What is Antral Ulcer & How is it Treated?
Antral ulcers are open and eroded lesions that can form in the lower portion of the stomach. It is a type of ulcer that is formed with all symptoms of peptic ulcer in the stomach. Peptic ulcer is quite common all over the world, and a significant portion of the patients having peptic ulcers are diagnosed with antral ulcers. People who develop the symptoms of antral ulcers should be promptly assessed and treated by a medical professional.
What is Antral Ulcer?
Antral ulcers are mostly chronic and open sores that develop on the lower stomach lining. Like other types of peptic ulcers, antral ulcers are caused by damage in the inner lining of the lower stomach. Antrum is the lowest part of stomach. When ulcers are formed in the antrum, the condition is called as antral ulcer.
The human stomach is filled with acid that mainly helps in digestion. This acid cannot damage the inner lining of the stomach due to the presence of a mucous membrane; but in certain condition, if the quantity of acid increases, it may cause damage to the antrum leading to formation of antral ulcer. Again, the Helicobacter pylori bacteria form colony within the mucus layer of the stomach and may damage the inner lining of the antrum severely causing antral ulcer.
Symptoms of Antral Ulcer
Following are the most obvious symptoms of antral ulcer –
- Burning or gnawing pain in the stomach. Pain can be maximum within the region of naval and breastbone. Pain maximizes when the stomach is empty.
- People with antral ulcer also develop all basic symptoms of an upset stomach like nausea, belching and vomiting.
- In advanced stages, the patient may have bloody stools. Blood stains may also be noted while vomiting.
- Weight loss, fatigue, loss of appetite, etc. are some of the other symptoms in antral ulcer.
Causes of Antral Ulcer
It is known that antral ulcers are formed when acid in the digestive tract erodes the inner surface of the antrum. On prolonged reaction with the inner surface, a painful open sore develop which is known as antral ulcer.
Some common causes that aggravate that condition are as follows:
- Helicobacter pylori (H. pylori) as a Cause of Antral Ulcer: This bacterium lives in the mucous layer of the stomach. Normally, this bacterium does not cause any harm to the mucous layer or the inner lining of the stomach. However, in some conditions, it may cause inflammation in the antrum, damaging the inner layer of that part and forming ulcer.
- Prolonged Use of Pain Killers: Use of aspirin and certain other types of over-the-counter nonsteroidal anti-inflammatory drugs on prolonged basis may also cause antral ulcer. Medicines like Ibuprofen and Naproxen, sodium mostly cause this type of damage. Antral ulcer is very common in older adults who take pain medications frequently.
- Excess Acid Production Causing Antral Ulcer: In some other health conditions like gastrinomas and tumors in the acid producing cells, acids are secreted in the digestive system in higher quantities. In these conditions, inner lining of the lower stomach may be severely damaged causing antral ulcer.
Risk Factors for Antral Ulcer
Following are the major risk factors in antral ulcer:
- Regular use of pain-killers.
- Smoking and drinking alcohol, which may aggravate the situation along with other causes like infection due to H.pylori and side effects of pain killers.
- Individuals under extreme stress for a long time may develop antral ulcer.
- Fast foods and spicy foods may also increase the risk of having antral ulcer.
Complications Associated with Antral Ulcer
Antral ulcer needs early treatment; otherwise, it may lead to other complications like:
- If infection intensifies further, it may create a perforation in the stomach aggravating the problem further.
- Antral ulcer can cause obstructions too. As the ulcer increases in size, swelling and inflammation may block the passage of food in the digestive tract.
- Bleeding may occur in advanced stage leading to anemia and blood stained vomiting.
Diagnosis of Antral Ulcer
In many situations, antral ulcers are detected by a physician depending on the characteristic symptoms. The visible indication helps in rightful diagnosis. If the symptoms do not improve after taking the medications, some diagnostic procedures may be ordered like the following:
- Test for H.pylori Bacteria to Diagnose Antral Ulcer: Doctors generally order for blood work, stool test and breath test to detect the presence of H.pylori in the stomach.
- Other Tests for Diagnosing Antral Ulcer: If blood work, stool test and breath test does not provide sufficient information about the problem, then the physicians recommend endoscopy or barium swallow test to diagnose the condition.
Treatment of Antral Ulcer
Treatment procedure depends on the principal cause of the antral ulcer. If it is caused due to H.pylori treatment is done to arrest the growth of the causative pathogen in the stomach. In other cases, relevant treatment procedures are followed:
- Antibiotics to Treat Antral Ulcer: Appropriate antibiotics are prescribed based on the causative agent. These include amoxicillin, levofloxacin, clarithromycin, metronidazole, and tetracycline.
- Medications for Reducing Acid Production to Treat Antral Ulcer: If it is detected that excessive acid production is the cause of antral ulcer in a patient, then medications like lansoprazole, rabeprazole, omeprazole, etc. are given for blocking part of the acid producing cells in the stomach. These acid inhibitors are called as proton pump inhibitors (PPI). Another type of acid blockers, called histamine blockers are also used to reduce the quantity of stomach acid released in the digestive system.
- Antacids: These are used to reduce the strength of the acid present in the stomach. Antacids provide symptomatic relief from antral ulcer, but do not provide permanent solution.
- Medications for Guarding the Inner Lining of the Antral Ulcer Affected Part: In severe cases, cytoprotective drugs like sucralfate and misoprostol are prescribed to guard the inner lining of the affected part of the stomach.
In most of the cases, proper medication and change in lifestyle can treat antral ulcers altogether. In severe cases, supportive medications may be prescribed for a long period of time to heal the sore completely. In some rare cases, physicians may advise surgery.
Management of Antral Ulcer at Home
As experts opine, in majority of cases, antral ulcer are formed due to unhealthy lifestyle. In fact, smoking, drinking alcohol, use of tobacco in any form, unhealthy beverages, fast foods, starvation for a long time, drinking inadequate water, late night snacking, etc. are the primary causes of antral ulcer. Thus, it is advised to follow a healthy lifestyle as much as possible. The following habits also help in reducing the risk of antral ulcers:
- Healthy Diet: Leafy vegetables, fruits, and other nutritious foods that are rich in essential nutrients like protein, carbohydrate, vitamin and mineral, should be included in daily diet. Patients who are under treatment for ulcer should avoid oily and spicy food.
- Probiotics to Prevent Antral Ulcer: Probiotics like yogurt and cheese help in digestion and also help in controlling the acid levels in the digestive system to a great extent.
- Preventing the Chance of Antral Ulcer by Limiting Pain Killer Usage: If a certain pain killer aggravate the condition, it should be avoided or the dosage should be reduced. Sometimes, an alternate pain killer may help in combating the condition.
- Other Factors: Adequate sleep, reduction in stress level, regular exercising, etc. can help a lot in management of antral ulcer.
Following physician's advice closely and changing lifestyle for the betterment, are two major ways for management of antral ulcer. In many occasions, ulcers relapse because the patients do not take medications as per the physician's advice. At the same time, timely treatment of antral ulcer like any other peptic ulcer is also important. Severity of the disease intensifies with time, thus early diagnosis and treatment can save a patient from undergoing a long-term treatment procedure.