U
Ulcers
Definition
An ulcer is any area of skin or mucous membrane
that erodes, causing the tissue to degenerate. In com-
mon use, ulcers refer to disorders such as these that
occur in the upper digestive tract. They may be called
gastric ulcers, peptic ulcers, or simply ulcers.
Description
Gastric ulcers refer to those that occur in the
lining of the stomach. Peptic ulcers also can develop
in the lower part of the esophagus, the stomach, the
first part of the small intestine (duodenum), and the
second part of the small intestine (jejunum).
Duodenal and gastric ulcers are the most common
types. About 80% of all ulcers occur in the digestive
tract and are called duodenal ulcers. Gastric ulcers
account for about 16% of peptic ulcers. While it was
once believed that stress and eating spicy foods caused
ulcers, it was later discovered that most ulcers are
caused by a bacterial infection. Some foods can aggra-
vate ulcer symptoms.
The body makes strong acids to digest food. A thin
lining protects the stomach and intestines from these
acids. But if something damages the lining, the acids
can reach the stomach and duodenal walls. Ulcers can
get larger and cause bleeding.
Demographics
One in 10 Americans will develop an ulcer at some
time in their lives. The American Gastroenterological
Association estimates that four million Americans have
peptic ulcer disease. Ulcers can occur at any age, but are
more common as people get older, particularly in peo-
ple over age 60. In fact, as many as one-half of people
over age 60 may have an ulcer. At least two-thirds of
ulcers are believed to be caused by bacteria and most of
the remaining ulcers are caused by use of non-steroidal
anti-inflammatory drugs (NSAIDS). Many people are
infected with the bacterium that causes ulcers although
ulcers may not actually develop from the bacterium.Causes and symptomsThe bacterium that causes peptic ulcers is called
Helicobacter pylori,orH. pylori. Although the discov-
ery thatH. pyloriwas the major cause of ulcers only
occurred in the 1990s, it is believed that the bacterium
has been around in humans’ digestive tracts for at least
60,000 years. The exact source ofH. pyloriand the way
in which it is transmitted from one person to another is
not known. Theories include transmission through
water, saliva, and person-to-person contact. Research-
ers also do not yet know why some people with the
infection develop ulcers while others do not. They
believe it may be due to characteristics of the infected
person, the type ofH. pylori, and other possible factors.
Use of NSAIDs is the second most common cause
of ulcers. These drugs include aspirin, ibuprofen, and
naproxen. Frequent and long-term use of these drugs
to reduce pain and inflammation may lead to ulcers, as
these drugs also weaken the lining of digestive walls.
Many older people use these drugs frequently to help
relieve pain and inflammation from arthritis, which
may help explain the higher number of older adults
with peptic ulcers.
The most common symptom of a peptic ulcer is a
burning sensation that occurs in the stomach between
the breastbone and belly button. Although the pain
can occur at any time, it often is worse between meals
when the stomach is more likely to be empty. The pain
often is described as a dull ache and it may be severe
enough to cause waking during the night. The pain
may last minutes or several hours and may come and
go. Sometimes, the pain goes away after eating.
Other symptoms of ulcers include a feeling of fullness
more quickly than normal during a meal, general loss of