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Peptic Ulcer

A peptic ulcer is also referred to as a duodenal or gastric ulcer, and is an erosion in the lining of the stomach or duodenal. The erosion takes place in the duodenum, or the first part of the small intestine. Peptic, means pepsin, the stomach enzyme that breaks down proteins in the stomach. Peptic ulcers are fairly common. About one in every 10 Americans develops an ulcer in their lifetime.

Peptic ulcers can be caused by a couple of things. Some ulcers are caused by long term use of non-steroidal anti-inflammatory agents (NSAIDs) found in aspirin and ibuprofen. But researchers think that most ulcers are caused by helicobacter pylori (H. pylori), a bacteria. It is not clear how H. pylori gets into a person’s body, but it may be through food or water. Some people may have H. pylori in their system, but never develop a peptic ulcer. H. pylori has been found in saliva of some people infected with ulcers, and in those cases could be spread by mouth-to-mouth kissing.

H. pylori bacteria attack the protective coating of the stomach and duodenum. This damage allows acid to leak into the sensitive lining underneath the stomach coating. The combination of the acid and the bacteria cause irritation, and the sore or ulcer is formed. The H. pylori can live in the stomach because it can use an enzyme to neutralize stomach acid, and then it can stay within the stomach lining.

Ulcers can also be developed due to excessive alcohol use or smoking and chewing tobacco. Also, if you are blood type O and have a family history of ulcers, research has shown that you may be more likely to develop ulcers. It is a myth that stress causes ulcers. Stress can worsen ulcer conditions in older patients, but there has been no clear connection made between stress and the development of peptic ulcers. Also, spicy food has not been determined as a cause for ulcers, but it can irritate existing ulcers.

The symptoms of an ulcer are widespread. However, remember, you can have an ulcer but not necessarily have the typical symptoms. The most common symptom of a peptic ulcer is abdominal discomfort. Characteristics include a feeling of dull, gnawing ache in the stomach that comes and goes for days or weeks, occurs two to three hours after eating or occurs in the middle of the night. The pain usually is also relieved by eating or by antacid medications. Other symptoms can be weight loss, poor appetite, bloating, burping, nausea and vomiting. If you are experiencing severe symptoms, it is an emergency situation and you should see a doctor immediately. These symptoms include sharp, sudden and persistent stomach pain, bloody or black stools or bloody vomit or vomit that looks like coffee grounds. More symptoms of an emergency situation include fainting, excessive sweating or confusion and a rigid, tough abdomen that is tender to the touch. These symptoms could be signs of more serious problems including obstruction, when the ulcer blocks food trying to exit the stomach; bleeding, when the ulcer or acid breaks a blood vessel; or perforation when the ulcer digs through the stomach or duodenal wall.

A doctor can diagnose if you have a peptic ulcer. They may perform one of several tests to determine if an ulcer is present. An upper GI may be taken, which is a series of x-rays taken after the patient drinks barium, a substance that allows the intestines to be easily viewed. An esophagogastroduodenoscopy (EGD) might also be performed by a gastroenterologist, who will insert a small tube into the mouth to take a look at the gastrointestinal tract, stomach and small intestines. During the EGD, the doctor may take a sample from the wall of the intestines to check for H. pylori. Breath tests are also used to detect H. pylori. A doctor will ask you to drink a urea solution containing a special carbon atom. If the H. pylori is present in the body, the urea will be broken down and the carbon will be released. Carbon is then carried to the lungs, and exhaled. The breath test is between 96 and 98 percent accurate.

Once your doctor has diagnosed that you have an ulcer, there are several medication options. If you have a H. pylori peptic ulcer, the doctor will treat you with drugs that kill the bacteria, protect the stomach lining and attempt to reduce the acid in the stomach. This takes a combination of drugs: antibiotics and acid-reducers like H2 blockers and proton pump inhibitors. The antibiotics kill the bacteria. The H2 blockers thwart histamine that stimulates acid. The proton pumps also suppress acid by stopping movement of acid into the stomach. The two together can cure H. pylori ulcers. A person diagnosed with a peptic ulcer also needs stomach protector medication, as well. The most proven treatment for these types of ulcers is by using a combination of these drugs for a one or two week period. It is often called “triple therapy.”

If peptic ulcers are untreated, they tend to come back. Also, if medicine is not taken properly, that can also make them more likely to reoccur. Taking the medicine correctly will ensure that the H. pylori is eliminated in the body and make your chances of developing another ulcer least likely. Also, if the peptic ulcers are untreated, you are more likely to have complications. Some of the common complications include bleeding internally, bowel obstruction and peritonitis.

There are several things you can do to prevent peptic ulcers from forming. First, stop smoking or chewing tobacco. The nicotine can irritate a peptic ulcer condition, or make you more likely to form one. Also, avoid excessive alcohol use. Also, try to avoid taking medications such as aspirin, ibuprofen or naproxen. They are harder on the stomach lining. Try acetaminophen, like Tylenol, instead.

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