An ulcer is an open sore on the surface of an organ or tissue. Ulcers in the oesophagus, stomach, and duodenum (the first part of the small intestine) are known as peptic or acid ulcers and are the most common type of ulcer.
Ulcers in the duodenum are related to excessive acid and pepsin that are produced by the stomach. Stomach acid is increased after drinking coffee or alcohol, taking certain medications, or smoking cigarettes.
Another factor in the majority of duodenal and gastric ulcers is a Helicobacter pylori bacterial infection. Ninety to 95 percent of duodenal ulcer patients have H pylori gastritis. Successful elimination of H pylori decreases the ulcer recurrence rate to less than 5 percent per year.
The cause of stomach ulcers may partly be due to an inherent weakness in the wall of the stomach. Non-steroid anti-inflammatory drugs (NSAIDs) can cause ulcers. Examples of this class of medications are aspirin and compounds like ibuprofen or naproxen. These have a damaging effect on the lining of the stomach. Users of NSAIDs are 3 times more likely to suffer serious gastrointestinal complications from peptic ulcers, such as bleeding, perforation, or death. Up to 60 percent of ulcer patients with complications do not have prior symptoms.
Ulcers can be present without symptoms. The first sign may be bleeding. The most common symptom with ulcers is pain in the area of the stomach. It is usually not severe, comes and goes throughout the day or night, and described as gnawing, dull, aching, or hunger-like. There may be a feeling of fullness, heartburn, bloating, or nausea.
Seek medical care for vomiting with blood, black tarry stools, or severe abdominal pain. Remember that poor blood supply to heart muscle can cause symptoms of upper abdominal pain, bloating, nausea, or fullness.
Ulcers require medical care, especially if there is bleeding. The most common test used to diagnose ulcers is an endoscopy. It involves passing through the mouth, a long, flexible tube that allows visual examination of the lining of the oesophagus and stomach. This is done to rule out cancer or confirm an infection. For ulcers in the upper small intestine, cancer is not a risk and removing tissue is not necessary. A biopsy can be done by removing a small piece of tissue through the instrument.
If an H pylori infection is present, antibiotics will be given to eliminate it. Treatment may also include medications that reduce stomach acid, and a medication to coat the surface of the ulcer to aid healing. There are medications that reduce ulcer relapse for patients who must continue taking arthritis medications.
Article #4421
Copyright (c) 2002 McKesson. All Rights Reserved.
