Danger: Medium

What is it?

Peptic ulcer disease (PUD) is a condition in which wounds form in the digestive tract, mainly in the stomach or the duodenum (a part of the intestine).

Who gets it?

You have about a 10% chance of having PUD during your lifetime. In the United States, about 4 million people get it each year.

The two main groups of people who get it are people who are treated with nonsteroidal anti-inflammatory medications (such as ibuprofen) and those who are infected with a specific germ called helicobacter pylori (see ahead).

What causes it?

Our stomach releases acid, which helps in the process of food breakdown in the body. Under normal conditions, the body can protect itself from that acid since it has a protective lining on the stomach and the duodenum. There’s usually a balance between the secretion of acid and the protective lining. When that balance is disrupted, a peptic ulcer can occur.

The following things are known to change that balance and bring about ulcers:

1. Infection with a germ called Helicobacter pylori (H. pylori) – There are estimates that about half of the world’s population are infected with it. The relationship between ulcers and H. pylori wasn’t known until 1982, when a researcher decided to prove his theory of a connection between the two by swallowing these bacteria. Not long after, he had ulcers.
   H. pylori is responsible for 90% of ulcers in the duodenum and 70% in the stomach.
2. Nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin: These are drugs used to treat pain, inflammation and fever. Everyone uses them from time to time. You might know them by their names: aspirin, ibuprofen (Advil, Motrin, Midol), naproxen (Aleve, Anaprox, Naprosyn), and others.
3. Zollinger-ellison syndrome: This is a rare tumor which we will cover here in the future. It causes extra secretion of acid.
4. Others: Other reasons include smoking, radiation therapy (such as for cancer), chemotherapy for cancer and others.

  
Aspirin. It and other NSAIDs can cause peptic ulcers. Photo by ragesoss.

This video shows how an ulcer develops:

How does it feel?

The main thing you feel when you have a peptic ulcer is abdominal pain (although you may also not feel it at all). The pain is usually located in the upper abdomen. If the ulcer is located in the duodenum, the pain is usually relieved by eating food. If it’s located in the stomach, it usually gets worse by eating.

If an ulcer isn’t treated properly, it can develop complications. These include:

1. Bleeding
2. Perforation – A hole through the wall of the stomach or duodenum
3. Gastric outlet obstruction – If the ulcer causes a swelling which blocks the passageway leading from the stomach to the small intestine. This can bring about early satiety when eating, a feeling of fullness, nausea and vomiting.

Since these complications may be life threatening, it’s important to seek treatment if you have a peptic ulcer.

How is it discovered?

There are a few things which can be done to discover a peptic ulcer:

1. H. pylori testing – There are several tests which can detect if you are infected with this germ. These tests include blood tests, tests for your breath and tests for your stool. If you are positive, you will be treated for infection and then get re-checked to see if the germ is gone.
2. Upper endoscopy – This is a tube with a camera inserted through your mouth to your intestines or stomach to see the appearance there. This is done more in older people or people with other symptoms such as weight loss, to rule out the possibility that the symptoms are caused by cancer and not by a peptic ulcer. A biopsy of the intestine or stomach can be taken during that test.

How is it treated?

There are a few ways to treat peptic ulcers:

1. Stopping taking NSAIDs – If they are the cause of the ulcer.
2. Treating H. pylori – This involves taking several medications together for about 7-14 days.
3. Acid suppression drugs – If there is no known infection with H. pylori, these drugs can also be used. They suppress the release of acid from the stomach.
4. Surgery – If complications develop, a surgery may be needed.

What happens after treatment?

Most patients are treated successfully with the cure of H pylori infection, avoidance of NSAIDs, and the use of acid suppression drugs.

In the past, more people had to be treated with surgery. Since the discovery of H. pylori and the above treatments, surgeries are rarely needed today.

The bottom line – How do I prevent it?

You can avoid having peptic ulcers or having them recurring if you follow these tips:

1. Quit smoking
2. Avoid heavy alcohol use
3. Don’t overuse NSAIDs
4. Contact your doctor if you have the symptoms mentioned above

Know of any tips of your own? Share them in the comments.

What next?

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