Stomach Ulcer (s)

A stomach ulcer is a sore or a raw patch that forms in the lining of the stomach (gastrointestinal tract) where acid and pepsin are present.

Stomach Ulcers are also known as gastric ulcers. Ulcers in the duodenum are called duodenal ulcers.

Both gastric ulcers and duodenal ulcers are generally referred to as peptic ulcers. Peptic ulcers are usually 1-2 cm in diameter.

Gastric ulcers are less common than duodenal ulcers. They are most common in elderly people and rare in people before middle age. However children can develop ulcers. Ulcers affect men and women equally.

Causes of Stomach Ulcers

The primary cause of peptic ulcers is an infection with bacteria called Helicobacter pylori (H. pylori). Helicobacter pylori produces substances that weaken the stomach's protective mucus and make it susceptible to the damaging effects of acid and pepsin, as well as produce more acid.

Ulcer development has also been attributed to a lesser extent on an imbalance between digestive fluids (hydrochloric acid and pepsin) and the stomach's inability to defend itself against them.

A number of lifestyle factors are also suspected playing a role in development of ulcers. These include smoking cigarettes, foods and beverages containing caffeine, alcohol as well as physical stress. Eating spicy food cannot cause ulcers but does worsen them.

Inheritance is often a factor in duodenal ulcers, especially when blood group O is present but it appears to be unimportant in gastric ulcers occurrences.

Helicobacter pylori

Most instances of peptic ulcers are due to Helicobacter pylori which is a spiral-shaped bacteria that lives in the acid environment of the stomach. Helicobacter pylori causes 90% of gastric and 75% of duodenal ulcers.

Helicobacter pylori is also found in the stomach of many people without ulcers or indigestion symptoms About 20 percent of people under 40 years old and 50 percent of those over 60 years have it. Most infected people, however, do not develop ulcers.

Smoking
Cigarette smoking increases chances of one getting an ulcer. Smoking individuals dramatically slows the healing of existing ulcers and contributes to ulcers recurrence.

Caffeine
Coffee, tea, sodas, and foods that contain caffeine do stimulate acid secretion in the stomach. This aggravates the pain of an existing ulcer. However, the amount of acid secretion which occurs after drinking decaffeinated coffee is the same as that produced after drinking regular coffee. The stimulation of stomach acid cannot therefore be attributed solely to caffeine.

Alcohol
There is no conclusive proof of a link between alcohol consumption and peptic ulcers. It is however widely accepted that ulcers are more common in people who have cirrhosis of the liver. This is a disease that is associated with heavy alcohol consumption.

Stress
Peptic ulcers are not caused by stress but it can make ulcers worse. Research indicates that individuals with ulcers often report that emotional stress increases ulcer pain.

On the other hand physical stress increases the risk of developing ulcers especially in the stomach. Therefore patients with injuries such as severe burns and those undergoing major surgery require rigorous treatment to prevent ulcers and ulcer complications.

Acid
It is believed that the stomach's inability to defend itself against the powerful digestive fluids contributes to ulcer formation.

There are several ways for the stomach to defend itself from these fluids thus warding off potential stomach ulcers.

It can produce mucus which is a thick smooth fluid that protects the stomach from the acids. An ulcer can result when the stomach produces excess acid and there is insufficient mucus to protect the stomach lining from damage.

The stomach can also produce a chemical called bicarbonate. Bicarbonate neutralizes and breaks down digestive fluids into substances less harmful to stomach tissue.

Blood circulation to the stomach lining, cell renewal, and cell repair also help protect the stomach.

Long term use of aspirin, ibuprofen, naproxen sodium and other Nonsteroidal anti-inflammatory drugs (NSAIDs) can cause or worsen ulcers. They do so by making the stomach vulnerable to the harmful effects of acid and pepsin. NSAIDs are present in many non-prescription medications used to treat fever, headaches, and minor aches and pains.

Both prescription and non prescription NSAIDs used to treat a variety of arthritic conditions, interfere with the stomach's ability to produce mucus and bicarbonate and affect blood flow to the stomach and cell repair.

This can all cause the stomach's defence mechanisms to fail. That results in an increased chance of developing a stomach ulcer. The ulcers disappear once the patient stops taking NSAIDs.

Stomach Ulcer Treatment

The immediate aim of treatment is the relief of discomfort. The protection of the gastric mucus barrier follows to promote healing.

Cessation of the causative agent such as NSAIDs and other secondary causes should be the first step in relief of discomfort.

Antacids which can be purchased over the counter can be used for relief of peptic ulcer symptoms.

They work by neutralizing gastric acids.

Antacids do not help to heal ulcers except for bismuth (Pepto Bismol). They are however inexpensive, safe and sufficient outpatient therapy in mild cases.