An
ulcer is an erosion (open sore) on the surface of an organ or tissue.
Ulcers most commonly erupt in the esophagus, stomach, and duodenum,
in which case they are known as peptic ulcers. About five million
Americans have peptic ulcers.
Causes
The
problem begins, in most cases, with a spiral-shaped germ that seems
to live for one purpose, digging holes in our stomachs. This
bacterium, known as Helicobacter pylori (H. Pylori for short), is
very common: It's found in about half of all people under 60 years
old in the United States. H. Pylori never causes problems in most
people, but in an unlucky minority, the bug burrows through the
stomach's protective mucous coating. The bacteria and stomach acid
irritate the sensitive lining beneath, causing ulcers to form.
In
some cases, H. Pylori isn't the villain, however. People who use
nonsteroidal anti-inflammatory drugs (NSAIDs) and aspirin for pain
relief over long periods can develop ulcers.
Heredity
also plays an important role in contributing to ulcers. People who
have a family history of ulcers seem to have a greater likelihood of
acquiring the condition, as do people with type O blood. In addition,
liver disease, rheumatoid arthritis, and emphysema are among the
conditions that may increase vulnerability to ulcers. Stomach and
pancreatic cancers also can cause these sores to form.
Symptoms
Users
can produce mild symptoms resembling heartburn or severe pain
radiating throughout the upper portion of the body. The most common
discomfort of ulcers is a burning sensation in the abdomen above the
navel that may feel like hunger pangs. Pain comes about 30 to 120
minutes after eating or in the middle of the night when the stomach
is empty. At this time, the acidic stomach juices are more apt to
irritate the unprotected nerve endings in the exposed ulcer. Usually,
pain subsides after eating or drinking something or taking an antacid
to neutralize stomach acid.
Some
people experience nausea, vomiting, and constipation. Blood in the
feces (discoloring them black), blood in the vomit, extreme weakness,
fainting, and excessive thirst are all signs of internal bleeding and
may appear in more advanced cases.
Although
ulcers are not usually life-threatening, they can cause serious
damage if left untreated. Ulcers may erode nearby blood vessels and
cause internal seepage of blood or hemorrhage (massive internal
bleeding). A perforated ulcer may penetrate an adjoining organ,
causing infection.
Diagnosis
Physicians
diagnose peptic ulcers primarily on the basis of an X-ray examination
after the patient has swallowed a special chalky substance called
barium. The barium makes the digestive tract visible on X-ray film,
allowing the doctor to view any abnormalities.
A
second diagnostic technique is called an upper GI endoscopy (also
called gastroscopy). The doctor inserts an endoscope (a flexible,
lighted, tubelike instrument) through the mouth and down the
esophagus to directly view the lining of the esophagus, stomach, and
duodenum. An endoscopic examination and a biopsy (removal of a tissue
sample for analysis) are necessary to confirm that an apparent ulcer
is not actually a cancerous growth. Helicobacter pylori can be
diagnosed with endoscopic biopsy or through a blood or breath test.
Treatment
Most
ulcers caused by H. Pylori can be cured with a combination of
antibiotics and acid-blocking drugs or bismuth subsalicylate (better
known as Pepto Bismol). Unfortunately, even though this information
has been widely disseminated in medical journals, some doctors still
send ulcer patients home with little more than orders to take it
easy, knock off the booze, and eat a bland diet. If you have
an ulcer-like symptoms, ask your doctor to perform tests that can
determine whether you have the H. Pylori bug, so that if prescription
medications are appropriate for your condition, you get them.
Treatment
of ulcers involves relieving the irritation, so that healing is able
to progress naturally. Antacids counteract stomach acid and relieve
symptoms, but they can also cause complications. For example, sodium
bicarbonate, a primary antacid ingredient, contains large amounts of
sodium, which can aggravate kidney disease or high blood pressure.
For
treatment of more problematic ulcers, a physician may prescribe other
preparations to promote healing. Sucralfate coats the stomach,
protecting it against gastric acid. Cimetidine, ranitidine, and other
H2 blockers inhibit gastric acid production. Antibiotics and antacids
are often prescribed to treat ulcers caused by infection with H.
Pylori.
Although
recent studies have shown that a bland diet is not necessary for
user management, such a diet is sometimes recommended until the
acute symptoms disappear. Thereafter, many doctors suggest avoiding
only those foods known to cause stomach distress.
Most
ulcers heal within two to six weeks after treatment begins. To
prevent recurrence, patients should continue to avoid cigarettes,
alcohol, and any foods or substances that appear to cause irritation
of the digestive tract lining.
When
drug therapy and diet cannot cure an ulcer, surgical repair may be
necessary. Surgery is appropriate for ulcers that recur or are
life-threatening, such as perforated ulcers. Sometimes, surgeons
remove a portion of the stomach and parts of the vagus nerve (which
controls digestive secretions) to reduce stomach acid production.
Usually, ulcers do not reappear after surgery.
Recently,
endoscopic cautery (burning of tissue through an endoscope), direct
injection of medications, and lasers have been quite successful in
stopping bleeding, reducing the size of lesions, and correcting
strictures (narrowing of the ducts due to scar formation). These
procedures have spared many individuals from surgery.
Once
they leave the doctor's office, ulcer patients can help their
condition by watching their diet. Check out the next section for home
remedies to take care of your digestive tract.
For
more information on ulcer-causing stress and its harmful effects,
visit the following:
To
see all of our home remedies and the conditions they treat, go to our
main Home Remedies page.
Among
the many digestive problems that herbal remedies can relieve, herbs
can also go a long way toward healing gastric ulcers. Find out how in
Herbal Remedies for Ulcers.
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