An ulcer is essentially an open sore that causes pain. Peptic ulcers are those that develop in the stomach and the upper part of the small intestine, known as the duodenum. Stomach ulcers are also referred to as gastric ulcers, while ulcers in the duodenum are called duodenal ulcers.
Peptic ulcers are a fairly common condition, predominantly affecting adults, and the good news is that most of them are treatable.
What Are the Primary Causes of Ulcers?
The majority of peptic ulcers arise from two main factors:
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Bacterial Infection: Helicobacter pylori (or H. pylori) bacteria are a common culprit, infecting the stomach and upper intestine. These bacteria weaken the protective mucosal lining of these organs. This weakening allows stomach acid to penetrate through to the sensitive tissue underneath. The acid and the bacteria then irritate this lining, leading to ulcer formation.
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Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Regular use of pain relievers like ibuprofen and aspirin, which are NSAIDs, can also contribute to ulcers. While effective in reducing inflammation and managing chronic pain conditions like arthritis, high doses or prolonged use of NSAIDs can damage the stomach lining in some individuals, making them susceptible to ulcers.
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Smoking and Alcohol: Lifestyle factors also play a role. Smoking cigarettes increases ulcer risk because nicotine stimulates the stomach to produce more acid. Similarly, excessive alcohol consumption over time can erode the stomach and intestinal lining, increasing vulnerability to ulcers.
While less common, stress can sometimes be a contributing factor to ulcer development. This is typically associated with significant emotional or physical stress, often in the context of other illnesses. Any condition that impairs the body’s natural healing processes, such as severe burns, can also increase the likelihood of developing an ulcer.
Recognizing the Signs and Symptoms of Peptic Ulcers
Stomach pain is the hallmark symptom of an ulcer. It’s often described as a sharp, gnawing ache localized between the breastbone and the navel. Characteristically, this pain frequently occurs a few hours after meals, and it can also manifest at night or in the early morning when the stomach is empty. Intriguingly, eating food or taking antacids can sometimes temporarily alleviate the pain.
Beyond stomach pain, other symptoms of ulcers may include:
- Loss of appetite
- Sudden, intense stomach pain
- Nausea
- Excessive burping or hiccupping
- Unexplained weight loss
- Vomiting (especially if there’s blood present, or if the vomit resembles coffee grounds, which are signs of a serious ulcer – seek immediate medical attention)
- Bloody or dark, tarry stools (this is also a critical symptom that requires immediate medical evaluation)
It’s crucial to consult a doctor if you suspect you might have an ulcer. Untreated ulcers can worsen, becoming larger and deeper, which can lead to serious complications like internal bleeding in the digestive system or perforation – a hole in the stomach or duodenal wall, both of which can be life-threatening.
How Are Ulcers Diagnosed by Doctors?
Diagnosing a peptic ulcer typically involves a combination of methods. Doctors will start with a physical examination, inquire about your symptoms, and gather your medical history. If ulcer symptoms are suspected, further diagnostic tests are usually performed.
One common test is an upper gastrointestinal (GI) series. This involves taking X-rays of the esophagus, stomach, and duodenum. The patient drinks a barium solution, which coats the digestive tract, making it visible on X-rays. Ulcers will often appear as distinct irregularities on these X-ray images.
Another frequently used diagnostic procedure is an endoscopy. During this procedure, the patient is typically sedated. A thin, flexible tube equipped with a miniature camera, called an endoscope, is gently inserted through the mouth and down into the esophagus, stomach, and duodenum. This allows the doctor to directly visualize the lining of these organs and identify any ulcers or abnormalities.
Doctors may also conduct tests to detect H. pylori bacteria. A blood test can identify antibodies to H. pylori, indicating a past or present infection. Alternatively, a stool test or breath test can directly detect the presence of active H. pylori infection. These tests are particularly important if an ulcer is detected through other methods, as H. pylori is a major cause and needs to be addressed in treatment.
Effective Treatment Approaches for Ulcers
The majority of ulcers caused by H. pylori are curable. Treatment typically involves a combination therapy, often referred to as triple or quadruple therapy, which includes:
- Antibiotics: Usually, two different types of antibiotics are prescribed to eradicate the H. pylori bacteria. These are typically taken for a period of 1 to 2 weeks.
- Acid Suppressors (Antacids or Proton Pump Inhibitors – PPIs): Medications to reduce stomach acid are crucial. These can be over-the-counter antacids for immediate relief or prescription-strength PPIs, which are more potent acid reducers. Acid suppressors help to relieve pain, protect the ulcer from further acid damage, and allow it to heal. PPIs are generally taken for a longer duration, typically 2 months or more, to ensure complete ulcer healing.
While the ulcer itself may take up to 8 weeks to fully heal, symptom relief, particularly pain reduction, is usually experienced much sooner, often within a few days to a week of starting treatment.
Can Peptic Ulcers Be Prevented?
While the exact mode of transmission of H. pylori bacteria isn’t definitively established, it’s believed to spread through saliva, possibly through kissing. It may also spread through contaminated food, water, or contact with infected vomit.
For individuals who need pain relief, acetaminophen (paracetamol) is a safer alternative to NSAIDs as it does not cause stomach ulcers. If NSAIDs are necessary, they should be used at the lowest effective dose for the shortest possible duration, and ideally under medical supervision.
Practicing good hygiene, especially thorough handwashing, is a key preventive measure for many infections, including H. pylori. Washing hands after using the restroom and before eating is particularly important. Maintaining a healthy lifestyle, including regular exercise and avoiding smoking and excessive alcohol consumption, also contributes to overall digestive health and can reduce ulcer risk.
