Conditions InDepth: Peptic Ulcer Disease
Peptic ulcers are eroded areas in the stomach (gastric ulcers) or first part of the intestine (duodenal ulcers). Ulcers occur in areas where the lining of the stomach or intestine is worn away and irritated, causing pain or bleeding.
Normally, a mucous coating protects the lining of the stomach and the intestine. This coating can be disrupted by a bacterial infection from Helicobacter pylori ( H. pylori ) or by irritating medicines (such as nonsteroidal anti-inflammatory medicines). When this mucous coat is disrupted, strong digestive juices can erode the lining underneath it. This causes the ulcer.
Lifestyle factors (such as diet and stress) were once thought to be wholly responsible for causing ulcers. They are now known to worsen ulcer conditions, but not to actually cause the erosion. The vast majority of ulcers are due to H. pylori infection or NSAID use.
In addition to creating discomfort, ulcers are serious because they can cause:
- Perforation : If an ulcer eats through the entire wall of your stomach or intestine, it is called a perforated ulcer. This is a very serious and potentially life-threatening condition, since the hole allows the contents of your stomach and intestine to leak out into the abdominal cavity.
- Obstruction : Scarring from ulcers can block flow through the stomach and/or duodenum. This can cause repeated vomiting, weight loss, and intense pain.
- Gastric Cancer : People who have had peptic ulcers have a much higher rate of stomach cancer than others. H. pylori is almost certainly a cause of stomach cancer and may account for the excess risk associated with peptic ulcer disease.
Many more people are infected with H. pylori than ever develop an ulcer. Researchers are still trying to understand why some people infected with this kind of bacteria develop ulcers and others don’t. Researchers are also trying to learn how people become infected with H. pylori. It may be passed in food or water. It also seems to live in the saliva of infected people, allowing the bacteria to be passed through kissing, for example.
American College of Gastroenterology website. Available at: http://www.acg.gi.org/ . Accessed March 3, 2006.
Cecil RL, Goldman L, Bennett JC. Cecil Textbook of Medicine . 21st ed. Philadelphia, PA: WB Saunders Company; 2000.
Meurer LN, Bower DJ. Management of helicobacter pylori infection. Am Fam Physician [online]. Apr 2002;65(7). Available at: http://www.aafp.org/afp/20020401/1327.html.
National Digestive Diseases Information Clearinghouse website. Available at:. http://digestive.niddk.nih.gov/ . Accessed March 3, 2006.
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