What Are Peptic Ulcers?

An ulcer is an open sore that fails to heal on the skin, internally or in mucous membranes. Peptic ulcers occur in the esophagus, stomach and duodenum, the first part of the small intestine. Ulcers in the stomach are called gastric ulcers, and those in the duodenum are called duodenal ulcers. The word peptic comes from the Latin word pepticus, meaning to cook or digest. Peptic ulcers form when digestive acids penetrate the lining of the stomach or intestine and sores develop that do not heal.

Symptoms of Peptic Ulcers

Often there are no symptoms of peptic ulcers, or people may experience mild pain in the upper abdomen. More pronounced symptoms include:

  • Nausea or vomiting
  • Blood in stools or sticky, black stools
  • Anemia
  • Fatigue or weakness
  • Poor appetite
  • Pain in the upper abdomen between meals or early in the morning
  • Feeling of a full stomach or bloating

Many of these symptoms are indicators of other health problems. People experiencing these problems should be evaluated by a health care professional to determine the cause.

Causes of Peptic Ulcers

There are two major causes of peptic ulcers. Scientists have demonstrated a link between the presence of the bacterium Helicobacter pylori (H. pylori) and the formation of ulcers. Although many beneficial bacteria and organisms are present in the gastrointestinal tract, people with the H. pylori bacterium may develop ulcers. The bacterium is responsible for between 60 and 80 percent of gastric ulcers and 70 and 90 percent of duodenal ulcers, although only about 20 percent of those who carry the bacterium develop ulcers.

Another common reason that people develop ulcers is through the use of non-steroidal anti-inflammatory drugs (NSAID), which include aspirin, celecoxib, ibuprofen, naproxen and meloxicam. Some are available only by prescription, but others are available as over-the-counter drugs or in other formulations like Alka-Seltzer®. Acetaminophen (such as Tylenol®) is not an NSAID and may be recommended by doctors as an alternative pain medication. People more susceptible to developing ulcers from taking NSAIDs are those more than 60 years old, those who have used NSAIDs for a long period of time, those who take blood thinners or steroids, or those who smoke or use alcohol regularly.

Medical professionals used to attribute the cause of peptic ulcers to stress. After the discovery of the association with H. pylori in 1983, doctors understood that while stress may aggravate symptoms in those who have ulcers, stress is not the cause. Other factors that may contribute to developing an ulcer or making symptoms worse include smoking, excessive use of caffeine, heavy use of alcohol and physical stress that weakens the body’s resistance.

Treatment of Peptic Ulcers

Treatment of ulcers due to H. pylori uses a combination of antibiotics to eradicate the bacterium and antacids or a proton pump inhibitor to reduce acid in the stomach. Reducing acids in the stomach promotes healing of mucous membranes and reduces symptoms of pain and nausea. Completing the course of medicines has a success rate of between 61 and 94 percent, depending on the combination of medicines used. A longer treatment time, 14 days as opposed to 10 days, has a higher success rate. Those who have a successful treatment have a 90 percent rate of cure.

Treatment of peptic ulcers due to NSAIDs varies. It is important to discuss NSAID use with your doctor. Use of proton pump inhibitors, antacids and alternative pain medication can help prevent the occurrence of peptic ulcers.

Sources:
http://annals.org/article.aspx?articleid=705145
http://www.bmj.com/content/348/bmj.g3320.long
http://www.cdc.gov/ulcer/keytocure.htm#treatment
http://www.cdc.gov/ulcer/keytocure.htm
http://dx.doi.org/10.1136/bmj.g3320
http://www.gastro.org/patient-center/digestive-conditions/peptic-ulcer-disease
http://www.hopkinsmedicine.org/healthlibrary/conditions/digestive_disorders/stomach_and_duodenal_ulcers_peptic_ulcers_85,P00394/
http://jama.jamanetwork.com/article.aspx?articleid=182574&resultClick=3
http://www.nlm.nih.gov/medlineplus/pepticulcer.html
http://patients.gi.org/topics/peptic-ulcer-disease/


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