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Understanding Ulcers

What Are Ulcers?

There is no clear evidence to suggest that the stress of modern life or a steady diet of fast food causes ulcers in the stomach and small intestine, but they are nonetheless common in our society: About one out of every 10 Americans will suffer from the burning, gnawing abdominal pain of a peptic (or gastric) ulcer at some point in life.

Peptic ulcers are holes or breaks in the protective lining of the duodenum (the upper part of the small intestine) or the stomach -- areas that come into contact with stomach acids and enzymes. Duodenal ulcers are more common than stomach ulcers. Comparatively rare are esophageal ulcers, which form in the esophagus -- or swallowing tube -- and are often a result of alcohol abuse.

Until the mid-1980s, the conventional wisdom was that ulcers form as a result of stress, a genetic predisposition to excessive stomach acid secretion, and poor lifestyle habits (including overindulging in rich and fatty foods, alcohol, caffeine, and tobacco). It was believed that such influences contribute to a buildup of stomach acids that erode the protective lining of the stomach, duodenum, or esophagus.

While excessive stomach acid secretion certainly plays a role in the development of ulcers, a relatively recent theory holds that bacterial infection is the primary cause of peptic ulcers. Indeed, research conducted since the mid-1980s has persuasively demonstrated that the bacterium Helicobacter pylori (H. pylori) is present in more than 90% of duodenal ulcers and about 80% of stomach ulcers.

Other factors also seem to contribute to ulcer formation. Overuse of over-the-counter painkillers (such as aspirin, ibuprofen, and naproxen), heavy alcohol use, and smoking exacerbate and may promote the development of ulcers. Research indicates that heavy smokers are more prone to developing duodenal ulcers than are nonsmokers, that people who drink alcohol are more susceptible to esophageal ulcers, and that those who take aspirin frequently for a long period of time are more likely to develop stomach ulcers than those who don't.

Other studies show that stomach ulcers are more likely to develop in older people. This may be because arthritis is prevalent in the elderly, and alleviating arthritis pain can mean taking daily doses of aspirin or ibuprofen. Another contributing factor may be that with advancing age the pylorus (the valve between the stomach and duodoneum) relaxes and allows excess bile (a compound produced in the liver to aid in digestion) to seep up into the stomach and erode the stomach lining.

Also, for no known reason, people with type A blood are more likely to develop cancerous stomach ulcers.

Duodenal ulcers tend to appear in people with type O blood, possibly because they do not produce the substance on the surface of blood cells that may protect the lining of the duodenum.

Fortunately, peptic ulcers are relatively easy to treat; in many cases they are cured with antibiotics, antacids, and other drugs that reduce the amount of acid produced by the stomach. There are also a variety of self-help and alternative treatments that can aid in relieving pain. Still, the dangers associated with peptic ulcers -- such as anemia, profuse bleeding, and stomach cancer -- are serious, so ulcers should always be monitored by your doctor.

WebMD Medical Reference

Reviewed by Varnada Karriem-Norwood, MD on March 12, 2014

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