What is a Peptic Ulcer
A peptic ulcer 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 excites more of an inflammatory reaction from the tissues that are eroded.
Peptic Ulcer Symptoms
Symptoms of ulcer disease are variable. Many ulcer patients experience minimal indigestion, abdominal discomfort that occurs after meals, or no discomfort at all. Some complain of upper abdominal burning or hunger pain one to three hours after meals or in the middle of the night.
These symptoms often are promptly relieved by food or antacids that neutralize stomach acid. The pain of ulcer disease correlates poorly with the presence or severity of active ulceration.
Some patients have persistent pain even after an ulcer is almost completely healed by medication. Others experience no pain at all. Ulcers often come and go spontaneously without the individual ever knowing that they are present unless a serious complication (like bleeding or perforation) occurs.
Causes
For many years, excess acid was believed to be the major cause of ulcer disease. Accordingly, the emphasis of treatment was on neutralizing and inhibiting the secretion of stomach acid. While acid is still considered necessary for the formation of ulcers, the two most important initiating causes of ulcers are infection of the stomach by a bacterium called
"Helicobacter pyloricus" and chronic use of anti-inflammatory medications, commonly referred to as NSAIDs (nonsteroidal anti-inflammatory drugs), including aspirin. Cigarette smoking also is an important cause of ulcer formation as well as failure of ulcer treatment.
Treatment
The goal of ulcer treatment is to relieve pain, heal the ulcer, and prevent complications. The first step in treatment involves the reduction of risk factors (NSAIDs and cigarettes). The next step is medications.