Patient Information Fact Sheet – Peptic UlcerWhat is a peptic ulcer?
A peptic ulcer is a sensitive, raw patch, very much like a mouth ulcer, which forms a break in the lining of the stomach or the duodenum. Gastric ulcers occur in the stomach and duodenal ulcers occur in the duodenum, the first part of the intestine after the stomach.
How is an ulcer formed?
The stomach produces hydrochloric acid and pepsin, which together start the digestion of food. In theory, these two substances could digest the lining of the stomach or duodenum just as they do the food, but several defense mechanisms protect the lining from such attack. Ulcers occur when the acid and pepsin break the defenses and “eat” away at the lining of the stomach and duodenum. The involvement of pepsin has led to the general description of ulcers as “peptic.” It is often thought that people with ulcers are making too much acid and pepsin. However, for the majority of sufferers this is not so and the amount of acid produced tends to get less with age.
A very important cause of developing an ulcer is a germ or bacterium called Helicobacter pylori, known as H. pylori. This is found in the lining of the stomach of at least half of the world’s population, and it is now certain that having this germ present makes developing ulcers much more likely. Patients with duodenal ulcers almost always have this germ present and at least 80% of gastric ulcer patients also have it. Researchers are actively investigating why it is that only some people who are infected with the germ get ulcers.
Who gets an ulcer?
Ulcers are very common and men are more prone to suffer than women. About one in 10 men and one in 15 women suffer from an ulcer at some time in their lives, but in most people they heal with treatment. People who have H. pylori present in the lining of their stomach are far more likely to develop further ulcers and so it is important that they receive treatment to clear this infection. This can usually be done by using a combination of medications, including antibiotics. Ulcers are rare in children and are more likely to occur as people get older. Sometimes peptic ulcers tend to run in families.
Another important cause of ulcers is the group of drugs used in the treatment of pain, particularly arthritis and rheumatism, called the non-steroidal anti-inflammatory drugs (NSAIDs). Aspirin and ibuprofen are in this group of common medication.
People throughout the world suffer from ulcers, but they are most common in Europe, North America, Southern India and Bangladesh.
What are the symptoms of a peptic ulcer?
The primary symptom is severe pain in the abdomen that is:
- usually felt at the top of the stomach, centrally between the ribs and sometimes going through to the back
- often burning in quality
- often eased by eating, only to recur once the food leaves the stomach
- often worse at night (in duodenal ulcer patients and may wake them up)
- sometimes accompanied by vomiting.