Peptic Ulcer

What are peptic ulcers?

A peptic ulcer is an actual break / sore on the protective lining of the stomach or the duodenum. Ulcers on the stomach are known as gastric ulcers and ulcers on the duodenum are known as duodenal ulcers. Peptic ulcers are a serious medical condition but with proper treatment can be controlled and in most cases healed.

What causes peptic ulcers?

Your stomach produces acid and pepsin to help with the digestion of food. Ulcers occur when the acid and pepsin break the defences and eat away at the lining of the stomach and duodenum.

A major cause of developing a peptic ulcer is a type of bacteria called Helicobacter Pylori (H.pylori) that lives on the lining of the stomach and the duodenum. H.pylori acts as an irritant to the lining of the stomach, causing inflammation of the stomach (known as gastritis) the infection may also play a role in the development of stomach cancer.

Other factors that may play a role in the formations of ulcers are smoking, drugs (such as aspirin, use paracetamol instead) and diet. Ulcers may also be hereditary. A combination of these factors including H.pylori may combine to cause peptic ulcers.

Where does H.pylori come from?

Researchers are not certain how H.pylori moves from the stomach of one person to the next. The H.pylori bacteria may be contagious but little is known about its transmission.

H.pylori is unlike most other bacteria, the acid in the stomach does not kill it.

What are the symptoms of a peptic ulcer?

Symptoms of ulcers can vary in one person to another but some of the most common symptoms of an ulcer are as follows:

• Pain or discomfort, which is located in the upper part of the stomach. Typically the pain is a burning pain and is often eased by eating something.
• Nausea and/or vomiting.
• Heartburn.
• Bad breath.

Symptoms do not have to be present all the time. In fact most peoples symptoms come and go even without the use of any medication. If you have any symptoms that you are worried about you should discuss your concerns with your doctor.

Are peptic ulcers a common infection?

In Britain, about half the population over middle age are infected with H.pylori. In Britain men are more prone to suffer than women.

Am I at risk of getting a peptic ulcer?

Sometimes there is no reason why you have developed an ulcer. However, you are at risk of developing an ulcer or making an existing one worse if you smoke, drink alcohol heavily or take medicines such as aspirin and anti-inflammatory drugs. If you take these drugs regularly you should consult your doctor to ask how you can minimize the effects to your stomach.

How is a peptic ulcer diagnosed?

Your doctor may be able to diagnose a peptic ulcer from your symptoms alone, however, to confirm the diagnosis you may need to have an endoscopy or a barium meal. An endoscopy involves a thin tube with a camera on it being passed down your throat and into your stomach enabling the doctor to see the stomach and duodenum lining. A barium meal is an X-ray of the stomach and duodenum. Both these tests will usually be done on an out-patients basis at your local hospital.

Since it is important to know whether H.pylori is present your doctor will usually do a blood test, either with, or instead of an endoscopy to look for the presence of H.pylori antibodies. You may be again tested after treatment to check that H.pylori has been eradicated.

How is a peptic ulcer treated?

Your doctor will usually advise you to eat a healthy diet and to avoid foods that cause you indigestion as well as to take antacids such as milk of magnesia (available from your pharmacy) to neutralize the stomach acids. In more severe cases, tablets, which reduce the amount of acid produced by the stomach, are prescribed.

If your ulcer is caused by H.pylori, it should respond to antibiotics. Almost all H.pylori infections can be eradicated in 2 weeks if the course of treatment is completed. This is why any positive result from our available test must be followed by a doctor's visit.

How can H-Pylori and peptic ulcers effect me in the future?

Peptic ulcers, like mouth ulcers tend to come and go, and without treatment recurrence is quite common. If H.pylori infection is successfully treated the chances of the infection coming back are slim.

If the ulcer is not treated the ulcer may erode into a blood vessel in the stomach wall, causing severe bleeding. The symptoms of this are vomiting of blood or if the bleeding is less severe it can result in dark black stools. If the ulcer becomes very deep, it can completely penetrate the thickness of the stomach wall. This is known as a perforated ulcer and can cause severe sudden pain and collapse. This occurs when acidic contents of the stomach are leaked out into the abdomen. Both of these conditions need urgent medical attention, if you notice any of these symptoms contact your doctor immediately.

Some ulcers can become malignant, therefore if ulcers are present it is best to have them thoroughly investigated.