Peptic ulcers explained
A peptic ulcer is a patch of tissue that has been eroded or made raw in the lining of either the stomach or the duodenum, much like a mouth ulcer is an eroded patch in the mouth. (The duodenum is the first part of the small intestine where it leads off from the stomach.) So, the term peptic ulcer covers both stomach (also known as gastric) ulcers and duodenal ulcers.
Stomach and duodenum showing peptic ulcers
What causes peptic ulcers?
Several factors may play a part in the formation of peptic ulcers. The most important one, infection with a bacterium called Helicobacter pylori, has only fairly recently been identified as a link with peptic ulcers. Other factors include: taking non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen; smoking; and the stomach or duodenum succumbing to the body’s own acidic digestive fluids (this can be exacerbated by Helicobacter pylori).
Not so long ago, until an Australian researcher discovered H. pylori, scientists believed that many ulcers were brought about by stress and eating spicy foods. However, we now know that approximately 90 per cent of duodenal ulcers and 70 per cent of stomach ulcers are caused by H. pylori.
How they form
It’s quite normal for your stomach to secrete strong acid and gastric juices to digest your food. You might expect that this acidic digestive juice would also erode the stomach itself and the duodenum, but the stomach and duodenum have a protective lining and the stomach secretes mucus to coat the stomach tissues. This protects the stomach tissues from its own digestive juices.
However, when H. pylori is living in the stomach or duodenum, it can sometimes interfere with this protective mechanism and allow the acid to attack the protective lining. This causes breaks in the lining, leaving it open to erosion by the powerful digestive juices.
Pain-killing medicines called NSAIDs, such as aspirin and ibuprofen, are another common cause of ulcers, especially in older people and people who have taken them regularly for a long time. These medicines interfere with the stomach’s protective lining.
Who gets peptic ulcers?
Ulcers don’t occur very often in children — they become more common with age. Men are affected more often than women. Duodenal ulcers are generally more common in men than women and often occur for the first time between the ages of 30 and 50. Gastric ulcers are more likely to affect people over the age of 60.
Probably two-thirds of the world’s population is infected with H. pylori, but in Australia only about 30 per cent of the population have the bacterium. It is more common in older people, migrants and disadvantaged sections of the community. Having the bacterium, though, doesn’t mean that you will necessarily develop an ulcer. Most people who have it don’t develop ulcers.
Over the past few years our knowledge of ulcers, how they develop and how they should be managed and treated has progressed rapidly. Today, peptic ulcers are generally easy to treat. Medications are available which greatly reduce the amount of acid produced by the stomach and permit healing of the ulcer. If H. pylori is present, antibiotics to eradicate it are also prescribed — this considerably reduces the chance of an ulcer coming back, as does avoiding NSAIDs.
Last Reviewed: 03 July 2009
Sponsored links
