GI HEALTH Two Commonly Confused Conditions WHAT YOU SHOULD KNOW ➢ GERD occurs when a muscle between the Here is how you can distinguish between a stomach ulcer and GERD. esophagus and stomach weakens. astroesophageal refl ux disease of that particular enzyme, it ➢ An ulcer is a sore in the stomach or small (GERD) and stomach ulcers are increases the possibility of a intestine lining. Gtwo common gastrointestinal dis- stomach ulcer. ➢ Both are treated with acid-reducing orders, but their symptoms differ, An infection medications, but duration varies. as do their causes. Peptic from H. pylori bac- “The symptoms of GERD Ulcer teria can also cause include heartburn and an ulcer because the GERD is more likely to affect peo- regurgitation of stom- bacteria can dam- ple who are overweight and smoke ach contents,” explains age the mucous coat- regularly. Some medications can gastroenterologist Kevin ing that protects the also cause it, such as those that treat Ghassemi, MD, Center An ulcer damages the stomach lining. stomach and duo- asthma, calcium channel blockers that | Dreamstime © Elenabsl for Esophageal Disorders, GERD results from a malfunction in denum (a tube-like treat high blood pressure, painkillers, Division of Digestive esophageal sphincter. structure that con- sedatives, and antidepressants. Diseases, David Geffen nects the stomach to Physicians can typically diagnose School of Medicine at UCLA. “Ulcers the small intestine). GERD through a medical history and more often cause pain in the upper Without the pro- your symptoms. If symptoms don’t abdomen, but they do not always tective coating of improve after lifestyle changes and cause pain. Sometimes the symp- mucus, the acids medications, further testing may toms are blood in the stool or black- GERD that break down be needed, including use of upper ened stool because the foods can touch GI endoscopy. ulcer is bleeding.” the sensitive lining, causing pain. In rare Treating GERD and Stomach Ulcers A Closer Look at cases a tumor that trig- The underlying issue for both these Stomach Ulcers gers the release of large conditions is the same—acid. In The best way to know if an ulcer amounts of stomach acid can GERD, acid in the esophagus is the is present is through a gastroenter- cause ulcers to form. Call or see your problem, whereas with an ulcer, acid ologist’s diagnosis, and that is most doctor right away if you: is causing a problem in the stom- typically done with an endoscope— • feel weak or faint ach lining. So, the medication used a thin, fl exible tube with a camera. • have diffi culty breathing to treat them is the same, an acid The endoscope is threaded down the • have red blood in your vomit reducer (e.g. Pepcid, Zantac and throat and into the stomach, allow- or vomit that looks like coffee Prilosec). ing the physician to see the lining of grounds “The treatment duration, how- the stomach and GI tract. Sometimes, • have red blood in your stool or ever, can differ depending on a biopsy, a small piece of tissue, may black stools whether it’s GERD or ulcer,” explains be taken from the lining for further • have sudden, sharp stomach pain Dr. Ghassemi. “The severity of the examination. that doesn’t go away. symptoms matter. Someone who has Ulcers of the stomach and small These symptoms could be signs severe refl ux may need to be treated intestine can be caused by long-term that the ulcer has caused a more seri- indefi nitely, whereas someone who use of NSAIDs (nonsteroidal anti- ous problem. has mild and intermittent refl ux may infl ammatory drugs), such as aspi- not need to be treated daily. In both rin, ibuprofen, and naproxen. Tylenol The Burning Pain of GERD cases, by reducing the amount of acid (acetaminophen) is not an NSAID. GERD affects about 20 percent of produced in the stomach, the damage Patients taking NSAIDs are vulnerable the population and is caused by a can heal.” to ulcers, especially if they have been weakened or relaxed esophageal Lifestyle strategies to reduce acid taking them for a long time. NSAIDs muscle (sphincter). When this mus- refl ux and possibly ulcer irritation work by blocking enzymes that cause cle doesn’t contract as it should, include not overeating and not lying pain and infl ammation. The problem stomach contents can fl ow back down for at least two or three hours is that one of the enzymes that the into the esophagus, causing heart- after eating. If you suspect you have NSAID blocks also protects the stom- burn, pain in the middle of the chest, an ulcer, see your doctor because to ach lining and helps control bleeding. nausea, bad breath, and problems treat it effectively, it’s crucial to know When the NSAID reduces the amount swallowing. the root cause. 4 October 2017.