Peptic Ulcers

What are Peptic Ulcers?

An ulcer is an open sore that forms when the lining of the gut is corroded by acidic digestive juices. Peptic ulcers can form in the lining of the stomach (gastric ulcers), duodenum (the first part of the small bowel or intestine) or the esophagus (gullet or swallowing tube). Peptic ulcers are quite common; it is known that 5-10% of the world’s population suffer from peptic ulcers at least once.

How do you get Peptic Ulcers?

While stomach acid plays a significant role in the development of ulcers, other factors may be involved, including infection with a bacterium called Helicobacter pylori and the long-term use of certain anti-inflammatory (pain killing) medicines. These act by irritating or damaging the lining of the stomach.

How serious are Peptic Ulcers?

Symptoms of an ulcer are variable, but may include upper abdominal burning or hunger pain 1-3 hours after meals and in the middle of the night. In some cases, serious complications can occur like bleeding or perforation (erosion of the ulcer right through the gut wall). Most ulcers are effectively healed with treatment.

How long do Peptic Ulcers last?

Persistent pain lasts for 4 weeks or more, but dyspepsia, the main symptom, comes and goes for months at a time. Many people therefore don’t seek medical advice and tend to use retail medicines from the chemist shop, like antacids, rather than seek the benefit of other medicines from the doctor.

How are Peptic Ulcers treated?

Most ulcers are effectively healed with treatment. Treatments for ulcers include: 

• Antacids to neutralise existing acid in the stomach.
  
  
• Acid suppressants like histamine2-receptor antagonists (blockers). Histamine is a chemical released in the body under many different conditions. In the stomach it can release more acid, so blocking its action reduces acid production. 
  
  
• Medicines called proton pump inhibitors also work on the cells in the stomach to reduce the production of acid. 
  
  
• These treatments are used in combination with antibiotics if Helicobacter pylori infection is involved, which is in more than 90% of cases. It should be noted that some patients have Helicobacter pylori without peptic ulceration.

There is no conclusive evidence that dietary restriction and bland diets play a role in ulcer healing. No proven relationship exists between ulcers and the intake of coffee and alcohol. However, as coffee stimulates acid secretion, and alcohol can cause inflammation of the stomach lining (gastritis), moderation in alcohol and coffee consumption is often recommended for patients with ulcers. 

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