Peptic Ulcers

What is a peptic ulcer?

It is a sensitive raw patch, like a mouth ulcer but larger, which forms a break in the lining of the stomach, gastric ulcer or duodenum, duodenal ulcer.

How is an ulcer formed?

Ulcers occur when the normal defence mechanisms of the stomach or duodenal lining fail, allowing hydrochloric acid and other digestive juices to “eat” away at the lining.

A very important cause of developing an ulcer is a bacterium called Helicobacter pylori. This is commonly found in the stomach lining of some people, and it is now certain that having this germ makes development of ulcers more likely. Almost all patients with duodenal ulcers and most with gastric ulcers, have Helicobacter present.

Medical research is actively investigating why only some people who are infected get ulcers.

Another important cause of ulcers is the group of drugs used in the treatment of pain, particularly arthritis and rheumatism, called Non-Steroidal Anti-Inflammatory drugs, NSAIDs. Aspirin is one of this group.

Stress probably does not cause ulcers, but does worsen symptoms if an ulcer is present.

How is an ulcer diagnosed?

A gastroscopy is performed to examine the lining of the oesophagus (gullet), stomach and duodenum. Tissue samples, biopsies, are also taken and tested for Helicobacter pylori.

What can be done for an ulcer?

The aim of the treatment is to:

• Eradicate Helicobacter pylori infection when present. Combinations of drugs including antibiotics are used in a comprehensive course.
• Reduce stomach acid to allow healing of the stomach and duodenal lining. Drugs do this by inhibiting the cells which produce the gastric acid.
• Most ulcers heal in 4-8 weeks but they are very likely to come back in the future unless H.pylori infection is successfully treated.
• The single most important factor in eradication of H. pylori is patient compliance in taking the drugs.

What are the side effects?

Generally ulcer drugs have few side effects. Some antacids may cause constipation, others may cause diarrhoea. Antibiotic treatment may cause mild stomach upsets. They are usually given for 1 week.

How can ulcers be avoided?

Don’t smoke — it slows healing of the ulcers and of course is a health risk.

Avoid aspirin or NSAIDs

Eg: Voltarol — use paracetamol instead. These drugs prevent the formation of protective substances in the stomach lining and can cause ulcers to bleed.

Patients who have to take aspirin or NSAIDs regularly eg: for arthritis should discuss with their doctor how to minimise the effects on their stomach and duodenum.

For further information:
www.corecharity.org.uk

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