A peptic ulcer is a sore in the lining of the bowel in the stomach or the upper part of the small intestine (duodenum) which becomes inflamed when digestive acid and enzymes are produced to digest food. The ulcer causes pain and can be quite debilitating. The ways in which ulcerations form are better understood all the time. This continues to be an important area of research.
It is estimated 8 to 10 million people are infected with H. pylori. The proportion of people with this infection increases considerably with age. About 10-20% of infected adults will develop ulcers. In First Nation communities, approximately 75% of the people are infected. H. pylori infection is considered to be a carcinogen by the World Health Organization (WHO) as it is associated with the development of stomach cancer.
For many years it was thought that stress or certain foods caused ulcers. It is now known that most ulcers are caused by a bacterium called Helicobacter pylori (H. pylori) that infects the stomach and duodenum and results in inflammation, pain and the actual ulcer. The initial infection usually first occurs in childhood, although an ulcer may not develop for many years. The second most common cause of an ulcer can be aspirin or non-steroidal anti-inflammatory drugs (NSAIDs).
Symptoms are not always the same for everyone who has a peptic ulcer. Some of the various symptoms are:
If you are experiencing the symptoms above, you may have an ulcer and should consult with your physician.
Safe and effective tests are available to help your physician diagnose whether or not you have an ulcer. These include:
There are several tests available to determine if you have H. pylori infection.
Acid-suppressing drugs can heal ulcers, however, if H. pylori is still present, the pain and risks associated with ulcers will come back. Therefore, the best treatment must involve getting rid of the infection as well.
An effective vaccine to prevent H. pylori infection in humans is not available. Researchers are actively working on the development of such a vaccine.
In the past, the recommended treatment involved a combination of two antibiotics and an acid-suppressing drug, called a proton-pump inhibitor (PPI), to be taken for ten days. However, over the years, H. pylori infections have become increasingly difficult to treat. As a result, new recommendations for treatment have recently been introduced which involved changes to the strength and length of time medication is to be taken. The new recommendations include the addition of a third antibiotic along with the PPI and that these are to be taken for 14 days. If you have been diagnosed with a peptic ulcer, ask your doctor about the new recommendations.
Can H. pylori infection be prevented?
No one knows for sure how H. pylori spreads, so prevention is difficult. There are currently no human vaccines available to protect against H. pylori infections.
Do ulcers come back?
Taking an ulcer medication can heal the ulcer but if the bacteria are still present, the ulcer will most likely come back. If an ulcer is caused by medication, then stopping the medication can prevent ulcer recurrences. There is a group of patients who may have ulcers unrelated to H. Pylori or drugs and these ulcers may recur spontaneously.
I have heard that H. Pylori can cause cancer. Is this true?
H. pylori infection is considered to be a carcinogen by the World Health Organization as it is associated with the development of stomach cancer. Medications for treating H. pylori are 80 — 90% effective.
What are the complications of ulcers?
There are three main complications that can result from peptic ulcers:
Click on the buttons on the body to the left or click from the list below where you are experiencing discomfort.