Can a small ulcer cause severe pain?

Hi Jeffina,

We have a protective mucosal layer in our stomach. This protects our stomach from acid and digestive enzyme (pepsin). In peptic ulcer, there is a breach in the mucosal lining of the stomach or duodenum (first part of the small intestine). Due to breach in the mucosal layer stomach acid and pepsin comes directly in contact with inner layer of the stomach or duodenum, which is extremely painful.

Abdominal pain is sharp or burning in nature and it is in the upper part of the abdomen just above the umbilicus. The pain is correlated to mealtimes. In gastric ulcers the pain appears in empty stomach and in case of duodenal ulcers the pain appears about three hours after taking a meal.

This will help you to understand, if your abdominal pain is due to peptic ulcer. Oesophagogastroduodenoscopy is a very useful diagnostic procedure and it also helps to diagnose cause behind peptic ulcer.

Hi Jeffina, NSAIDs is a common cause of peptic ulcer. As you have a history of NSAIDs use, it might be the cause of peptic ulcer, however H. Pylori infection is also a common cause and it need to be ruled out. Your biopsy report will confirm if you have H. pylori infection. For H. pylori infection, we need to take recommended antibiotics along with antacid treatment.

As you are feeling like ‘food is stuck in your stomach’, it seems due to ulcer is in the oesophagus or the upper part of the stomach. Pain during swallowing or difficulty in swallowing is a common symptom in oesophageal ulcer.

To reduce symptoms antacid like ‘Mucaine gel’ is very useful. It contains ‘oxethazaine’; it is a topical anaesthetic, which reduces stomach pain.

Hi Jeffina,

For a few years I have been to see doctors and been to A&E with suspected Gallstones/Gallblader attack! and in EXTREME pain, pain was my top right of adominal where gallbladder is, this would last 1 day and would aventually go. I ended up in A&E and given morphine, I would be referred for ultrascans on Gallblader and pancreas and these came back fine, the doctors just thought maybe was sand like bile causing pain from gallbladder, I learnt to manage pain, last week the pain came back, was very painful I would say 10 times worse than my previous broken arm, the pain was in the same area, I ended up back in A&E after bloods, morphine I was alowed home they believed it was a duodenal ulcer as same pain, same location as before and other tests rulled out Gallblader, that night was fine but next day pain was back I went to my doctor who has refered me to the surgical team, it has since Ben 5 days and I'm feeling ok. During the 5 days I couldn't eat and was in much pain. So hopefully I shall soon find out if it is a ulcer! And if it is, yer then very painfull. Hope makes sense, I'm  dyslexic and phone changes words. 

Hi Jeffina, yes, I've read some studies that say that perceived pain is not correlated with the severity of the ulcer. Some patients report severe pain with small structural damage while others report mild pain with worse damage. I don't know why this is exactly, could be due to differences in the function of the nervous system. Hope this helps. 

If you have several attacks and the test show small ulcer, it is a confirmation the you are suffering from peptic ulcer disease. I suspect that due to the gradual weakening of your intestine due to ulcer, the reception of food by your intestine is slowed, hence, the unused digestive enzyme (digestive acids) results to your severe pain that comes and goes(attacks). It is possible that when you eat small food you feel a full stomach(dyspepsia) , this is because of the weakness and poor reception of your intestine.

Lansoprazole is a proton pump inhibitor that regulates the production of digestive acid. Long time use of this drug will cause a constant pinning pain under the rib case, especially, by the right-hand side.

Hopefully, an effective and efficient drug for your ailments is on the way and may be available in few years, in the meantime, please consult a gastroenterologist, I am sure your ailments will be managed successfully. I may advise further if the ailments becomes severe and life threatening.