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January 17, 2006 > Tending To Tummy Troubles

Tending To Tummy Troubles

Tending To Tummy Troubles

At one time or another, nearly everyone suffers from some sort of digestive disorder - heartburn, gas, constipation, diarrhea, nausea, vomiting or stomach pain. While such discomforts generally subside fairly quickly, recurring symptoms may indicate a more serious condition.

One common serious digestive disease is peptic ulcer - a sore on the lining of the stomach or duodenum (the beginning of the small intestine). Peptic ulcers occur when stomach acid penetrates the stomach or duodenal lining and causes erosions that may produce upper abdominal pain and lead to internal bleeding and possibly anemia and other complications. According to the American Gastroenterological Association, an estimated one in 10 Americans will develop peptic ulcer disease.

"People used to think that ulcers were caused by stress or even by eating spicy foods," says Dr. Bhupinder Bhandari, a gastroenterologist at Washington Hospital. "We now understand, however, that the vast majority of ulcers - more than 90 percent - are caused by a type of bacteria called Helicobacter pylori, or H. pylori. The bacteria attack the stomach lining. Another frequent cause of ulcers is the overuse of nonsteroidal anti-inflammatory pain medications such as ibuprofen and aspirin."

The most common symptom of an ulcer is a burning pain in the stomach, between the breastbone and navel. The pain is most common when the stomach is empty, but it can occur at any time. Other symptoms may include nausea, vomiting, blood in the stool or loss of appetite.

"People who have symptoms of a peptic ulcer should definitely consult their physician and be tested for H. pylori infection or exposure," explains Dr. David Levin, a Washington Hospital pathologist. "There are several tests to determine if you are infected with H. pylori. One is a simple blood test that evaluates whether you have developed antibodies to the bacteria. There also is a breath test that requires you to drink a liquid that contains a special carbon atom. If H. pylori is present, it releases the carbon to the lungs and the carbon is discovered when you breathe into a container. We also can perform a stool test to detect H. pylori."

Levin notes that an endoscopy exam also can be used to test for ulcers or other causes of digestive symptoms. In this test, the doctor inserts a small flexible tube through the mouth and into the stomach. A camera attached to the tube allows the doctor to look for inflammation or ulcers. An endoscopy also can enable the doctor to take small samples of the stomach lining to test for the presence of H. pylori.

"H. pylori is a fairly widespread organism, and not everyone who is infected will develop ulcers," Levin adds. "The mechanism for transmission of the bacteria is unknown, but researchers think it may be acquired through food or water. Also, the Center for Disease control notes that person-to-person transmission may be possible. In any event, t makes sense to follow common-sense precautions to avoid being infected with the bacteria by washing your hands frequently, cooking your food thoroughly and drinking water from a clean, safe source."

Treatment for peptic ulcers resulting from H. pylori infection includes a combination of antibiotics to kill the bacteria. Other medications may be indicated to reduce the acid in the stomach and protect the stomach lining.

"Following your doctor’s treatment recommendations is important," says Bhandari. "Untreated ulcers can result in internal bleeding. You also may experience bloating, vomiting, weight loss, narrowing of the stomach and gastric obstructions from scarring that prevent food from continuing down the gastrointestinal tract. Most ulcers can be treated successfully with medication. It’s extremely uncommon for an ulcer to require surgical treatment unless there is uncontrolled bleeding."

Bhandari adds that duodenal ulcers are more common than stomach ulcers. "A gastric ulcer in the stomach may actually be a sign of stomach cancer," he says. "You shouldn’t hesitate to consult your physician if you experience recurrent stomach pain."

To promote greater awareness of digestive disorders, including peptic ulcers, Washington Hospital will conduct a Health & Wellness seminar on Tuesday, January 24 from 1 to 3 p.m. The seminar, featuring Dr. David Levin will be held in the Conrad E. Anderson, M.D. Auditorium, Rooms A & B, in the Washington West Building located at 2500 Mowry Avenue in Fremont. For more information about the Health & Wellness seminar, or to register to attend, please call (800) 963-7070.

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