An ulcer, which is a hole or sore in the tissue lining, can occur almost anywhere in the digestive tract, but is found most frequently in the duodenum, the small intestine. A duodenal ulcer is about 10 times more common than a gastric ulcer, an ulcer in the stomach. Together, they are medically known as peptic ulcers, which we generally refer to simply as ulcers.
How common is peptic ulcer?
About 6 percent of our population - over 14.8 million Americans - are diagnosed with peptic ulcers each year.
What causes ulcers?
Over 90% of duodenal ulcers and a large percentage of stomach ulcers are caused by Helicobacter pylori (H. pylori) bacterial infections or the long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and aspirin.
Normally, the lining of the stomach and duodenum is protected from the digestive juices in some manner that is not known. Ulcers occur in the duodenum when there is an excessive secretion of acid, which breaks down the resistance of the intestinal lining, or in the stomach when the lining is vulnerable to even normal amounts of acid and pepsin. Of these two factors, the first - excessive acid - is the one that lends itself more readily to medical treatment.
How does one know he has an ulcer?
Pain in the pit of the stomach is the most common symptom of an ulcer. Usually, the pain is not sharp but, rather, a gnawing or burning sensation, somewhat similar to a hunger pang. The cause of the pain is unclear, but may be caused by the corrosive action of acid and pepsin on the open sore in the empty stomach or duodenum. It is often relieved by eating or taking an antacid, which neutralizes the acid.
How are ulcers diagnosed?
An X-ray examination is made of the gastrointestinal tract, particularly the stomach and duodenum. If there is an ulcer, in 90 percent of the cases, it will show up on the X-ray film. Other tests of the blood, stool and gastric juices confirm the diagnosis. An alternative and more accurate method of diagnosis is endoscopy: the use of a flexible fiberoptic instrument to examine the stomach and duodenum.
If the disorder is in the stomach, further tests will be taken to make certain it isn't stomach cancer that often looks like a peptic ulcer on X-ray film. With endoscopy, the stomach can be entered and photographed and a sample can be taken of the affected area and tested for malignancy. About 6 to 20 percent of suspected stomach ulcers are actually malignancies and these must be treated by surgery.
How are ulcers treated?
The purpose of treatment is to facilitate the healing of the ulcer by reducing the amount of acid secreted by the stomach, clearing any bacterial infection, and stopping harsh pain medicine.
As for diet, patients usually benefit from small frequent feedings, such as six small-sized meals a day instead of the three full-sized meals. This keeps some food in the stomach throughout the day to absorb and neutralize acid.
Alcohol, caffeinated drinks such as coffee, tea and cola that are potent stimulants of acid secretion, and aspirin, should be avoided. There are recent studies that show that smoking increases the time of healing in gastric ulcer, and that there is an increased incidence of duodenal ulcer in smokers regardless of alcohol and coffee ingestion.
Aren't there any other dietary restrictions?
Eating a bland, soothing diet is helpful. Avoid alcohol, caffeine, smoking and spicy foods.
Note: The materials presented in this section are for general information and do not substitute for medical advice. Patients have the right to receive accurate, easily understood information about their health plans, professionals, and facilities, and to a choice of health care providers sufficient to ensure access to appropriate high-quality health care.