Peptic ulcers

A peptic ulcer is a sore in the lining of the stomach or duodenum. The duodenum is the first part of the small intestine. This type of sore can develop when there is an excessive production of stomach acid, or when the protective mucous layer that coats the stomach and duodenum is weakened.

Symptoms

While some individuals with active peptic ulcers have no symptoms, others may have symptoms, such as:

  • Pain, a burning sensation or discomfort in the abdomen;
  • Increased appetite or loss of appetite;
  • Belching and a feeling of fullness or bloating after eating;
  • Nausea and more rarely vomiting.

Causes

The most common causes of peptic ulcers are:

  • Helicobacter pylori, also known as H. pylori, a bacterium that is found in the vast majority of individuals with peptic ulcers. It survives in stomach acid and burrows deep into the mucus lining of the stomach;
  • Certain medications such as non-steroidal anti-inflammatories (e.g., ibuprofen (Advil® or Motrin®) and aspirin).

Certain lifestyle habits and other factors may increase one's chances of developing ulcers or hinder treatment. These include:

  • Smoking
  • Drinking alcohol
  • Eating foods that irritate the stomach
  • Stress
  • Genetic predisposition

Treatment

If H. pylori is present, treatment usually consists of 3 or 4 medications, including antibiotics. Successful H. pylori eradication will prevent ulcer recurrences.

When the bacterium is not responsible for the infection, an acid-reducing treatment lasting a few weeks will allow the ulcer to heal. Depending on the strength of the medication and the location of the ulcer, treatment can last between 4 and 12 weeks. If treatment is discontinued as soon as the patient feels well (after a few days), the pain will return as soon as the effect of the medication wears off.

Avoiding irritants such as anti-inflammatories, smoking, alcohol, caffeine (coffee, tea, cola), acidic juices (tomato and grapefruit juice), spicy foods, fatty foods and large meals is also advised.

Lastly, contrary to popular belief, drinking milk does not relieve ulcer-related pain. In fact, it may worsen the pain as it stimulates acid secretion in the stomach.

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