HomeAnswersMedical Gastroenterologystomach biopsyIs it usual to have more than one gastric ulcer?

I have two acute gastric ulcers. Is it usual to have more than one ulcer?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Ajeet Kumar

Medically reviewed by

Dr. Preetha. J

Published At October 27, 2020
Reviewed AtJanuary 31, 2024

Patient's Query

Hi doctor,

I had a gastroscopy last year, which showed chronic gastritis. I had the gastroscopy repeated the previous week; it now shows I have two acute gastric ulcers. I am worried as there are two of them. I have been given Omeprazole. Do you think that they can both heal or not? Is it usual to have more than one? Also, what is the likelihood that they could be malignant?

Thanks.

Answered by Dr. Ajeet Kumar

Hello,

Welcome to icliniq.com.

I can understand your concern very well.

Well, yes, it is common to have more than one ulcer in the stomach. But to answer your second concern, whether it will heal with Omeprazole or not is difficult to say unless I see your endoscopy report personally.

The ulcer's (greater curvature, lesser curvature, or antrum-parts of the stomach) morphology and size will suggest the ulcers' nature.

The ulcers in the antrum are usually ones that heal with Omeprazole (proton pump inhibitor). However, this is not the rule. We also repeat endoscopy in four to six weeks if the ulcer location and ulcer morphology are suspicious of cancer. And given the biopsy reveal something conspicuous.

I would appreciate it if you could share the endoscopy report with me, including images recently done. If possible, share with me a year back endoscopy as well. And also, upload the biopsy report of the previous endoscopy and the latest biopsy report if available.

Kindly also let me know that have you been on Aspirin or painkillers? And do you smoke?

Kind regards.

The Probable causes

Peptic ulcer disease. H pylori or drug-induced. Stomach malignancy.

Patient's Query

Thank you, doctor, for your reply.

I will get the reports over to you as soon as I can. In the meantime, the doctor said that the ulcers are in the stomach's upper body. Are these more difficult to heal than if they were in the antrum?

Answered by Dr. Ajeet Kumar

Hi,

Welcome back to icliniq.com.

The ulcer in the upper stomach can heal if the morphology looks benign (non-malignant) or secondary to drugs or Helicobacter pylori infection. However, they will not heal if it turns out to be a malignant ulcer. Similarly, ulcers in the antrum, but with fungating growth type with heaped up margin and some oozing of blood, non-Helicobacter pylori, and non-drug induced, are the ulcers are difficult to heal and suggest more a cancerous process. So, healing depends upon multiple factors, as mentioned above.

Patient's Query

Thanks for your reply doctor.

The endoscopy report says that the two ulcers are located in the proximal upper body, Does this mean that they are not located in either the lesser curvature or greater curvature, but rather in the body? Kindly help.

Answered by Dr. Ajeet Kumar

Hello,

Welcome back to icliniq.com.

I read your query and understood your concern. The proximal part of the stomach refers to the fundus or the uppermost part of the stomach body. The stomach is divided into three parts, the fundus (the uppermost part), the stomach body, the incisura, and the antrum. The stomach body comprises the greater curvature, lesser curvature, anterior wall, and posterior wall. The incisura is the junction between the stomach body and the antrum. The antrum is the most distal part that connects to the small bowel. Endoscopists have different styles of writing endoscopy reports. Some organize them from proximal to distal locations, while others provide more specific details about whether the ulcer is on the anterior wall, posterior wall, greater curvature, or lesser curvature. These terms are often combined to precisely describe the approximate location of the ulcer, such as proximal stomach body over greater curvature. The simplest way to avoid confusion with this terminology is to review the photo images from the endoscopy. I understand your concerns, as there is misleading information on the internet regarding the location of ulcers and even suggesting the possibility of cancer. However, I must emphasize that this is not a definitive rule. A biopsy report and the presence of H. pylori are two major factors that can confirm the exact nature of the condition. I hope this has helped you. Kindly follow up if you have more doubts.

Thank you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ajeet Kumar
Dr. Ajeet Kumar

Medical Gastroenterology

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