Gastrointestinal symptoms are extremely common in systemic mastocytosis (SM): Up to 80% of patients will experience symptoms like bloating, pain or nausea. Peptic ulcers are sometimes to blame. People with SM are at increased risk of developing peptic ulcer disease, a condition mainly affecting the stomach and small intestine.
Living with peptic ulcer disease can be very uncomfortable. Fortunately, with the right treatment, most peptic ulcers can be healed or even cured.
What is peptic ulcer disease, and why does it develop in SM?
Peptic ulcer disease is a condition where open sores form in the lining of the gastrointestinal tract. Usually, these sores form in the stomach (called stomach ulcers) or the first part of the small intestine (called duodenal ulcers), but they can also develop in the bottom of the esophagus or middle portion of the small intestine.
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Peptic ulcers happen when something weakens the lining of the stomach and intestines. Normally, this special lining protects the gastrointestinal tract from the corrosive acids in your stomach. When the lining is weakened, stomach acid is able to eat through it.
Peptic ulcer disease in SM is believed to be caused by increased histamineHistamine A chemical released by mast cells when they are activated. Histamine causes many of the allergy-type symptoms in mastocytosis, including flushing, itching and hives. levels in the blood. This can lead the body to produce too much gastric acid, which then damages the stomach lining. Histamine levels in the gastrointestinal tissue may also contribute to symptoms, although the exact mechanisms are still unclear.
Symptoms to be aware of
One of the most common symptoms of peptic ulcer disease is upper abdominal pain. People with stomach ulcers may experience pain in as little as 15 to 30 minutes after eating, while those with intestinal involvement might not experience pain until two to three hours after a meal.
Other symptoms of peptic ulcer disease include:
- Bloating.
- Nausea.
- Vomiting.
- Weight loss or gain.
- A feeling of fullness.
Potential complications of peptic ulcer disease
In some cases, peptic ulcer disease can cause more serious symptoms that may require urgent treatment, such as:
- Worsening difficulty swallowing.
- Significant unintentional weight loss.
- Gastrointestinal bleeding, which may present in the vomit or stool.
- Recurrent vomiting.
If left untreated, peptic ulcer disease can cause a perforation, or hole, to form in the lining of the gastrointestinal tract. This is a medical emergency that needs to be treated immediately. People with perforated ulcers might experience sudden and severe pain that spreads to the shoulder or back.
Treatment options for peptic ulcers
Thankfully, there’s several treatment approaches to peptic ulcer disease.
Medication
In SM, H2 receptor blockers are a first-line defense against peptic ulcers. These work by stopping histamine from binding to the histamine H2 receptor, preventing the release of gastric acid. Approved H2 receptor blockers in the United States include famotidine, cimetidine and nizatidine.
Proton pump inhibitors (PPIs) are a second-line therapy for peptic ulcer disease in SM. PPIs reduce acid secretion in the stomach by blocking an enzyme called hydrogen-potassium adenosine triphosphatase, also known as the “proton pump.” Examples of PPIs approved for use in the United States include:
- Omeprazole.
- Lansoprazole.
- Pantoprazole.
- Esomeprazole.
- Dexlansoprazole.
- Rabeprazole.
Lifestyle changes
Current evidence doesn’t support any specialized diets to help treat or prevent peptic ulcers. However, if you notice that certain foods make your pain worse, try to avoid them as your ulcers heal. For many, symptoms are aggravated by coffee, soda, alcohol, spicy foods or chocolate.
Quitting smoking can reduce the risk of future ulcers and help existing ones heal. You should also avoid nonsteroidal anti-inflammatory drugs like aspirin or ibuprofen, as they can worsen ulcers.
Read more about gastrointestinal symptoms and mastocytosisMastocytosis Rare disease caused by the buildup of mast cells. Cutaneous mastocytosis primarily affects the skin and is more common in children, while systemic mastocytosis affects internal organs and is more common in adults.: “How does systemic mastocytosis affect the digestive system?”
