There are two main types of ulcers: a gastric ulcer, which is found in the lining of the stomach, and a duodenal ulcer, located in the upper part of the small intestine. Ulcers are commonly known as peptic ulcers or helicobacter pylori. According to the University of Maryland Medical Center, duodenal ulcers are three times more common than gastric ulcers in the United States. Often, patients suffering from symptoms of duodenal or gastric ulcers do not actually have any ulcers. This condition is known as functional dyspepsia.
A duodenal ulcer forms in the lining of the upper part of the small intestine, or duodenum. It is characterised by an open sore or raw area. The University of Maryland Medical Center states that the average ulcer is between 1.25 inches and 1.5 inches in diameter.
The action of stomach acid and pepsin on the duodenal lining of a susceptible individual causes a duodenal ulcer. Ulcers can be exacerbated by certain lifestyle choices, such as excessive coffee consumption, smoking and high stress levels. An infection of the antrum, which is the part of the stomach adjoining the pylori (the top of the duodenum), can also cause duodenal ulcers. Helicobacter pylori is the bacteria that generally causes this infection, and is found in the mucous layer of the stomach. Non-steroidal anti-inflammatory drugs (NAIDs), including uncoated ibuprofen, can cause gastric and duodenal ulcers if the medication is not enteric-coated. This coating prevents it from causing damage to the stomach lining. NAIDs are often prescribed for back pain.
Dyspepsia is the collective name given to the most common ulcer symptoms. The symptoms may be persistent and recur regularly, or may not return for many months. The symptoms can include a patient feeling full; a lower fluid intake; hunger and an empty sensation; or a gnawing pain in the stomach one to three hours after eating. Many people find that these symptoms can be alleviated by eating. Nausea is very common, and some patients find vomiting relieves the symptoms.
People suffering from peptic ulcer disease often experience varying degrees of pain. The pain can remain localised and stationary, but can also become diffuse. The location and type of pain vary depending on the ulcer site. Sufferers describe pain associated with ulcers as aching, gnawing or burning, localised to the upper abdomen. Others describe a stabbing pain in the gut. Often, ulcer-associated pain can radiate into the back and the chest, which can be frightening and disconcerting for the sufferer, as these symptoms can easily be mistaken for conditions such as heart attacks.
Antacid medications can help some patients to alleviate symptoms. If the patient tests positive for helicobacter pylori, antibiotics will usually be administered. Most ulcers will heal if treated with an anti-secretory drug to reduce the production of stomach acid. Lifestyle changes may also have to be made, such as smoking cessation and a reduction of the amount of caffeine consumed. A patient's diet should be scrutinised, as patients may be consuming foods that exacerbate duodenal ulcers and their symptoms, such as excessively fatty or rich foods. Surgery may be required if complications occur, such as bleeding or perforation
Ulcer-Associated Back Pain
A patient may experience diffuse (widespread) generalised pain radiating into the back. Some patients have also reported experiencing a sensation of a tight band of pain across the back, just above the hips. It is very common for patients to report that back pain associated with duodenal ulcers seems worse when they are in a seated position, and that in some cases standing or taking a gentle walk can help to relieve their back pain.