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The Conversation UK
Radio 2 DJ Steve Wright died from a ruptured stomach ulcer – what you need to know
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1 day ago
Steve Wright, a former Radio 2 DJ, died from a ruptured stomach ulcer at the age of 69, the BBC recently revealed. Although Wright died in February, the cause of death has only just been made known.
But what causes stomach ulcers and how can they be prevented?
Two causes
There are two main causes of stomach ulcers. One is H pylori, a species of bacteria that isn’t killed by stomach acid. In fact, it thrives in an acidic environment.
In the stomach, it moves through the protective layers of mucus that line the stomach and produces an enzyme called urease that damages the stomach lining.
The second cause is drugs called non-steroidal anti-inflammatories, or NSAIDs. Possibly the most well-know NSAID is ibuprofen.
Ibuprofen reduces the production of hormone-like substances called prostaglandins, which help heal tissue damage and injury. But it doesn’t just do this at the source of the pain – it acts on the whole body, including the stomach.
In the stomach prostaglandins reduce acid secretion and stimulate mucus production. This means that when people take NSAIDs they reduce the production of protective prostaglandins, which in turn increases acid production and decreases the production of substances that protect the gastric lining.
Contrary to popular belief, stress and spicy foods don’t cause stomach ulcers, but they can make them worse.
How do ulcers form?
Initial damage to the stomach lining appears as irritation, known as gastritis. If this progresses, the innermost lining can erode. Without treatment, larger sores (ulcers) appear in the gastric lining, eroding down into the underlying submucosa and underlying muscular layer.
If this occurs, the stomach contents, including all the microbes within it, can leak into the abdominal cavity and cause a significant infection called peritonitis. This can swiftly progress to sepsis, which can rapidly lead to death.
Before perforation, the patient may notice dark (black) poo which smells foul and has a tar-like consistency, this is a classical symptom of a bleeding ulcer called melena. The dark colour of the faeces is caused by the digestive breakdown of the blood in the intestines.
Who gets ulcers?
Ulcers can affect anyone, but they are more common in men and in older adults. Studies show that up to 78% of people over 65 may have a stomach ulcer.
A doctor can usually make a diagnosis based on symptoms alone, but the gold standard for diagnosis is gastroscopy, where a small camera on a tube is inserted into the mouth and swallowed enabling the doctor to see the internal lining of the stomach.
Treatment is often aimed at reducing stomach acid to allow the lining to repair. Two types of drugs are taken to promote this: H2 receptors, such as famotidine, or proton pump inhibitors, such as omeprazole or lansoprazole.
People who have an ulcer that was caused by NSAIDs may need to take one of these drugs in the long term to prevent a relapse.
Ulcers in the stomach are usually easily treatable once the cause is identified and can prevent more serious complications, such as cancer, particularly where H pylori is the cause. So if you have any of the symptoms listed above, do see your GP as soon as you can.
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