Do you think you may have a peptic ulcer? Learn more here.

Peptic ulcer disease is a common ailment, affecting one out of ten persons in the United States at some point in their life. In the past it was thought that stress and poor diet were the main causes of PUD (peptic ulcer disease) but recently some of the real causes have gradually become clear.

What is a peptic ulcer?
The stomach secretes strong acid and other digestive juices to help digest food. The wall of the stomach is protected by a thick mucous coating. An ulcer is an open sore in the lining of the stomach or intestine. If the ulcer occurs in the stomach, it is called a gastric ulcer. If it occurs in the intestine, it’s called a duodenal ulcer. Once a sore develops in the lining, the stomach acid and pepsin (a digestive enzyme) do the damage. Both types of ulcers are called “peptic”.

What are the symptoms of a peptic ulcer?
A gnawing or burning sensation below the breastbone, in the upper abdomen is a common complaint. Sometimes this feeling goes all the way to the backbone. These symptoms occur a few hours after eating. Different persons have different symptoms. For some the feeling gets worse after they eat, and for some it gets better. Some people experience pain or burning for a short time and some for hours. Some people never experience any symptoms. Hunger and bloating or pressure are symptoms that some experience. Black stools indicate bleeding and this is a very serious complication associated with ulcers.

Causes of peptic ulcers
Great strides were made in determining what causes most peptic ulcers with the discovery of the Heliobacter pylori bacteria (H. pylori). Stress and poor diet are now thought to have little to do with the formation of ulcers but may worsen an ulcer that already exists. H. pylori is now thought to be the real culprit in more than 90% of cases. The other major cause is thought to be nsaids and aspirin. Some causes are not known.

What is H. pylori?
H. pylori is just about the only bacteria that can live and thrive in the highly acidic environment of the stomach. It has a corkscrew spiral shape and can attach itself to, and burrow into, the lining of the stomach.

The bacteria are thought to be ingested from food or a drinking glass. It is extremely common, about 20% of Americans under the age of forty, and about 50% of people over sixty have H. pylori in their stomachs. Given the amount of people that have this in their stomachs, it’s clear that only a small percent of people with it ever develop problems from it.

There is a concern that we may be over treating people with antibiotics and making the bacteria more resistant. Some research shows that acid reflux or GERD can develop or increase with the eradication of the bacteria by use of antibiotics.

Diagnosis
There are three different ways H. pylori can be discovered. The most common is a simple blood test. Antibodies against the bacteria are detected in the blood sample indicating exposure to the bacteria. There is now a breath test available to determine infection. The third way is by the procedure called an endoscopy. This is the most invasive way, where a camera is put down the throat and into the stomach to see the lining. A sample of the cells can also be taken.

Treatment
The usual treatment is through the use of antibiotics. It is recommended that at least until it has healed, the patient should abstain from; smoking, alcohol, aspirin and nsaids. Acid inhibiting drugs may also be prescribed.

Most peptic ulcers are healed this way and surgery is usually not needed except if the ulcer fails to heal or bleeding cannot be stopped.