Articles by Dr. Erdman are for informational purposes, and are not to be taken as specific medical advice.
Is that pain in your abdomen just a belly ache, or could it
be reflux or a peptic ulcer? How do you know?
A short term ache in the upper abdomen is usually just that,
an upset stomach that passes quickly.
Pain in the upper abdomen that burns up into the chest and
throat is most likely a reflux condition, actually caused by too little stomach
acid. (See my website for an article on reflux on June 28, 2012.)
Peptic ulcers are a whole different problem. About seven
percent of Americans are diagnosed with ulcers, some 16 million in total, and
500,000 new cases each year.
Obviously the stomach is at the bottom end of the esophagus.
After the stomach, the upper part of the small intestine is next, called the
duodenum. It is about 12 inches long. Glands inside the stomach produce acid
and pepsin. The stomach also produces mucus to protect the stomach lining from
the acid.
If you have an ulcer on the stomach wall or duodenal lining,
the mucosal protection is broken down. These ulcers can heal on their own, but
approximately 35% of them cause serious issues such as bleeding or perforation
of the stomach wall.
Inflammation of the stomach or duodenum can lead to infection
and narrowing or blockage at the duodenal sphincter. This can lead to food
leaving the stomach more slowly until it completely blocks. This is a worst
case scenario where vomiting of food occurs due to the blockage. Symptoms of a
peptic ulcer vary depending on where it is and the degree of inflammation. Most
pain is located right below the sternum and include: gnawing or burning between
meals or at night, burping, feeling full after small amounts of food, heart
burn, nausea, loss of appetite and increased pain after eating fatty foods.
Severe cases can have black stools from bleeding, vomiting blood and trouble
breathing.
In 2005, the Nobel Prize was given to two doctors for their
discovery of the link between the bacteria heliobacter pylori and peptic ulcer
disease. It linked inflammation and ulceration of the stomach to an infection
from bacteria.
Although the infections appear to heal by reducing gastric
acid, they often come back quickly because the treatment did not reduce the level
of bacteria or treat the inflammation.
Heliobacter pylori causes chronic infection and inflammation
that may or may not produce symptoms. The stomachs ph of 4, highly acidic,
usually protects the stomach from bad bacteria.
Unfortunately, treatment with proton pump inhibitors (PPI’s),
antacids and H2 blockers only treat the symptoms by reducing stomach
acid. Reducing acid simply allows bacteria to flourish. Then, when you stop
taking these drugs, the acidity rises, resulting in more ulceration and more
infections.
Treating the cause is not simple, but is effective in
actually healing the problem. First, you must eliminate any known foods that
trigger pain. This could be anything from alcohol, coffee, and nicotine to
chocolates and mints. Many drugs impact the stomach lining including NSAIDS
like ibuprofen, aspirin or naproxen.
Second, you need to replenish the good bacteria of the gut
by using high quality probiotics and eating fermented foods like sauerkraut.
Another helpful recommendation would be to take a couple
tablespoons of raw apple cider vinegar to maintain a healthy balance of gastric
acid production and create an environment in the stomach that inhibits
bacterial growth of heliobacter pylori. Try it, it works.