Peptic ulcer

Overview

Peptic ulcers are open sores that form on the inner lining of the stomach and the upper part of the small intestine, known as the duodenum. The primary symptom of peptic ulcers is stomach pain. There are two types of peptic ulcers: gastric ulcers, which develop inside the stomach, and duodenal ulcers, which occur in the upper portion of the small intestine.

The most common causes of peptic ulcers are infection with a bacterium called Helicobacter pylori (H. pylori) and the prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium. It is important to note that stress and spicy foods do not directly cause peptic ulcers, but they can exacerbate the symptoms.

The treatment for peptic ulcers involves eradicating H. pylori infection, minimizing NSAID use, and using medications to heal the ulcer. This includes antibiotics, acid-suppressing drugs, and medications to protect the stomach lining.

Symptoms

Symptoms of a peptic ulcer include:

• Burning stomach pain
• Feeling of fullness, bloating, or belching
• Intolerance to fatty foods
• Heartburn
• Nausea

The most common symptom is a burning pain in the stomach, which tends to worsen with stomach acid and when the stomach is empty. Eating certain foods that help neutralize stomach acid or taking acid-reducing medication can provide temporary relief, but the pain may return. It is often more pronounced between meals and during the night. It’s worth noting that many individuals with peptic ulcers may not experience any symptoms at all.

In some cases, ulcers can cause more severe signs or symptoms, such as:

• Vomiting blood (which may appear red or black)
• Presence of dark or tarry blood in stools
• Difficulty breathing
• Feeling lightheaded or faint
• Nausea or vomiting
• Unexplained weight loss

Causes

Peptic ulcers develop when the acid in the digestive tract erodes the inner lining of the stomach or small intestine, resulting in painful open sores that may bleed. The digestive tract is naturally protected by a mucous layer, but an excess of acid or a decrease in mucus can lead to ulcer formation.

Common causes of peptic ulcers include:

• Bacterium: Helicobacter pylori (H. pylori) bacteria reside in the mucous layer that safeguards the tissues lining the stomach and small intestine. While H. pylori often causes no issues, it can trigger inflammation in the inner layer of the stomach, resulting in an ulcer. The precise mode of H. pylori transmission remains unclear, but it may occur through close person-to-person contact or contaminated food and water.
• Regular use of specific pain relievers: Certain pain medications, such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen sodium, can irritate or inflame the stomach and small intestine linings. Acetaminophen, however, does not have the same effect.
• Other medications: Concurrent use of NSAIDs with certain medications like steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate, and risedronate can significantly increase the likelihood of developing ulcers.
• Other causes: Ulcers may also arise from various infections or illnesses, undergoing surgery, or having a rare condition called Zollinger-Ellison syndrome (gastrinoma). In Zollinger-Ellison syndrome, tumors consisting of acid-producing cells form in the digestive tract. These tumors can be cancerous or noncancerous and lead to excessive acid production, causing damage to the stomach tissue.

Risk factors

In addition to the risks associated with taking NSAIDs, certain factors can increase your risk of developing peptic ulcers or make existing ulcers worse. These factors include:

• Alcohol consumption: Drinking alcohol can irritate the stomach lining and increase stomach acid production, potentially leading to the development or worsening of ulcers.
• Smoke. Smoking may heighten the risk of peptic ulcers, particularly in individuals infected with H. pylori.
• Untreated stress: Unmanaged stress can contribute to the severity and healing process of ulcers.
• Spicy food consumption. Eating spicy foods may aggravate ulcer symptoms but does not directly cause ulcers.
• Family history of ulcers. Having a family history of ulcers can increase your susceptibility to developing ulcers.
• Pre-existing illnesses. Conditions like liver, kidney, or lung disease can exacerbate ulcers and hinder the healing process.

While these factors alone do not directly cause the formation of ulcers, they have the potential to worsen existing ulcers and hinder the healing process.