Ulcers

What are Ulcers?


Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain. Peptic ulcers include:


  • Gastric ulcers that occur on the inside of the stomach

  • Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum)

Achalasia

Symptoms


  • Burning stomach pain

  • Feeling of fullness, bloating or belching

  • Intolerance to fatty foods

  • Heartburn

  • Nausea


The common peptic ulcer symptom is burning stomach pain where stomach acid makes the pain worse. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night.


Many people with peptic ulcers don't even have symptoms. Less often, ulcers may cause severe signs or symptoms such as:


  • Vomiting or vomiting blood — which may appear red or black

  • Dark blood in stools, or stools that are black or tarry

  • Trouble breathing

  • Feeling faint

  • Nausea or vomiting

  • Unexplained weight loss

  • Appetite changes


Causes


The most common causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve). Stress and spicy foods do not cause peptic ulcers, however, they can make the symptoms worse.


Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the stomach or small intestine creating a painful open sore that may bleed. Your digestive tract is normally coated with a mucous layer that protects against acid. If the amount of acid is increased or the amount of mucus is decreased, you could develop an ulcer.


Common causes include:


  • Bacterium. Helicobacter pylori bacteria commonly live in the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, the H. pylori bacterium causes no problems, but it can cause inflammation of the stomach's inner layer, producing an ulcer.

  • Regular use of certain pain relievers. Taking aspirin, as well as certain over-the-counter and prescription pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs) , can irritate or inflame the lining of your stomach and small intestine. These medications include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox DS, others), ketoprofen and others. They do not include acetaminophen (Tylenol, others).

  • Medications. Taking certain other medications along with NSAIDs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax) and risedronate (Actonel), can greatly increase the chance of developing ulcers.


Risk factors


In addition to having risks related to taking NSAIDs, you may have an increased risk of peptic ulcers if you:


  • Smoke. Smoking may increase the risk of peptic ulcers in people who are infected with H. pylori.

  • Drink alcohol. Alcohol can irritate and erode the mucous lining of your stomach, and it increases the amount of stomach acid that's produced.

  • Have untreated stress.

  • Eat spicy foods.


Alone, these factors do not cause ulcers, but they can make ulcers worse and more difficult to heal.


Complications


Left untreated, peptic ulcers can result in:


  • Internal bleeding

  • A hole in your stomach wall

  • Obstruction

  • Gastric cancer


Prevention


You may reduce your risk of peptic ulcer if you follow the same strategies recommended as home remedies to treat ulcers. It also may be helpful to:


  • Protect yourself from infections. It's not clear just how H. pylori spreads, but there's some evidence that it could be transmitted from person to person or through food and water.

  • You can take steps to protect yourself from infections, such as H. pylori, by frequently washing your hands with soap and water and by eating foods that have been cooked completely.

  • Use caution with pain relievers. If you regularly use pain relievers that increase your risk of peptic ulcer, take steps to reduce your risk of stomach problems. For instance, take your medication with meals.