An ulcer is an open sore that forms when the lining of the gut is corroded by acidic digestive juices. Peptic ulcers can form in the lining of the stomach (gastric ulcers), duodenum (the first part of the small bowel or intestine) or the esophagus (gullet or swallowing tube). Peptic ulcers are quite common; it is known that 5-10% of the world’s population suffer from peptic ulcers at least once.
What Causes Ulcers?
Use of painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve, Anaprox, Naprosyn, and others), ibuprofen (Motrin, Advil, Midol, and others), and many others available by prescription. Even aspirin coated with a special substance can still cause ulcers.
Ulcers are sores on the lining of your digestive tract. Your digestive tract consists of the esophagus, stomach, duodenum (the first part of the intestines) and intestines. Most ulcers are located in the duodenum. These ulcers are called duodenal ulcers. Ulcers located in the stomach are called gastric ulcers. Ulcers in the esophagus are called esophageal ulcers.
Almost all peptic ulcers occur in people taking non-steroidal anti-inflammatory drugs (NSAIDs) or those infected with Helicobacter Pylori (H. Pylori). NSAIDs are anti-inflammatory medications like aspirin, naproxen, and ibuprofen. H. Pylori is a bacterium that has adapted to living on the surface lining of the stomach. H. Pylori and nonsteroidal anti-inflammatories impair the ability of the stomach and duodenum to protect themselves from acid and pepsin and are thus predisposed to ulcer formation. Emotional stress in itself does not cause ulcers, but it may contribute to their development in a small degree.
Signs and symptoms of peptic ulcer
The most important symptom of an ulcer is pain. It is usually sharp and severe. In a few cases there is also a steady aching or gnawing sensation in the upper abdomen. The patient can always put his finger on the sore spot.
In duodenal ulcers the pain comes on when the patient is hungry; it may even be severe enough to awaken him at night. In many cases the pain is relieved by eating food, but is made worse by taking alcohol, condiments, and coffee.
Patients with stomach ulcers may feel worse after taking food. Sometimes the ulcer may not be noticed for several weeks or months, only to flare up again under emotional strain or after taking alcohol.
Treatment of peptic ulcer
You should see a doctor if you have symptoms of an ulcer. Treatment often involves a combination of medications to kill the Helicobacter pylori bacteria, reduce acid levels, and protect the GI tract. This combination strategy allows your ulcer to heal and reduces the chance it will come back. Take all of your medications exactly as prescribed.
The medications may include one or more of the following:
Antibiotics to kill Helicobacter pylori
Acid blockers (like cimetidine, ranitidine, or famotidine)
Since peptic ulcer disease has become a curable condition, surgery is no longer considered an acceptable treatment for ulcers, except for patients experiencing an emergency complication that cannot be managed by medical or endoscopic treatment. Surgical resection of the gastrinoma is the optimal treatment for patients with ZES.
Endoscopy is a procedure used to treat most bleeding ulcers. The doctor inserts a long, thin instrument with a tiny camera on the end through your mouth and into your stomach and duodenum Heat or electricity can be applied to the sore, which makes the blood clot. Treatment may include injecting epinephrine or another medication into the ulcer. Bleeding may recur after treatment.