my patients that if you belch and the symptoms go away, it probably isn’t related to your heart but to your esophagus,” Bauman said. “But if you have shortness of breath or sweating, then it’s likely a heart-related issue.”

However, everyone is different, and not all symptoms are caused by one or the other, so:

When in doubt, check it out!

If you’re not sure if it’s heartburn or your heart, seek medical attention right away. It’s very easy to confuse the two issues so let a doctor rule out the most severe possibility. This is an especially important message for women.

“Women are more likely to call help for someone else but not themselves,” Bauman said. In fact, 81 percent of women said they would call 911 for someone else showing signs of a heart attack but only 65 percent would call for themselves, according to a special report in Circulation.

She added: “I always tell people if you’re concerned and not sure if it’s your heart, it’s better to err on the side of checking it out and having someone tell you it’s not a heart attack.”

How to avoid reflux.

There are some things you can do to keep the heartburn away.

  1. “Stay away from alcohol, cigarettes, aspirin/anti-inflammatories and citrus (which can relax the valve between the esophagus and the stomach and make it easier for acid to splash up),” Bauman advised.
  2. And if you experience heartburn at night, try giving gravity a hand. “Raise the head of your bed on blocks (about 6 inches) so gravity can help keep your stomach contents down in the stomach,” Bauman said.
  3. Another possible remedy can be not to eat close to bedtime or late at night. When your stomach is full of food or busy digesting food, try letting it finish that work before heading to bed.
  4. Some over-the-counter medications can also help.
  5. See your doctor to discuss your symptoms.

Is It an Ulcer or GERD?

That burning sensation in your stomach could be an ulcer — or it might be gastroesophageal reflux disease (GERD), a chronic acid reflux condition.

Either way, you should schedule a doctor’s visit to find out whether you have GERD or an ulcer. Both ulcers and GERD can be treated with the help of a gastroenterologist.

Ulcer or GERD: Stomach Discomfort

The two conditions are actually different, even if they make you feel equally miserable. By some estimates, one in five people experience heartburn at least weekly. Stomach discomfort can easily have a negative effect on your life, leading to:

  • Lost sleep
  • Difficulty enjoying social activities
  • Problems with eating and drinking

Ulcer or GERD: Understanding the Differences

An ulcer is a small sore or lesion in the lining of your stomach or duodenum, the first part of your intestine. This sore is often aggravated by your stomach acid, but is usually not caused by the acid itself. More likely, the cause is either a bacterium known as Helicobacter pylori (H. pylori) or taking non-steroidal anti-inflammatory drugs (NSAIDs).

GERD, on the other hand, means that your stomach acid is coming up from your stomach into your esophagus, causing a burning sensation (sometimes referred to as acid indigestion or heartburn) and unpleasant taste in the back of your mouth. This has to occur at least twice a week to be considered GERD.

“Most patients with GERD have either heartburn or regurgitation, a sense of things coming back up into your throat,” explains James McGuigan, MD, professor of medicine in the division of gastroenterology, hepatology, and nutrition at the University of Florida College of Medicine in Gainesville. But a small percentage of people with GERD have the same kind of “epigastric” pain that patients with ulcers complain about, says Dr. McGuigan.

Ulcer or GERD: Know the Symptoms

Although you may not realize it, your description of your symptoms will help your doctor distinguish between an ulcer and GERD.

An ulcer often comes with these symptoms:

  • Burning sensation in your gut, about halfway between the navel and breastbone
  • Pain or discomfort two to three hours after eating
  • Pain that wakes you up at night
  • Pain that is eased by eating, drinking, or taking antacids
  • Blood in your stool or vomit

Some symptoms of GERD that do not occur with ulcers are:

  • Tasting acid or food in the back of your mouth
  • Dry cough
  • Sore throat
  • Trouble swallowing
  • Asthma-like symptoms
  • Increased heartburn in response to some “trigger” foods
  • Worsening of symptoms when you are lying down or bending over

Ulcer or GERD: Making the Diagnosis

Your doctor will talk to you about the pain you have been experiencing.

“Generally, when there is suspicion of an ulcer, you recommend endoscopy. If the suspicion is for GERD, you do a therapeutic trial,” says McGuigan. A therapeutic trial involves taking prescription acid-reducing medication for a while to see if that controls your symptoms.

Depending on your symptoms, your doctor may also order:

  • A blood test. This will show whether you have been exposed to H. pylori.
  • A barium study. With this test, also called an upper gastrointestinal or GI series, you will drink a liquid and then a radiologist takes X-rays of your esophagus, stomach, and intestine. This can show whether you have ulcers or any structural problems such as an obstruction that could be causing your symptoms.
  • Endoscopy. For this test, done while you are sedated, your doctor uses a thin, flexible tube with a camera inserted down your throat to look at the inside of your esophagus and stomach. The camera allows the doctor to see ulcers or other problems, like scarring of the esophagus that could be caused by GERD.

An accurate diagnosis will get you one step closer to relief.

Acid reflux disease is the most common upper gastrointestinal disease in Western countries, affecting over seven million Americans alone. The condition occurs when gastric acid splashes up into the esophagus, causing damage. Another common GI condition that affects 4.6 million Americans is peptic ulcer disease. Peptic ulcers can have some symptoms in common with acid reflux and are often treated with PPI medications — causing some confusion between two conditions that are actually quite different.

What is peptic ulcer disease?

Peptic ulcers occur when the acid in the digestive tract eats away at the lining of the stomach or small intestine, creating irritated or raw spots that can become painful open, bleeding sores. Some of the symptoms of peptic ulcer disease include burning stomach pain, feeling full quickly, bloating, intolerance to fatty foods, heartburn, and nausea. So it is easy to see why the initial symptoms of peptic ulcer might be confused with acid reflux disease.

What causes peptic ulcer disease?

Peptic ulcer disease is most frequently caused by a bacterial infection or the overuse of certain medications. Helicobacter pylori bacteria or H. Pylori can be found in the mucosal layer of the GI tract. In most cases it doesn’t cause any problems, but for some it can cause irritation and ulcers. Another factor that can contribute to the development of peptic ulcer disease is the overuse of NSAIDs. These medications, while great for reducing inflammation in conditions like arthritis or pulled muscles, can irritate the lining of the GI tract. As with acid reflux disease, people who smoke, drink alcohol in excess, or eat spicy foods may be more likely to develop peptic ulcers.

How are peptic ulcers treated?

Peptic ulcer treatment may vary depending on the cause contributing to the problem. If an H. Pylori infection is confirmed (usually by a simple blood or breath test) your doctor will most likely prescribe a combination of two antibiotics along with acid suppressing medications. Should the cause of your peptic ulcer be linked to NSAIDs, your doctor will usually recommend discontinuing the medication (or recommend an alternative pain reliever) along with acid suppressing medications.

While acid reflux and peptic ulcer disease may share some similar symptoms and treatments it is vital to get an accurate diagnosis**.** When left untreated, peptic ulcers can cause internal bleeding, perforation of the stomach or small intestine, infection of the abdominal cavity, or an obstruction in the GI tract.** If you experience significant or new abdominal pain or unexplained weight loss or appetite changes; have dark (tar-like) stools or trouble breathing; or feel faint; or are vomiting blood, seek immediate medical care.**** See More Helpful Articles:**

Allergy, Intolerance, or Acid Reflux?

Acid Reflux and MSPI

Infant Acid Reflux: At a Glance

“Presence of H. pylori leads to a reduced disease-free interval, and, therefore, eradication therapy should be considered in patients with ,” write Werner Schwizer, MD and colleagues.

In an interview with WebMD, Schwizer, associate professor of gastroenterology at University Hospital in Zurich, Switzerland, says that the theory about H. pylori being protective against GERD arose following an observation that some duodenal ulcer patients who received antibiotics to kill H. pylori infection later went on to develop Barrett’s esophagitis, a disorder linked to acid-reflux disease. “There was indirect evidence, lets say observational evidence, without really testing that, so that was the basis of our study.”

In the study 70 patients with GERD were divided into three groups, with all patients receiving the acid reducer Prevacid 30 mg twice daily for 10 days, followed by 30 mg once daily for 8 weeks. Patients who were infected with H. pylori were randomly assigned to receive either antibiotics or a placebo for the first 10 days. Patients not infected with H. pylori were used for comparison, which was called the control group.

The patients were followed for 6 months at 2-week intervals for GERD symptoms. At the end of the study, the researchers determined that patients who were still infected with H. pylori had on average an earlier return of symptoms (at 54 days) than patients in whom H. pylori had been eradicated (at 100 days). The control group had the longest symptom-free period, at 110 days.

When they classified the patients according to severity of inflammation of the esophagus, called esophagitis, those with the most inflammation relapsed rapidly, compared to those with low levels of inflammation. Once again, after the researchers considered the amount of esophagitis a patient had, the investigators found that those with H. pylori relapsed more rapidly.

The study was small, however — only 58 patients completed the study, and the authors acknowledge that further research of the underlying mechanisms will be needed to confirm their observations.

A gastroenterologist who was not involved in the study tells WebMD that he’s still not convinced.

Heartburn, Hiatal Hernia, and Gastroesophageal Reflux
Disease (GERD)

On this page:

  • What are the symptoms of GERD?
  • GERD in Children
  • What causes GERD?
  • How is GERD treated?
  • What if symptoms persist?
  • What are the long-term complications of GERD?
  • Points to Remember
  • Hope Through Research
  • For More Information

Gastroesophageal reflux disease, or GERD, occurs when the lower esophageal sphincter (LES) does not close properly and stomach contents leak back, or reflux, into the esophagus. The LES is a ring of muscle at the bottom of the esophagus that acts like a valve between the esophagus and stomach. The esophagus carries food from the mouth to the stomach.

When refluxed stomach acid touches the lining of the esophagus, it causes a burning sensation in the chest or throat called heartburn. The fluid may even be tasted in the back of the mouth, and this is called acid indigestion. Occasional heartburn is common but does not necessarily mean one has GERD. Heartburn that occurs more than twice a week may be considered GERD, and it can eventually lead to more serious health problems.

Anyone, including infants, children, and pregnant women, can have GERD.

What are the symptoms of GERD?

The main symptoms are persistent heartburn and acid regurgitation. Some people have GERD without heartburn. Instead, they experience pain in the chest, hoarseness in the morning, or trouble swallowing. You may feel like you have food stuck in your throat or like you are choking or your throat is tight. GERD can also cause a dry cough and bad breath.

GERD in Children

Studies* show that GERD is common and may be overlooked in infants and children. It can cause repeated vomiting, coughing, and other respiratory problems. Children’s immature digestive systems are usually to blame, and most infants grow out of GERD by the time they are 1 year old. Still, you should talk to your child’s doctor if the problem occurs regularly and causes discomfort. Your doctor may recommend simple strategies for avoiding reflux, like burping the infant several times during feeding or keeping the infant in an upright position for 30 minutes after feeding. If your child is older, the doctor may recommend avoiding

  • sodas that contain caffeine
  • chocolate and peppermint
  • spicy foods like pizza
  • acidic foods like oranges and tomatoes
  • fried and fatty foods

Avoiding food 2 to 3 hours before bed may also help. The doctor may recommend that the child sleep with head raised. If these changes do not work, the doctor may prescribe medicine for your child. In rare cases, a child may need surgery.

*Jung AD. Gastroesophageal reflux in infants and children. American Family Physician. 2001;64(11):1853-1860.

What causes GERD?

No one knows why people get GERD. A hiatal hernia may contribute. A hiatal hernia occurs when the upper part of the stomach is above the diaphragm, the muscle wall that separates the stomach from the chest. The diaphragm helps the LES keep acid from coming up into the esophagus. When a hiatal hernia is present, it is easier for the acid to come up. In this way, a hiatal hernia can cause reflux. A hiatal hernia can happen in people of any age; many otherwise healthy people over 50 have a small one.

Other factors that may contribute to GERD include

  • alcohol use
  • overweight
  • pregnancy
  • smoking

Also, certain foods can be associated with reflux events, including

  • citrus fruits
  • chocolate
  • drinks with caffeine
  • fatty and fried foods
  • garlic and onions
  • mint flavorings
  • spicy foods
  • tomato-based foods, like spaghetti sauce, chili, and pizza

How is GERD treated?

If you have had heartburn or any of the other symptoms for a while, you should see your doctor. You may want to visit an internist, a doctor who specializes in internal medicine, or a gastroenterologist, a doctor who treats diseases of the stomach and intestines. Depending on how severe your GERD is, treatment may involve one or more of the following lifestyle changes and medications or surgery.

Lifestyle Changes

  • If you smoke, stop.
  • Do not drink alcohol.
  • Lose weight if needed.
  • Eat small meals.
  • Wear loose-fitting clothes.
  • Avoid lying down for 3 hours after a meal.
  • Raise the head of your bed 6 to 8 inches by putting blocks of wood under the bedposts–just using extra pillows will not help.

Medications

Your doctor may recommend over-the-counter antacids, which you can buy without a prescription, or medications that stop acid production or help the muscles that empty your stomach.

Antacids, such as Alka-Seltzer, Maalox, Mylanta, Pepto-Bismol, Rolaids, and Riopan, are usually the first drugs recommended to relieve heartburn and other mild GERD symptoms. Many brands on the market use different combinations of three basic salts–magnesium, calcium, and aluminum–with hydroxide or bicarbonate ions to neutralize the acid in your stomach. Antacids, however, have side effects. Magnesium salt can lead to diarrhea, and aluminum salts can cause constipation. Aluminum and magnesium salts are often combined in a single product to balance these effects.

Calcium carbonate antacids, such as Tums, Titralac, and Alka-2, can also be a supplemental source of calcium. They can cause constipation as well.

Foaming agents, such as Gaviscon, work by covering your stomach contents with foam to prevent reflux. These drugs may help those who have no damage to the esophagus.

H2 blockers, such as cimetidine (Tagamet HB), famotidine (Pepcid AC), nizatidine (Axid AR), and ranitidine (Zantac 75), impede acid production. They are available in prescription strength and over the counter. These drugs provide short-term relief, but over-the-counter H2 blockers should not be used for more than a few weeks at a time. They are effective for about half of those who have GERD symptoms. Many people benefit from taking H2 blockers at bedtime in combination with a proton pump inhibitor.

Proton pump inhibitors include omeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), and esomeprazole (Nexium), which are all available by prescription. Proton pump inhibitors are more effective than H2 blockers and can relieve symptoms in almost everyone who has GERD.

Another group of drugs, prokinetics, helps strengthen the sphincter and makes the stomach empty faster. This group includes bethanechol (Urecholine) and metoclopramide (Reglan). Metoclopramide also improves muscle action in the digestive tract, but these drugs have frequent side effects that limit their usefulness.

Because drugs work in different ways, combinations of drugs may help control symptoms. People who get heartburn after eating may take both antacids and H2 blockers. The antacids work first to neutralize the acid in the stomach, while the H2 blockers act on acid production. By the time the antacid stops working, the H2 blocker will have stopped acid production. Your doctor is the best source of information on how to use medications for GERD.

What if symptoms persist?

If your heartburn does not improve with lifestyle changes or drugs, you may need additional tests.

  • A barium swallow radiograph uses x rays to help spot abnormalities such as a hiatal hernia and severe inflammation of the esophagus. With this test, you drink a solution and then x rays are taken. Mild irritation will not appear on this test, although narrowing of the esophagus–called stricture–ulcers, hiatal hernia, and other problems will.
  • Upper endoscopy is more accurate than a barium swallow radiograph and may be performed in a hospital or a doctor’s office. The doctor will spray your throat to numb it and slide down a thin, flexible plastic tube called an endoscope. A tiny camera in the endoscope allows the doctor to see the surface of the esophagus and to search for abnormalities. If you have had moderate to severe symptoms and this procedure reveals injury to the esophagus, usually no other tests are needed to confirm GERD.
    The doctor may use tiny tweezers (forceps) in the endoscope to remove a small piece of tissue for biopsy. A biopsy viewed under a microscope can reveal damage caused by acid reflux and rule out other problems if no infecting organisms or abnormal growths are found.
  • In an ambulatory pH monitoring examination, the doctor puts a tiny tube into the esophagus that will stay there for 24 hours. While you go about your normal activities, it measures when and how much acid comes up into your esophagus. This test is useful in people with GERD symptoms but no esophageal damage. The procedure is also helpful in detecting whether respiratory symptoms, including wheezing and coughing, are triggered by reflux.

Surgery

Surgery is an option when medicine and lifestyle changes do not work. Surgery may also be a reasonable alternative to a lifetime of drugs and discomfort.

Fundoplication, usually a specific variation called Nissen fundoplication, is the standard surgical treatment for GERD. The upper part of the stomach is wrapped around the LES to strengthen the sphincter and prevent acid reflux and to repair a hiatal hernia.

This fundoplication procedure may be done using a laparoscope and requires only tiny incisions in the abdomen. To perform the fundoplication, surgeons use small instruments that hold a tiny camera. Laparoscopic fundoplication has been used safely and effectively in people of all ages, even babies. When performed by experienced surgeons, the procedure is reported to be as good as standard fundoplication. Furthermore, people can leave the hospital in 1 to 3 days and return to work in 2 to 3 weeks.

In 2000, the U.S. Food and Drug Administration (FDA) approved two endoscopic devices to treat chronic heartburn. The Bard EndoCinch system puts stitches in the LES to create little pleats that help strengthen the muscle. The Stretta system uses electrodes to create tiny cuts on the LES. When the cuts heal, the scar tissue helps toughen the muscle. The long-term effects of these two procedures are unknown.

Implant

Recently the FDA approved an implant that may help people with GERD who wish to avoid surgery. Enteryx is a solution that becomes spongy and reinforces the LES to keep stomach acid from flowing into the esophagus. It is injected during endoscopy. The implant is approved for people who have GERD and who require and respond to proton pump inhibitors. The long-term effects of the implant are unknown.

What are the long-term complications of GERD?

Sometimes GERD can cause serious complications. Inflammation of the esophagus from stomach acid causes bleeding or ulcers. In addition, scars from tissue damage can narrow the esophagus and make swallowing difficult. Some people develop Barrett’s esophagus, where cells in the esophageal lining take on an abnormal shape and color, which over time can lead to cancer.

Also, studies have shown that asthma, chronic cough, and pulmonary fibrosis may be aggravated or even caused by GERD.

For information about Barrett’s esophagus, please see the Barrett’s Esophagus fact sheet from the National Institute of Diabetes and Digestive and Kidney Diseases.

Points to Remember

  • Heartburn, also called acid indigestion, is the most common symptom of GERD. Anyone experiencing heartburn twice a week or more may have GERD.
  • You can have GERD without having heartburn. Your symptoms could be excessive clearing of the throat, problems swallowing, the feeling that food is stuck in your throat, burning in the mouth, or pain in the chest.
  • In infants and children, GERD may cause repeated vomiting, coughing, and other respiratory problems. Most babies grow out of GERD by their first birthday.
  • If you have been using antacids for more than 2 weeks, it is time to see a doctor. Most doctors can treat GERD. Or you may want to visit an internist–a doctor who specializes in internal medicine–or a gastroenterologist–a doctor who treats diseases of the stomach and intestines.
  • Doctors usually recommend lifestyle and dietary changes to relieve heartburn. Many people with GERD also need medication. Surgery may be an option.

Hope Through Research

No one knows why some people who have heartburn develop GERD. Several factors may be involved, and research is under way on many levels. Risk factors–what makes some people get GERD but not others–are being explored, as is GERD’s role in other conditions such as asthma and bronchitis.

The role of hiatal hernia in GERD continues to be debated and explored. It is a complex topic because some people have a hiatal hernia without having reflux, while others have reflux without having a hernia.

Much research is needed into the role of the bacterium Helicobacter pylori. Our ability to eliminate H. pylori has been responsible for reduced rates of peptic ulcer disease and some gastric cancers. At the same time, GERD, Barrett’s esophagus, and cancers of the esophagus have increased. Researchers wonder whether having H. pylori helps prevent GERD and other diseases. Future treatment will be greatly affected by the results of this research.

For More Information

The U.S. Government does not endorse or favor any specific commercial product or company. Trade, proprietary, or company names appearing in this document are used only because they are considered necessary in the context of the information provided. If a product is not mentioned, this does not mean or imply that the product is unsatisfactory.

National Digestive Diseases Information Clearinghouse

2 Information Way
Bethesda, MD 20892-3570
Email:

The National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1980, the clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.

Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This fact sheet was reviewed by G. Richard Locke, M.D., Mayo Clinic; and Joel Richter, M.D., Cleveland Clinic Foundation.

PRACTICALLY ACTIVE: Peptic ulcers are all about the acids

I’m not the type to get ulcers. I give them.

— Former N.Y. Mayor Ed Koch

A few months back, I started feeling yucky. I tried to ferret out information using my symptoms but got nowhere. I had been experiencing headaches, nausea, feeling faint and often got sick after eating. It was not heartburn or acid reflux.

I told Mom my symptoms, and she thought it might be an ulcer. I went to the medical clinic and discussed things with the doctor. She must have thought it was a peptic ulcer and prescribed omeprazole. More on that drug later.

I didn’t know the actual causes and symptoms of an ulcer. My self-diagnosis went from heart attack to stroke and back. I realized it was time to become more informed.

According to information from The Mayo Clinic, peptic ulcers are open sores. There are gastric ulcers that occur inside the stomach and duodenal ulcers that occur on the inside of the upper portion of the small intestine or duodenum.

Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the stomach or small intestine. The tract is coated with a mucous layer that protects against acid, but if the acid increases or the protective layer decreases, an ulcer can form.

There are varying levels of symptoms, with the most common being burning stomach pain, which I really didn’t have, nausea, a feeling of fullness, fatty food intolerance and heartburn. Less often there can be more severe signs like:

■ Tarry stools

■ Feeling faint

■ Unexplained weight loss

■ Appetite changes

■ Trouble breathing

Those symptoms should be a reason to get to the doctor.

Nearly three-quarters of people with peptic ulcers do not have symptoms. Or their symptoms go away after eating or taking antacids, so a connection isn’t made that there could be a bigger problem than just a little heartburn.

Common causes include:

■ A bacterium. Helicobacter pylori (H. pylori) lives in the mucous layer that protects the tissues that line the stomach and small intestine from acid. Often it causes no problems but can cause inflammation and produce an ulcer.

It’s not clear how the bacterium spreads, but it can be transmitted by close person-to-person contact like kissing, or food and water.

■ Regular use of aspirin or certain over-the-counter and prescription pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs). They can irritate or inflame the lining of the stomach or small intestine. Those include ibuprofen, naproxen sodium and ketoprofen. Acetaminophen (Tylenol) is not a culprit.

■ Other medications taken along with NSAIDs, like steroids, anticoagulants and low-dose aspirin.

Risk factors can include smoking and alcohol, as well as untreated stress and spicy foods, which don’t cause the ulcers but can make symptoms worse.

Left untreated, peptic ulcers can result in internal bleeding, infection and obstruction of the digestive tract. Doctors recommend we protect ourselves from infection and use caution with the pain medications we take.

As I said, I was prescribed omeprazole, and it has worked wonders. My symptoms are gone.

According to the U.S. National Library of Medicine’s MedlinePlus, it is used to treat symptoms of gastroesophageal reflux disease (GERD), in which the stomach produces too much acid, and for ulcers. I take a prescription capsule, but there are over-the-counter versions that treat recurring heartburn.

PARK IT

A couple of months ago I wrote about van accessible parking and a company that makes sticky notes to put on the cars of handicap parking scofflaws. The company website is Braunability.com.

The notes read, “You put me in a bit of a tight spot. These blue stripes save me the space I need to get in and out of my accessible vehicle. Without that extra space, I’m stuck. Please remember that next time.”

The company sent me four of the pads, which have about 20 to 25 sticky notes. I will send a pad to the first four folks who email with their interest and address.

Email me at:

Style on 10/28/2019

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