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Talk Tuesday - Ep. 4: Peptic Ulcers

October 28, 2020

Speaker 1: The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address on talk Tuesdays or for any other medical problem.

Speaker 2: Welcome to Talk Tuesdays brought to you by my virtual physician, a direct to consumer multi-specialty telemedicine company that operates in multiple States.

Speaker 1: Thank you for joining us today. My name is Stephanie and I'm part of the team here at my virtual physician. We are a direct to consumer multi-specialty telemedicine provider operating in multiple States. It's taught Tuesday and we are continuing our weekly educational series to talk with experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is Dr. Ginger Coleman. She is a general surgeon and she's going to talk to us about peptic ulcers and what we need to know about them. So Dr. Coleman, thank you for joining us. Thank you for having me. Yeah. So can you start by explaining what is a peptic

Speaker 3: Or gastric ulcer? Yeah, so, um, the word peptic really just sort of means that it's in your digestive tract. So there's, there's two types of ulcers. Um, you can have gastric ulcers or do a Denal ulcers, um, that are in the first part of your small intestine that's connected to your stomach. Um, so peptic sort of encompasses both of those, um, entities. The gastric ulcers are probably the most common, um, and essentially what an ulcer is, is a little tear or break in the lining of your stomach or your small intestine. Um, those, your stomach has a barrier sort of like a mucus barrier that protects it from all of the coffee and other caustic things that you probably consume on a daily basis. And when you get a little tear, um, that you guess is supposed to kind of help protect it and heal, um, when that barrier fails is when you get an ulcer.

Speaker 3: Um, and there's, there's a couple of things that are related to those and can cause them, but essentially it's, it's just a failure of that protective barrier of your stomach and creates this little hole. Okay. So how do you, how does it happen? Why do people get them, um, the most common, um, cause of these that, that we really know about is actually a bacteria called H pylori that's Helicobacter, pylori, um, and it's a little, uh, bacteria that, that actually damages the lining of your stomach and also keeps that mucosal barrier, um, from healing. So it, it kind of just keeps perpetuating this, uh, ulcer. You can get rid of the bacteria and it should heal the ulcer. There are some other things that can cause it things like smoking, drinking, alcohol, um, caffeine, um, even stress, uh, patients that are in the hospital, maybe intubated, you know, on a ventilator or, um, have really severe burns.

Speaker 3: They can get different types of ulcers, but it's the same underlying process. It's, it's decreased blood flow to the area and it, and it damages that you co-sell lining. Okay. How would I know if I had it, the symptoms of an ulcer, some for some people they're pretty vague for a lot of people, they it's just, you have this abdominal pain, it's kind of this gnawing burning upper abdominal pain. Uh, a lot of times you can relate it to when you eat. Um, sometimes it'll hurt when you eat just shortly thereafter, maybe about 30 minutes. And sometimes it'll, it'll take a couple hours. Um, sometimes it feels better when you eat. So those kind of, um, help you differentiate whether it's in your stomach or in your small intestine, but it's not very specific. Um, but it is something to take note of, if you, if you realize that that's what's happening, some people will feel bloated, you can have nausea.

Speaker 3: Um, but most commonly what sends people to, uh, see a doctor is the pain. There may be some aspect of, you know, heartburn or reflux, but, but usually it's just that severe gnawing pain. Yeah. And so can also cause more serious damage or is it just painful? They can, um, they can cause a lot more damage actually. Um, as a surgeon, that's something that we see come through the ER from time to time, um, where you have an ulcer that gets so severe that it essentially erodes all the way through the stomach. And so it, it perforates, um, yeah, it's not very fun for anyone. Um, so it, it actually just sort of ruptures, it opens up whether it's the small intestine or the, or the stomach. Um, and so you get all of those gastric acids and juices sort of flowing through your entire abdomen.

Speaker 3: It can make you very sick. The ulcer can also erode into a blood vessel. So sometimes people will come in bleeding from these ulcers because it's eroded into a vessel that's in the area. Um, so they can be pretty severe and it is something worth, worth seeing a doctor for if you're experiencing some abdominal pain like that. Yeah. And how do you treat them? So predominantly no one will ever see a surgeon for a gastric ulcer. Hopefully, hopefully that is the case. They're, they're pretty much managed with, um, proton pump inhibitors or PPIs that you may have heard Nexium, Omeprazole, things like that. Um, and so it may not be something that you need long-term depending on sort of what caused the ulcer, but most of the time people stay on them for, for a long time. Initially you want to treat it for about six weeks with the proton pump inhibitor.

Speaker 3: There are some other medications you can give that kind of help coat the stomach, the lining of the stomach, and to relieve some of the pain of the ulcer, but also try and help protect that barrier. Um, you can treat the ulcer with medication and if it gets better than you can kind of assume that it's an ulcer, you don't necessarily have to see it to prove it. It's just sort of based on symptoms and ruling out other things. Um, but to definitively diagnose it and treat it, um, you need an endoscopy, which is where they put a camera in your mouth and go and look in your stomach and they can see where it is in the stomach. They can see if you have one, maybe it's just gastritis, which is just, you know, sort of diffuse irritation of your stomach. Um, when they do an endoscopy, they would look at where the ulcer is, how big it is and take biopsies of it to make sure that there's not any, uh, risk of cancer.

Speaker 3: Some of these can, can Harbor underlying malignancy. So, so that is important, but you don't have to do the endoscopy initially. Um, it's purely medical treatment. If it doesn't get better or you have recurrent ulcers that, that don't seem to go away. Um, if it's related to some other, um, diseases where you're prone to getting ulcers, um, that's when you may see a surgeon and may need an operation to remove that acid part, that asset to creating part of your stomach. Um, but usually it's just medicine. Yeah. And, um, but is there a way to treat it at home like yourself versus medicine?

Speaker 1: Do you cut back on caffeine or alcohol or that,

Speaker 3: So you can with it being affiliated, I mean, there's no proof per se, that caffeine causes ulcers may make it worse. Um, nicotine or tobacco smoking that all decreases the blood supply to well, to everything, but especially your stomach. So, so it gets less blood flow, which will make it worse. Um, alcohol can irritate it, it can make the pain worse. It also sort of affects that mucosal barrier. So taking medications like ibuprofen, Aleve, Naproxen, Motrin, anything like that, those are, those are big time medications that are associated with gastric ulcers. If you can stop them, you should stop them. Now, some people aren't able to just for other underlying conditions, but those are a big player in the development and recurrence of gastric ulcers. So stopping those nicotine caffeine, alcohol, all of those things may not cure it, but they can help at least decrease the pain and maybe prevent further injury or worsening of the ulcer.

Speaker 1: Awesome. What are some symptoms that someone would have if they need to seek medical attention immediately for a stomach ulcer?

Speaker 3: Yeah. So if you know, you have one and you're maybe already taking medication, maybe not either way, if you, if you know that you have a cynical, certain use, you experienced or pretty sudden onset of severe sharp pain in your abdomen, that that doesn't get better, that doesn't go away. That actually gets worse with moving and you, and you start to have a fever or things like that. You need to go to the emergency room. Um, other things would include vomiting, blood, or sort of what they call coffee ground emesis. It kind of actually looks like coffee grounds in cycled blood. Um, that's a concerning sign, uh, and then any darker, bloody stools that would be a sign of bleeding that's concerning that, that the ulcer may be involving a blood vessel. Okay.

Speaker 1: Well, thank you, Dr. Coleman, you have shared some really great information today and answered questions that I think many Americans have on their minds. I appreciate you joining us for Talk Tuesday and telling us what we need to know about ulcers and how to treat them when to seek attention, all of that. So for everyone else, joining us as well, this has been talked Tuesdays with my virtual. If you would like to schedule a consultation or find out more information, you can check out our website at We look forward to seeing you again, and we hope you have a great week.

Speaker 1: The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address on Talk Tuesdays or for any other medical problem.

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