Peptic ulcer disease
Overview
Relief may be on the way
Until recently, most people thought that the likelihood of developing an ulcer depended on their lifestyle. However, scientists have discovered the underlying cause of most ulcers: Helicobacter pylori. This bacteria exists in the digestive tracts of more than half the world's population, yet most of them will never develop an ulcer. Despite this discovery, though, lifestyle still plays a role in the development of ulcers. The likelihood of developing one increases if you smoke, have poor eating habits, consume an excessive amount of alcohol, and are experiencing stress. So if you feel a burning sensation in your digestive tract, it may indicate an ulcer.
Detailed Description
Peptic ulcer disease involves the formation of small erosions along the digestive tract by stomach fluids, which contain hydrochloric acid and the enzyme pepsin (hence the name peptic ulcer).
Ulcers can occur anywhere from the stomach to the upper duodenal section of the small intestine. So peptic ulcers can be further classified as gastric ulcers, and duodenal ulcers, depending on their location.
The lining of the gastrointestinal (GI) tract is protected by a thick mucosal layer, which continually rebuilds itself as stomach acid destroys it. Ulcers start when an overproduction of acid or an underproduction of mucus degrades the mucosa, allowing erosion to occur and ulcers to form. The mechanisms of erosion are still not fully understood, but -- with the recent discovery of the Helicobacter pylori bacteria -- the cause is. Somehow, H. pylori is able to survive the acidic environment of the stomach and reproduce in the mucosa. Its reproduction causes damage to the tissue and leads to ulcer formation.
If you think you might have an ulcer, it's important to seek medical advice for diagnosis and treatment. If left untreated, an ulcer can further erode the mucosa until bleeding, obstruction, or perforation occurs. Follow-up is always recommended, as recurrence is likely if H. pylori is not completely eradicated. In some untreated cases, ulcers have been shown to lead to a greater chance of developing stomach cancer.
A wide range of therapies exist to effectively treat symptoms and heal ulcers, so only in rare cases is surgery needed. The main reason treatments fail is noncompliance (i.e., not sticking to the medical treatment your doctor has suggested). Risk factors like alcohol, coffee, aspirin and even NSAIDs (nonsteroidal anti-inflammatory drugs, such as ibuprofen), and especially cigarettes have been shown to aggravate existing ulcers, so it's important to follow your doctor's advice regarding diet and lifestyle modifications.
Drug Therapy
| Antibiotics To eliminate H. pylori bacteria | ||
Biaxin |
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Tetracycline |
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| Histamine receptor antagonists (H2 blockers) To promote healing via slowing or stopping gastric acid production: | ||
Tagamet |
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Pepcid |
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Zantac |
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| Proton pump inhibitors to stop acid production: | ||
Prilosec |
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Prevacid |
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Protonix |
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Aciphex |
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| Mucosal protectants: directly protect the stomach and intestinal lining from damage: | ||
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Carafate |
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Last updated 23 May 2012
Synonyms
- Gastric ulcer
- Duodenal ulcer
- Helicobacter ulcer
- PUD (peptic ulcer disease)
Pronunciation
PEP-tik UL-ser
Characteristics of Peptic Ulcers
An ulcer is a small erosion that forms along the digestive tract. Formations occurring in the upper segment of the small intestine are known as duodenal ulcers. These are the most common. Ulcerations in the stomach are known as gastric ulcers. Those found in the esophagus are known as esophageal ulcers; these are the least common. The ulcer is a sore or crater from one to two inches in diameter, depending on the progression of the erosion. The surrounding inflamed area is called the ulcer crater.
How Common Are Peptic Ulcers?
Approximately 20 million Americans suffer from ulcers, with duodenal ulcers accounting for more than 75% of all cases. Anyone can develop an ulcer, but they are rare in children and adolescents. Duodenal ulcers are more likely to form between ages 30 and 60, whereas gastric ulcers usually appear after age 60. Gastric ulcer cases are distributed equally between males and females, although men are twice as likely as women to develop duodenal ulcers.
What You Can Expect
Current medical treatments and medications make for a good prognosis if you are diagnosed with peptic ulcer disease. Duodenal ulcers are not as severe as gastric ulcers and in almost all cases are benign. Gastric ulcers may become malignant; therefore, a biopsy may be necessary. If peptic ulcer disease is diagnosed before complications or perforation occur, medication can be prescribed to eradicate the Helicobacter pylori bacteria, heal the ulcer, provide symptomatic relief, and in most cases, prevent recurrence.