Steve Wright, a former Radio 2 DJ, died from a ruptured stomach ulcer at the age of 69, the . Although Wright died in February, the cause of death has only just been made known.
Author
Adam Taylor
Professor and Director of the Clinical Anatomy Learning Centre, Lancaster University
But what causes stomach ulcers and how can they be prevented?
Two causes
There are two main causes of stomach ulcers. One is , a species of bacteria that isn’t killed by stomach acid. In fact, it thrives in an acidic environment.
In the stomach, it moves through the protective layers of and produces an enzyme called that damages the stomach lining.
The second cause is drugs called non-steroidal anti-inflammatories, or NSAIDs. Possibly the most well-know NSAID is ibuprofen.
Ibuprofen reduces the production of hormone-like substances called prostaglandins, which help heal tissue damage and injury. But it doesn’t just do this at the source of the pain – it acts on the whole body, including the stomach.
In the stomach prostaglandins and stimulate . This means that when people take NSAIDs they reduce the production of , which in turn increases acid production and decreases the production of that protect the gastric lining.
Contrary to popular belief, stress and spicy foods don’t cause stomach ulcers, but they can make them worse.
How do ulcers form?
Initial damage to the stomach lining appears as irritation, known as . If this progresses, can erode. Without treatment, larger sores (ulcers) appear in the gastric lining, eroding down into the underlying .
Ulcers can range from 3mm to . If treatment isn’t sought for a long enough period the erosion can tear all the way , out into the cavity around the abdominal organs.
If this occurs, the stomach contents, including all the microbes within it, can and cause a significant infection called peritonitis. This can swiftly progress to sepsis, which can .
Ruptured ulcers are associated with up to , and this can rise as with increasing age. Even those who make it to the hospital and have surgery are at .
Before perforation, the patient may notice dark (black) poo which smells foul and has a tar-like consistency, this is a classical symptom of a bleeding ulcer called . The dark colour of the faeces is caused by the in the intestines.
Who gets ulcers?
Ulcers can affect anyone, but they are more and in older adults. Studies show that up to may have a stomach ulcer.
, taking , especially if , consuming large quantities of alcohol over a (because alcohol damages the stomach lining) and stomach injury all increase the risk too.
In older adults, there is an increased risk of dying from ulcers because the , and managing ulcers can become difficult because of with other medications.
How they’re treated
Not all stomach ulcers have symptoms, but when they do cause symptoms they usually include , .
A doctor can usually make a diagnosis based on symptoms alone, but the is , where a small camera on a tube is inserted into the mouth and swallowed enabling the doctor to see the internal lining of the stomach.
Treatment is often aimed at reducing stomach acid to allow the lining to repair. Two types of drugs are taken to promote this: H2 receptors, such as , or , such as omeprazole or lansoprazole.
People who have an ulcer that was caused by NSAIDs may need to take one of these drugs in the long term to prevent a .
Ulcers in the stomach are usually easily treatable once the cause is identified and can prevent more serious complications, such as , particularly where H pylori is the cause. So if you have any of the symptoms listed above, do see your GP as soon as you can.
Adam Taylor does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
