What you don’t know about ulcer and the simple way to deal with it


What you don’t know about ulcer and the simple way to deal with it


A peptic ulcer is a type of sore that develops in the digestive system. The word “ulcer” means open sore, and “peptic” means that acid is the cause of the sore. However, this terminology is from a prior era when all ulcers in the esophagus, stomach, and duodenum were thought to be caused by acid damage.  A peptic ulcer (stomach or duodenal) is a break in the inner lining of the esophagus, stomach, or duodenum.

A peptic ulcer of the stomach is called a gastric ulcer; of the duodenum, a duodenal ulcer; and of the esophagus, an esophageal ulcer. Peptic ulcers occur when the lining of these organs is corroded by the acidic digestive (peptic) juices which are secreted by the cells of the stomach. A peptic ulcer differs from an erosion because it extends deeper into the lining of the esophagus, stomach, or duodenum and incites more of an inflammatory reaction from the tissues that are involved. Peptic ulcer also is referred to as peptic ulcer disease.

Peptic ulcer disease is common, affecting millions of Americans yearly. Moreover, peptic ulcers are a recurrent problem; even healed ulcers can recur unless treatment is directed at preventing their recurrence. The medical cost of treating peptic ulcer and its complications runs into billions of dollars annually. Recent medical advances have increased our understanding of ulcer formation. Improved and expanded treatment options now are available.

Peptic ulcers come with a lot of misconceptions. Commonly referred to as ulcers or stomach ulcers, they can occur in your stomach, esophagus, or duodenum (upper part of your small intestine). Well-meaning people may tell you that your stressful job caused the ulcer, or that you should avoid eating spicy foods. However, these statements are not true. Much more is known about ulcers today than ever before.

What You Need To Know

1. Stress doesn’t cause ulcers, but it can worsen symptoms

Contrary to popular belief, stress does not directly cause an ulcer. Ulcers are actually caused by a specific type of bacteria called H. pylori, as well as long-term use of some pain relievers and medications. NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen, and naproxen are popular NSAIDs that can cause ulcers if used for long periods. If you already have an ulcer due to one of these causes, frequent high stress levels can increase your discomfort.

2. Pain from an ulcer is not caused by food

Ulcers are usually most painful at night when your stomach is empty. Antacids and certain foods may provide temporary pain relief, but they may not help your long-term symptoms. The American College of Gastroenterology states that people with ulcers do not need to follow a bland diet.

3. Medications that treat heartburn are also effective against ulcers

Because stomach acid is the main culprit in ulcer formation, taking medications to reduce this acid can alleviate your symptoms and help the ulcer heal. Your physician may prescribe antacids and/or medications that reduce or block stomach acid production. If the H. pylori bacteria is found in your body, you may also be prescribed a course of antibiotics.

4. Ulcers can cause long-term and serious health problems if not treated

Over time, ulcers can cause internal bleeding, an infection from a hole in your stomach, and scar tissue that impedes proper digestion.

5. The best way to diagnose an ulcer is with an endoscopy

Although certain x-rays can also find ulcers, an endoscopy will allow your gastroenterologist to see even the smallest ulcers, and to potentially treat them during the procedure. During the endoscopy, your physician will use a small lighted scope to look into your esophagus, stomach, and small intestine.

Thanks to modern medical technology, ulcers can be diagnosed and treated more effectively than ever before. If you are having ongoing abdominal pain, even if it’s mild, discuss it with your physician so the cause can be determined. Some ulcers are not extremely painful, but with the potential for dangerous complications, they should be treated.

Types of Peptic Ulcers

The most common kinds of peptic ulcers are:

Gastric ulcers: A common type of ulcer, these occur on the inside of the stomach. The symptoms of gastric ulcers include feelings of indigestion and heartburn, weight loss, and repeated episodes of gastrointestinal bleeding. Ulcer pain often is described as gnawing, dull, aching, or resembling hunger pangs. The patient may be nauseated and suffer loss of appetite. About 30% of patients with gastric ulcers are awakened by pain at night. Many patients have periods of chronic ulcer pain alternating with symptom-free periods that last for several weeks or months. This characteristic is called periodicity.

Duodenal ulcers: These are located at the beginning of the small intestine (called the small bowel or duodenum). The symptoms of duodenal ulcers include heartburn, stomach pain relieved by eating or antacids, weight gain, and a burning sensation at the back of the throat. The patient is most likely to feel discomfort two to four hours after meals, or after having citrus juice, coffee, or aspirin. About 50% of patients with duodenal ulcers awake during the night with pain, usually between midnight and three a.m. A regular pattern of ulcer pain associated with certain periods of day or night or a time interval after meals is called rhythmicity.

Esophageal ulcers: These occur inside the esophagus (the tube that carries food from your throat to your stomach).

  • Peptic ulcer formation is related to pylori bacteria in the stomach and nonsteroidal anti-inflammatory medications (NSAIDs) in 50% of patients. For the remaining 50% there are miscellaneous causes such as drugs, lifestyle factors (smoking), severe physiological stress, and genetic factors; or the cause is unknown.
  • Ulcer pain may not correlate with the presence or severity of ulceration.
  • The main symptom of a stomach or duodenal ulcer is upper abdominal pain which can be dull, sharp, or burning (a hunger-like feeling). (Bloating and burping are not symptoms of peptic ulcer, and vomiting, poor appetite, and nausea are uncommon symptoms of peptic ulcer.)



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