A pyloric ulcer is a peptic ulcer situated in the pylorus, which is the bottom end of the stomach that leads into the duodenum, terminating in the pyloric sphincter. The pyloric sphincter is a ring of muscle that contracts to close the opening between the stomach and the duodenum. Ulcers are open sores or raw areas in the lining of the stomach or duodenum.
Peptic ulcers are caused by pepsin and stomach acid causing damage to the mucus layer of the stomach or duodenal lining. Medications in the non-steroidal, anti-inflammatory (NSAID) category, such as ibuprofen--especially those medications without an enteric coating, which is designed to minimise damage from NSAID medications--can be a cause of ulcers. Some lifestyle factors can exacerbate symptoms of ulcers, such as a high caffeine intake, smoking and elevated stress levels. Heliobacter pylori is a bacteria that is usually the cause of an infection of the antrum (the part of the stomach joining the pylorus), which can cause duodenal ulcers.
Symptoms of pyloric ulcers are essentially the same for other duodenal ulcers. Dyspepsia is the medical term for the most common combined symptoms. Some people experience all the symptoms of an ulcer without any ulcers being present; this condition is known as functional dyspepsia. Symptoms may occur regularly and frequently, or they may not reappear for weeks or months. The symptoms include a person feeling very full, and not being able to drink as much fluid as normal; an empty, gnawing sensation in the stomach, which is often painful, and commonly occurs one to three hours after eating, accompanied by a feeling of hunger. Many sufferers find that eating can alleviate the sensations of gnawing and emptiness. Nausea is another common symptom, as is a sensation of acid travelling up into the throat.
People suffering from stomach or duodenal ulcers experience varying degrees of pain. The pain can sometimes remain localised, but can also become widespread, across the entire abdomen. Patients often complain that the abdominal pain can seem worse when they are in a sitting position. Pain associated with peptic ulcers can radiate into the chest, behind the sternum, or into the back, which can be a very frightening experience, as these sensations can be mistaken for heart attacks or other chronic conditions.
Pyloric ulcers can cause complications by causing the pylorus to become inflamed. This can lead to a condition known as pyloric stenosis. The inflammation causes a narrowing of the pylorus, which delays the passage of the stomach contents into the intestine and leads to repeated vomiting, sometimes of food consumed up to 24 hours previously. In some cases, there is visible movement and distension of the stomach. Other complications common to all peptic ulcers include hemorrhaging, which may involve vomiting blood and a dark substance that looks like coffee grinds. This condition is serious, and requires emergency treatment.
Antacid medications may help to alleviate symptoms in some patients. If helicobacter pylori is found to be present, and the likely cause for the ulcer, antibiotics may be administered. Anti-secretory medications may be administered to reduce the production of stomach acid, allowing the ulcer to heal. Lifestyle changes may need to be considered, such as stopping smoking, reducing caffeine and stress levels, and reducing the consumption of rich or very fatty foods. If pyloric stenosis is present, and anti-secretory medication fails, surgery may be required.