Dear Doctor, I do not suffer from any ulcers because I recently did an endoscopy, Helicobacter Pylori test using breath and had a general medical examination which showed I was normal. However, yesterday I got serious headache and vomited some blood. Could I have hidden ulcers?
Most peptic ulcers are caused by a germ; Helicobacter Pylori and the rest by painkillers of the type NSAIDs of which Diclofenac is used by many Ugandans for diverse pains, including headaches. NSAIDS can cause acute bleeding peptic ulcers resulting in vomiting blood.
Headache may be associated with vomiting (migraine headache) and if forceful, or prolonged, a crack in the inner lining, where the oesophagus meets the stomach may develop resulting in vomiting blood (Mallory Weis syndrome).
This bleeding though may be associated with abdominal pain, stops on its own and may require no treatment but continued vomiting and headache may require being addressed.
Blood tests may be used to detect antibodies to H. pylori infections and if negative, one may have never had infection or the infection is recent. If positive, this means that one may have been infected at some point in the past. H.Pylori antibody tests may remain positive even after successful eradication of the germ.
Breath tests for urea, a substance produced by H. Pylori to resist stomach acid, if positive means active infection is present. Stool tests, if positive for the germs antigen also indicate ongoing infection. But stool tests are also useful in indicating bleeding that may not be otherwise noticeable even when a victim looks at his own stool.
Whereas it was always believed that stress can cause ulcers, it is likely stress associated combined factors such as alcohol and painkillers consumption on their own or in presence of H.
Pylori infection that may lead to ulcers.
Stress-induced gastritis, (stress- ulcer syndrome), can cause erosions in the inner lining of the stomach with some bleeding requiring proper diagnosis and treatment. This, however, is usually due to stress of another kind called physiological stress, like in severe burns or severe injuries, or being bedridden when there is reduced blood supply to the stomach, causing the ulcers.