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Ulcers
Dr. Sachin Vaikunth leads a discussion on ulcers, including possible causes and preventative measures, as well as treatment options.
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Learn more about Sachin S. Vaikunth, MD
Sachin S. Vaikunth, MD
Dr. Sachin Vaikunth is a board-certified general surgeon who has advanced training in minimally invasive laparoscopic, bariatric and robotic surgical procedures. He completed his undergraduate degree in political science at Brown University in Providence, Rhode Island. He then earned his Doctor of Medicine, with honors, from the Vanderbilt University School of Medicine in Nashville, Tennessee. Dr. Vaikunth continued his medical education by completing a surgical residency at the University of Michigan Health System in Ann Arbor, Michigan. He then followed up with fellowship training in minimally invasive/bariatric surgery at the University of Pittsburgh Medical Center in Pittsburgh, Pennsylvania. Dr. Vaikunth’s clinical interests include striving to provide his patients with the most advanced and minimally invasive surgical procedures, and is known as an informative, approachable, and compassionate medical provider. An accomplished author, Dr. Vaikunth has contributed numerous articles to national peer reviewed publications. He is a member of the American College of Surgeons and the American Medical Association and, also certified in advanced cardiac life support and fundamentals of laparoscopic surgery. Dr. Vaikunth is affiliated with Morton Plant North Bay Hospital.Learn more about Sachin S. Vaikunth, MD
Transcription:
Ulcers
Intro: This is BayCare HealthChat. Another podcast from BayCare Health System.
Joey Wahler (Host): Sometimes people say, "If you keep that up, you'll give me an ulcer." So what exactly are ulcers? What causes them and how are they treated? This is BayCare HealthChat, a podcast sponsored by BayCare. Thanks for listening. I'm Joey Wahler. Our guest, Dr. Sachin Vaikunth, general surgeon for BayCare. Dr. Vaikunth, thanks for being with us.
Dr Sachin Vaikunth: Thank you for having me.
Joey Wahler (Host): For those unfamiliar, what is an ulcer?
Dr Sachin Vaikunth: An ulcer basically is an erosion or an injury to the stomach lining or the first portion of the small intestine called duodenum. Now, we're specifically talking about what we call peptic ulcers. You can have other ulcers at various portions of the body. But today, the focus is on the peptic ulcers, which are related to injuries to the lining of the stomach or the first portion of the small intestine and duodenum.
Joey Wahler (Host): Right. Thanks for making that distinction. When we do talk peptic ulcers, what are the typical causes of that?
Dr Sachin Vaikunth: When we talk about causes, it's important to keep in mind that the environment in the stomach is very acidic. It has a low pH, so the stomach secretes acid, and this is important in immune function, helping you digest your food, because a lot of things cannot survive in that type of environment. The body has certain protective factors it uses to help protect the lining of the stomach and the small intestine to avoid injury to the lining while it is in that state where there is a lot of acid in the stomach. And when people think of this, they think of factors that damage the lining of the stomach, like the acid and potentially bile that can go back up from the small intestine, back up into the intestine. Smoking, certain medications, certain infections with certain bacteria are thought to cause damage to the lining.
And then on the other hand, you have protective factors. You have mucus that your body makes; bicarbonate, which is a substance that neutralizes the acid somewhat. You have other growth factors, the cells tend to regenerate quickly in the stomach if there is damage, to quickly fix that area that's damaged. And then, the stomach has a very good blood supply. All those things factor in to help protect the stomach lining. When you have an imbalance in terms of the damaging factors and the protective factors, then you tend to get these ulcers.
Joey Wahler (Host): And then going back to what I mentioned, can someone or something "give someone an ulcer"? What about stress as a potential cause?
Dr Sachin Vaikunth: Stress has been related to ulcers. People who have stress, potentially depression and anxiety have been shown to have higher rates of ulcer formation. It's not exactly completely clear what that is. But just stress by itself won't give you an ulcer, it's how it affects those damaging factors versus protective factors, that balance. And so certain other things are also needed to give you an ulcer, those types of situations that offset that balance that's normally there.
Joey Wahler (Host): Gotcha. What would be some of the typical symptoms someone would notice if they have an ulcer?
Dr Sachin Vaikunth: They’re generally non-specific. You may have some mild pain in the upper portion of your abdomen. You may have some burning discomfort. Sometimes people have nausea. Unfortunately, these aren't very specific necessarily to ulcers. Specifically, for ulcers in the first portion of the small intestine called the duodenum, right after the stomach empties into it, those types of ulcers tend to happen maybe two to three hours after a meal. Sometimes they can be relieved by food or antacids. And sometimes people will complain that they're woken up in the middle of the night and the pain and the ulcers from the duodenum may wake them up.
Ulcers in the stomach proper itself tend to be worse with food. But again, it's kind of very nonspecific. And so, the patient's doctor will need to be on high alert looking for these types of things, because we can have pain in the belly from a number of causes.
Joey Wahler (Host): And as we mentioned, you're a general surgeon by trade. What are the typical treatments for a peptic ulcer?
Dr Sachin Vaikunth: We have a lot of good medications now that suppress the acids, which are called proton pump inhibitors, like omeprazole or the trade name is Prilosec, which you'll find in your local pharmacy or grocery store. There's also histamine blockers, because histamine is also important in causing acid secretion, so stuff like Pepcid or Zantac. And the other thing is these days they will test for a bacteria called H. Pylori, which is also important in ulcer formation. And if you do have ulcers and you're found to have this bacteria, we will treat that and make sure that it's eradicated, because this helps heal the ulcer and help prevent the ulcer from coming back.
Joey Wahler (Host): How about risk factors here in terms of preventing an ulcer in the first place or trying to get rid of one once you have it? What are some of the do's and don'ts for people in their own lifestyle, diet, et cetera.?
Dr Sachin Vaikunth: When you look at the damaging factors versus protective factors, so things that tend to be a damaging factor are use of nonsteroidal anti-inflammatories like Aleve or Naprosyn is the generic name or Advil or ibuprofen. Overuse of those types of things tend to damage the lining of the stomach. You also have smoking, which tends to constrict the blood vessels and there's some irritants in the smoke, which helps cause a damage to the lining of the stomach as well. And then, alcohol can also cause toxicity to the lining of the stomach. And then, we talked about stress before, so things you can do to help reduce your stress level may help reduce ulcer formation. So obviously, avoid overuse of that nonsteroidal anti-inflammatories, stop smoking and then, try to reduce the stress and alcohol in your life. And these may help reduce your risk of getting ulcers. Also, spicy foods can tend to cause problems, so if you do have pain and you tend to eat spicy foods, that may be something that you would think about cutting down or cutting out completely if you have these types of issues.
Joey Wahler (Host): How about potential complications, doctor, if this is left untreated or maybe undiagnosed in the first place?
Dr Sachin Vaikunth: The complications that can happen are the ulcer really eats away at the lining of the stomach and then it can cause bleeding. Sometimes this bleeding can be life-threatening depending on how fast it is or maybe kind of just slow bleeding over time. And what you'll see is people will complain of vomiting blood or vomiting like coffee ground-type substance. People also may have black tarry stools. If the bleeding is fast enough, you may have bloody stools, because the blood comes so fast and doesn't have time to get processed in the intestine and you could have bloody stools.
In addition to the bleeding, sometimes if it arose enough, it can create a hole or a perforation in the lining of the stomach or the duodenum. And then, it could lead to a situation where the contents of the stomach or the small intestine leak into the belly, which is also a life-threatening situation. It could lead to infection and sepsis, potentially death if not treated in timely matter.
The other complication is sometimes when you have all that inflammation, it can cause scarring in your stomach and so your stomach doesn't empty as properly. And you may need a procedure to allow for passage of the contents of your stomach into the small intestine. It may need a different connection because of that area where the stomach empties into the small intestine, which is called the pylorus. And if that gets scarred up from all the damage from the acid, the stomach may not empty properly, and you may need another procedure where we have to bypass that area that's blocked and allow the food and other substances to get back into the small intestine so you can eat properly.
Joey Wahler (Host): And so in summation here, since this is obviously not something to be put off if you feel it needs to be checked into, what's your message for those listening who think they may have an ulcer?
Dr Sachin Vaikunth: I would recommend that they talk to their physician right away. And then usually what happens, they'll get referred to a gastroenterologist. And then, the first test that's done is called endoscopy where they place a camera down the throat into the stomach and small intestine. They look for evidence of ulcers. They'll look for evidence of the bacteria we talked about previously called H. pylori. They may take some biopsies of the area to make sure there's not an underlying cancer or something worse going on. And those types of things should be done right away. And then the other thing, going back to what we talked about, trying to reduce your risk of having problems, stop smoking if you can, cut back or stop your alcohol intake, avoid spicy foods and, again, try to reduce the stress in your life if possible.
Joey Wahler (Host): Well, folks, we trust you're now more familiar with ulcers, the causes and treatments. Dr. Sachin Vaikunth, thanks so much again.
Dr Sachin Vaikunth: All right. Thank you.
Joey Wahler (Host): And for more information, please visit BayCare.org. That's BayCare.org. If you found this podcast helpful, please do share it on your social media. And thanks again for listening to BayCare HealthChat, a podcast sponsored by BayCare. Hoping your health is good health, I'm Joey Wahler.
Ulcers
Intro: This is BayCare HealthChat. Another podcast from BayCare Health System.
Joey Wahler (Host): Sometimes people say, "If you keep that up, you'll give me an ulcer." So what exactly are ulcers? What causes them and how are they treated? This is BayCare HealthChat, a podcast sponsored by BayCare. Thanks for listening. I'm Joey Wahler. Our guest, Dr. Sachin Vaikunth, general surgeon for BayCare. Dr. Vaikunth, thanks for being with us.
Dr Sachin Vaikunth: Thank you for having me.
Joey Wahler (Host): For those unfamiliar, what is an ulcer?
Dr Sachin Vaikunth: An ulcer basically is an erosion or an injury to the stomach lining or the first portion of the small intestine called duodenum. Now, we're specifically talking about what we call peptic ulcers. You can have other ulcers at various portions of the body. But today, the focus is on the peptic ulcers, which are related to injuries to the lining of the stomach or the first portion of the small intestine and duodenum.
Joey Wahler (Host): Right. Thanks for making that distinction. When we do talk peptic ulcers, what are the typical causes of that?
Dr Sachin Vaikunth: When we talk about causes, it's important to keep in mind that the environment in the stomach is very acidic. It has a low pH, so the stomach secretes acid, and this is important in immune function, helping you digest your food, because a lot of things cannot survive in that type of environment. The body has certain protective factors it uses to help protect the lining of the stomach and the small intestine to avoid injury to the lining while it is in that state where there is a lot of acid in the stomach. And when people think of this, they think of factors that damage the lining of the stomach, like the acid and potentially bile that can go back up from the small intestine, back up into the intestine. Smoking, certain medications, certain infections with certain bacteria are thought to cause damage to the lining.
And then on the other hand, you have protective factors. You have mucus that your body makes; bicarbonate, which is a substance that neutralizes the acid somewhat. You have other growth factors, the cells tend to regenerate quickly in the stomach if there is damage, to quickly fix that area that's damaged. And then, the stomach has a very good blood supply. All those things factor in to help protect the stomach lining. When you have an imbalance in terms of the damaging factors and the protective factors, then you tend to get these ulcers.
Joey Wahler (Host): And then going back to what I mentioned, can someone or something "give someone an ulcer"? What about stress as a potential cause?
Dr Sachin Vaikunth: Stress has been related to ulcers. People who have stress, potentially depression and anxiety have been shown to have higher rates of ulcer formation. It's not exactly completely clear what that is. But just stress by itself won't give you an ulcer, it's how it affects those damaging factors versus protective factors, that balance. And so certain other things are also needed to give you an ulcer, those types of situations that offset that balance that's normally there.
Joey Wahler (Host): Gotcha. What would be some of the typical symptoms someone would notice if they have an ulcer?
Dr Sachin Vaikunth: They’re generally non-specific. You may have some mild pain in the upper portion of your abdomen. You may have some burning discomfort. Sometimes people have nausea. Unfortunately, these aren't very specific necessarily to ulcers. Specifically, for ulcers in the first portion of the small intestine called the duodenum, right after the stomach empties into it, those types of ulcers tend to happen maybe two to three hours after a meal. Sometimes they can be relieved by food or antacids. And sometimes people will complain that they're woken up in the middle of the night and the pain and the ulcers from the duodenum may wake them up.
Ulcers in the stomach proper itself tend to be worse with food. But again, it's kind of very nonspecific. And so, the patient's doctor will need to be on high alert looking for these types of things, because we can have pain in the belly from a number of causes.
Joey Wahler (Host): And as we mentioned, you're a general surgeon by trade. What are the typical treatments for a peptic ulcer?
Dr Sachin Vaikunth: We have a lot of good medications now that suppress the acids, which are called proton pump inhibitors, like omeprazole or the trade name is Prilosec, which you'll find in your local pharmacy or grocery store. There's also histamine blockers, because histamine is also important in causing acid secretion, so stuff like Pepcid or Zantac. And the other thing is these days they will test for a bacteria called H. Pylori, which is also important in ulcer formation. And if you do have ulcers and you're found to have this bacteria, we will treat that and make sure that it's eradicated, because this helps heal the ulcer and help prevent the ulcer from coming back.
Joey Wahler (Host): How about risk factors here in terms of preventing an ulcer in the first place or trying to get rid of one once you have it? What are some of the do's and don'ts for people in their own lifestyle, diet, et cetera.?
Dr Sachin Vaikunth: When you look at the damaging factors versus protective factors, so things that tend to be a damaging factor are use of nonsteroidal anti-inflammatories like Aleve or Naprosyn is the generic name or Advil or ibuprofen. Overuse of those types of things tend to damage the lining of the stomach. You also have smoking, which tends to constrict the blood vessels and there's some irritants in the smoke, which helps cause a damage to the lining of the stomach as well. And then, alcohol can also cause toxicity to the lining of the stomach. And then, we talked about stress before, so things you can do to help reduce your stress level may help reduce ulcer formation. So obviously, avoid overuse of that nonsteroidal anti-inflammatories, stop smoking and then, try to reduce the stress and alcohol in your life. And these may help reduce your risk of getting ulcers. Also, spicy foods can tend to cause problems, so if you do have pain and you tend to eat spicy foods, that may be something that you would think about cutting down or cutting out completely if you have these types of issues.
Joey Wahler (Host): How about potential complications, doctor, if this is left untreated or maybe undiagnosed in the first place?
Dr Sachin Vaikunth: The complications that can happen are the ulcer really eats away at the lining of the stomach and then it can cause bleeding. Sometimes this bleeding can be life-threatening depending on how fast it is or maybe kind of just slow bleeding over time. And what you'll see is people will complain of vomiting blood or vomiting like coffee ground-type substance. People also may have black tarry stools. If the bleeding is fast enough, you may have bloody stools, because the blood comes so fast and doesn't have time to get processed in the intestine and you could have bloody stools.
In addition to the bleeding, sometimes if it arose enough, it can create a hole or a perforation in the lining of the stomach or the duodenum. And then, it could lead to a situation where the contents of the stomach or the small intestine leak into the belly, which is also a life-threatening situation. It could lead to infection and sepsis, potentially death if not treated in timely matter.
The other complication is sometimes when you have all that inflammation, it can cause scarring in your stomach and so your stomach doesn't empty as properly. And you may need a procedure to allow for passage of the contents of your stomach into the small intestine. It may need a different connection because of that area where the stomach empties into the small intestine, which is called the pylorus. And if that gets scarred up from all the damage from the acid, the stomach may not empty properly, and you may need another procedure where we have to bypass that area that's blocked and allow the food and other substances to get back into the small intestine so you can eat properly.
Joey Wahler (Host): And so in summation here, since this is obviously not something to be put off if you feel it needs to be checked into, what's your message for those listening who think they may have an ulcer?
Dr Sachin Vaikunth: I would recommend that they talk to their physician right away. And then usually what happens, they'll get referred to a gastroenterologist. And then, the first test that's done is called endoscopy where they place a camera down the throat into the stomach and small intestine. They look for evidence of ulcers. They'll look for evidence of the bacteria we talked about previously called H. pylori. They may take some biopsies of the area to make sure there's not an underlying cancer or something worse going on. And those types of things should be done right away. And then the other thing, going back to what we talked about, trying to reduce your risk of having problems, stop smoking if you can, cut back or stop your alcohol intake, avoid spicy foods and, again, try to reduce the stress in your life if possible.
Joey Wahler (Host): Well, folks, we trust you're now more familiar with ulcers, the causes and treatments. Dr. Sachin Vaikunth, thanks so much again.
Dr Sachin Vaikunth: All right. Thank you.
Joey Wahler (Host): And for more information, please visit BayCare.org. That's BayCare.org. If you found this podcast helpful, please do share it on your social media. And thanks again for listening to BayCare HealthChat, a podcast sponsored by BayCare. Hoping your health is good health, I'm Joey Wahler.