In common usage, an ulcer is an open sore in the stomach lining. However, ulcers can appear elsewhere. The terms ulcer, gastric ulcer, and peptic ulcer are often used loosely and interchangeably.
Bacteria cause ulcers
In the past it was thought that stress led to ulcers, but research has proven otherwise. It was in 1984 that a family physician, Dr. Barry Marshall, from Australia, came up with a finding that turned the entire long held view of ulcers upside down.
Unfortunately, the misinformation surrounding the true cause of ulcers was still not widely known in the late ‘90s. A CDC survey during that time found most health care consumers were unaware that peptic ulcer disease was caused by infection with H. pylori bacteria in 9 of 10 cases.
About 60 percent of respondents then still believed that ulcers were caused by stress and 17 percent thought that ulcers were caused by spicy foods. Many still hold those beliefs.
According to Answers.com, “The single most common cause of gastric ulcers is the use of nonsteroidal anti-inflammatory drugs, or NSAIDs. The widespread use of NSAIDs is thought to explain why the incidence of gastric ulcers in the United States is rising.” Apparently these drugs make it easier for H pylori bacteria to exist.
Experts believe that 90% of all people with ulcers are infected with H. pylori. But strangely enough, most people infected with H. pylori don’t develop an ulcer. Doctors aren’t completely sure why, but think it may partly depend upon the individual person — for example, those who develop ulcers may already have a problem with the lining of their stomachs.
It’s also thought that some people may naturally secrete more stomach acid than others — and it doesn’t matter what stresses they’re exposed to or what foods they eat. Peptic ulcers may have something to do with the combination of H. pylori infection and the level of acid in the stomach.
How Ulcers Form
When H. pylori bacteria do cause ulcers, here’s how doctors think it happens:
- Bacteria weaken the protective coating of the stomach and upper small intestine.
- Acid in the stomach then gets through to the sensitive tissues lining the digestive system underneath.
- Acid and bacteria directly irritate this lining resulting in sores, or ulcers.
Although H. pylori are responsible for most cases of peptic ulcers, these ulcers can happen for other reasons, too. Some people regularly take pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen, that fight inflammation in the body and are used to treat long-term painful conditions like arthritis. If taken in high daily doses over a long period of time, NSAIDs can cause ulcers in some people.
Smoking also is associated with peptic ulcers. Smoking increases someone’s risk of getting an ulcer because the nicotine in cigarettes causes the stomach to produce more acid. Drinking a lot of alcohol each day for a period of time can also increase a person’s risk of ulcers because over time alcohol can wear down the lining of the stomach and intestines.
In certain circumstances stress can help cause ulcers. But this usually only happens when illness involving severe emotional or physical stress is involved — such as when someone too sick to eat for a long period of time.
Ulcers occur because of uncontrolled increased acid production in the stomach and changes in the immune system (the body system that fights infection). With any illness where the body’s ability to heal is challenged (such as when someone has serious burns from a fire), there is a risk for developing ulcers.
Signs and Symptoms
Stomach pain is the most common symptom of an ulcer. It usually feels like sharp aches between the breastbone and the belly button. This pain often comes a few hours after eating. It can also happen during the night or early in the morning, when the stomach is empty. Eating something or taking an antacid medication sometimes makes the pain go away for awhile.
Other symptoms of ulcers can include:
- loss of appetite
- sudden, sharp stomach pains
- frequent burping or hiccuping
- weight loss
- vomiting (if blood is in the vomit or the vomit looks like coffee grounds, which only happens with severe ulcers, call a doctor right away)
- bloody or blackish bowel movements (this could indicate a serious problem, so call a doctor right away if you see this)
When to see a doctor
Anyone who thinks he or she may have an ulcer needs to see a doctor. Over time, untreated ulcers grow larger and deeper and can lead to other problems, such as bleeding in the digestive system or a hole in the wall of the stomach or duodenum, which can make someone very sick.
Ulcers caused by H. pylori bacteria are generally treated with a combination of medications:
- Usually two antibiotics to kill the H. pylori bacteria are taken every day for about 2 weeks.
- Antacids — acid blockers or proton pump inhibitors — are given for 2 months or longer to lessen the amount of acid in the stomach and help protect the lining of the stomach so the ulcer can heal.
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