Health Basics

WHAT IS ULCER?
Ulcers are sores on the lining of your stomach or small intestine which is called Peptic 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. Sores also could be on your esophagus (throat). Ulcers in the throat are called esophageal ulcers.

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). Most ulcers are located in the small intestine.
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 your symptoms worse.
Symptoms of an ulcer
Common ulcer symptoms include:
• Discomfort between meals or during the night (duodenal ulcer)
• Discomfort when you eat or drink (gastric ulcer)
• Stomach pain that wakes you up at night
• Feel full fast
• Bloating, burning or dull pain in your stomach
• Comes and goes days or weeks at a time
• The discomfort lasts for minutes or hours
• Intolerance of Fatty food.
• Heartburn
If your ulcer becomes perforated (torn), it becomes a bleeding ulcer. This can cause the following symptoms:
• Nausea
• Vomiting blood
• Unexpected weight loss
• Blood in your stool or dark stools
• Pain in your back
• Unexplained weight loss
• Feeling faint

What causes Ulcer?
Most ulcers are cause by Heliocobacter pylori (H. pylori). This is a bacterial infection. Acids from the foods we eat can make the pain and discomfort worse. Long-term use of aspirin or anti-inflammatory medicines (ibuprofen) are also a common cause of ulcers. Stress and spicy foods can make an ulcer worse. Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the stomach or small intestine.
The acid can create a painful open sore that may bleed. Your digestive tract is coated with a mucous layer that normally protects against acid. But if the amount of acid is increased or the amount of mucus is decreased, you could develop an ulcer.
Common causes include:
• A 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.
It's not clear how H. pylori infection spreads. It may be transmitted from person to person by close contact, such as kissing. People may also contract H. pylori through food and water.
• 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).
• Other 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: Bleeding can occur as slow blood loss that leads to anemia or as severe blood loss that may require hospitalization or a blood transfusion. Severe blood loss may cause black or bloody vomit or black or bloody stools.
• A hole (perforation) in your stomach wall: Peptic ulcers can eat a hole through (perforate) the wall of your stomach or small intestine, putting you at risk of serious infection of your abdominal cavity (peritonitis).
• Obstruction: Peptic ulcers can block passage of food through the digestive tract, causing you to become full easily, to vomit and to lose weight either through swelling from inflammation or through scarring.
• Gastric cancer: Studies have shown that people infected with H. pylori have an increased risk of 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.
Work with your doctor to find the lowest dose possible that still gives you pain relief. Avoid drinking alcohol when taking your medication, since the two can combine to increase your risk of stomach upset.

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