Stomach ulcers affect 50 out of 100,000 Austrians every year. The very similar duodenal ulcers occur about three times as often, by the way, significantly more often in men than in women. Typical symptoms are pain in the middle upper abdomen, more on the right than on the left, says Univ.-Prof. Rainer Schöfl. “There are two types of pain: the so-called fasting pain, which occurs when you have nothing in your stomach and which gets better after eating for about an hour. And the pain that occurs ten to 20 minutes after eating,” explains the boss of gastroenterology from the Ordensklinikum Barmherzige Schwestern in Linz. However, if the pain occurs 1.5 hours after eating, this more likely indicates problems with the pancreas, gall bladder or small intestine.
Damage to the mucous membrane
If the ulcer penetrates very deeply, continuous boring pain can result. Then the “pit” extends not only into the mucous membrane, but also into the layers below. In the case of a breakthrough into the abdominal cavity, which is very rare, the pain is so severe that you have to go to the hospital immediately. In addition to pain, bloating, nausea, black stools or vomit and, very rarely, collapse can indicate an ulcer.
Ulcers in the stomach and in the directly adjoining duodenum are diagnosed with a gastroscopy. “During the gastroscopy, you are offered a sleep injection. However, after that you have to be picked up by someone you trust,” says the expert. During the ten-minute examination, a tube is inserted into the mouth, through which the stomach and duodenum can not only be visually assessed, but samples can also be taken. This is because cancer is very rarely confused with a gastric ulcer and can be diagnosed with a tissue sample. By the way, tumors occur only in the stomach, and not in the duodenum. Also, tumors cannot develop from ulcers. The causes of the ulcers are varied.
Helicobacter pylori: The germ weakens the mucous membrane, stomach acid can attack it more easily and cause ulcers or gastritis. In Austria, 15 to 20 percent are carriers of the germ, worldwide it is 50 percent. However, Helicobacter pylori does not always cause problems.
Painkiller: Certain pain relievers such as Voltaren, Parkemed and Seractil promote the development of stomach and duodenal ulcers – and these are often recognized later because the drugs do not cause abdominal pain.
Genetic inclination: The fact that the ulcers occur more frequently according to blood groups suggests hereditary factors (stomach ulcers more often with blood group A, duodenal ulcers with blood group 0).
Lifestyle: Nicotine, stress, psychosomatic disorders and high-proof alcoholic beverages all have a negative effect. “However, these factors were clearly overestimated in the past,” says Schöfl.
Circulatory disorders: “They are very rarely the cause – for example after operations, clearly overrated,” says Schöfl.
Hormontumore: They massively stimulate acid production, but are very, very rare.
Treating stomach and duodenal ulcers is relatively easy: on the one hand, the doctor prescribes acid blockers, on the other hand, Helicobacter pylori is fought with antibiotics for two weeks. For gastric ulcers, another gastroscopy is done after two months to check whether they have healed. The complete healing of the defects is also the guarantee that it is not cancer. In the case of duodenal ulcers, a breath or stool sample can be used to test whether the harmful intestinal germ has been successfully eliminated. If medication is the cause, these should be discontinued or replaced with others.
Acid blockers: No long-term medication!
By the way, Primar Schöfl advises against the long-term use of acid blockers: “In order to absorb minerals such as iron, calcium or magnesium, you need acids. If these are missing, deficiencies can arise.” Taking acid blockers over a longer period of time can also increase the susceptibility to infections and allergies. A change in lifestyle can also have a positive effect, but according to Schöfl this should be done in addition to drug therapy. “With a preventive gastroscopy, perhaps coupled with a preventive colonoscopy, Helicobacter pylori could be found and treated before it can cause anything,” says the internist.
Anniversary: The gastroenterological department in the Ordensklinikum was founded in July 2001 and has been headed by Primary Rainer Schöfl from the start. Around 5,000 gastroscopies and more than 3,000 colonoscopies are performed each year. The focus is also on hepatology and nutritional and metabolic medicine.
Gastroscopy
During a gastroscopy or gastroscopy, the experts examine the esophagus, stomach and duodenum with a special endoscope. Tissue samples can also be taken.
The examination is not painful, takes around ten minutes and can be performed under sedation.
Across Austria, 300,000 gastroscopy is performed annually, at the Ordensklinikum Linz there are 7,000 to 8,000.
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