What causes stomach ulcers? That’s a familiar question when it comes to discussing about ‘peptic’ (a Latin and ancient Greek vocabulary) that refers to the ‘digestive system’. There are several answers since many times the problem is a consequence of more than one factor.
First off, what are actually ulcers in the stomach?
anatomy of your healthy stomach is naturally coated in a tough layer of mucus.
This sticky mucus layer plays a key role for lots of things, including for
protection. It is responsible to protect the lining (soft tissue) of the
mucus is crucial part of the balance system to keep the stomach lining healthy
in long term. For example, it’s important to protect the soft lining during
digestion, including from foreign pathogens and stomach acid that breaks down
something goes awry with the balance, — let’s say when the mucous layer loses
its ability to protect the lining of stomach or when you end up with a lot of
stomach acid (higher than normal) –, your stomach is likely to digest itself,
resulting in an open sore called ulcer.
that forms in the stomach is called ‘gastric or stomach ulcer’. It also can
affect soft-lining tissues in the upper portion of small intestine, in such
case the condition is called ‘duodenal ulcer’. Both types belong to a group of open sores
affecting digestive tract known as peptic
of gastric ulcer can vary, depending on how severe it is. When it occurs for
the first time, the size is usually very tiny. But over time it may get worse
and become larger in size (could be over an inch long).
diagnosis is important to treat the disease more effectively so the patient can
have a complete recovery with no lingering after effects.
many people with the disease may not seek medical help until the symptoms
become quite advanced. Even about three-quarters of all cases, there is no early
warning sign of the disease.
open sore is small, there is usually no symptom. As the disease progresses, a
number of discomforts and symptoms will occur. They may vary greatly from
person to person. But the most common one is a burning pain in the upper
usually gets worse with empty stomach (when your stomach acid is high) and will
relieve for a while when you take antacids. Other symptoms may include heartburn,
bloating, feeling of fullness, belching, and indigestion
common cases, the disease may also cause severe symptoms such as changes in
appetite (appetite loss), trouble breathing, weight loss with unknown reason,
dark blood (tarry) in the stools, feeling faint, or even vomiting blood .
How serious is the problem?
ulcer complications are rare – but if they occur, they could be very dangerous.
These include; internal bleeding, perforation (a dangerous condition in which the
ulcer causes a hole through the stomach wall), and swelling that can be large
enough to block the passage of food through the stomach.
ulcer is more likely to occur if an ulcer develops at the site of a blood
vessel. And when it carves into a blood vessel in the stomach, this triggers
bleeding which may occur rapidly (acute) or slowly (long-term bleeding). This
bleeding could be fatal (life-threatening) so it requires immediate treatment or
(if necessary) surgical intervention.
bleeding may develop in the following ways:
chronic long-term bleeding. It can cause anemia (a condition of when the body
is at a low red blood cell count (lower than normal) due to inadequate iron).
Sometimes patients may not notice this slowly bleeding until they become
bleeding that progresses rapidly. This kind of heavily bleeding is rare, but it
is very dangerous if not immediately treated.
bleeding that continues without medical intervention could be very dangerous.
Losing about one-third of the total blood could be enough to cause serious
consequences such as the failure of some organs – or even a death if you lose
one-half of your total blood .
complications are preventable. With prompt treatment, the disease can be cured
– especially if it hasn’t become advanced.
So, what causes stomach ulcers?
For many years, it’s was thought that
excessive acid is to blame for the cause of stomach ulcer. But today we know
that most cases of peptic ulcer are not caused by acid damage, though excess
acid can worsen the open sore.
In fact, the disease is often caused by the
following two main factors :
it on Helicobacter pylori, a kind of
bacteria that commonly live in the stomach and small intestine. Though not all
people with H-pylori infection develop ulcers, it’s common to find this
bacterial infection in many patients with peptic ulcers.
use of pain relievers especially NSAIDs. Those medicines can hurt the lining of
the stomach and small intestine, leading to an open sore in long term.
probably not fully understood yet why bacterial infection caused by Helicobacter
pylori is the leading cause of peptic ulcers – about 60-70% in stomach ulcers
and over 90% for duodenal ulcers.
half of all people at the age of 60 have been infected. Interestingly, the vast
majority of people with this bug remain healthy (they don’t have symptoms of
peptic ulcer disease). Only a small percentage (for unknown reason) develops
the disease .
know that the bacteria can inflame the stomach and small intestine’s walls. And
this may make ulcers more likely!
the bacteria that live close to the stomach’s surface lining may stimulate more
acid secretion. As a result, excessive amount of stomach acid would provoke
causes H. pylori in your
stomach? The exact answer is not known. But in general, the infection is likely
to occur in areas of overcrowding and poor sanitation. It may also spread
through close contacts (e.g. tainted foods or kissing).
Medicines that cause ulcers in the stomach
pylori infection, blame it on certain medicines that provoke inflammation in
your stomach lining.
say pain killers – the most popular ones include ibuprofen, aspirin, naproxen
sodium, or ketoprofen – these NSAIDs (non-steroidal anti-inflammatory drugs) could
be tough on your digestive system. They can set the stage for a peptic ulcer
either in the stomach or small intestines .
risk is particularly true when you take the medicines for long-term use. The
same goes for other medicines such as blood thinners, steroids, and some drugs
for treating osteoporosis since they may also provoke inflammation in the
stomach lining (especially when you take them along with NSAIDs).
effects of these medicines also vary from person to person. Some people could
be more sensitive than others. Not everyone is at risk of developing side
effects (including ulcers) of NSAIDs.
safe, discuss with your doctor if you’re in doubt on any medicines you’re
taking. If necessary, your doctor may prescribe extra therapy (proton pump
inhibitor for example) to help control your stomach acid level or prescribe the
medicines at lowest dose possible.
of developing ulcer in the stomach may also increases with the following risk
Age factor — as with most health
conditions, the risk for stomach ulcer increases with age! In other words, it’s
likely to form later in life (most commonly over age 60 or 70).
How about gender? Yap, it also have an effect but
not significant. Women are likely to develop the disease than men. The story is
different for duodenal ulcers, because it affects more men than women .
A personal history of stomach ulcer! If you have had the disease
before, you’re likely to have it for the second time. So it’s important to
follow treatment plan completely so the risk of recurrence can be minimized.
Lifestyle factors! These include cigarette smoking,
stress, and poor diet.
smoke is bad for lots things in your body, including the digestive system. It
has toxins which some may hurt your stomach lining. It also puts you at high
risk of getting H. pylori infection. In fact, active smokers are likely to get
peptic ulcers if compared to non-smokers .
perceived everyday life stress has an effect, too. Although now we know that
stress is not the main underlying cause of stomach ulcer, it’s still to blame
to increase the risk or make the disease get worse during treatment.
having painful disease such as stomach ulcer would increase your stress tension
or even make you depressed. But though stress is inevitable, it’s manageable!
about your diet? Diet is probably not the main underlying cause, but it can
increase the risk of the disease.
stomach is a crucial organ to digest foods. So it’s always worthwhile to pay
attention on what you eat. If you think you’re at high risk of developing
stomach ulcer, here are a few common culprits to restrict in your diet:
Milk, including dairy products
Milk can drive more acid production in your stomach. Even if you’re not lactose intolerance, it’s much better to consume milk and dairy products in moderation. This idea is also good for your weight control!
Like smoking, alcohol can also irritate your stomach lining, especially when you drink excessively. Even drinking a little may make your stomach secrete more acid than usual.
Overload dietary fiber
While fiber is a good way to help keep your digestive system work in balance, overload fiber in the stomach could be counterproductive. Too many fibers may result in increased amount of stomach acid. Again, the key is a healthy balanced diet (eat them in moderation).
Also, avoid or restrict such things as:
Large meals (overeating).
Eating late at night, including late night snack. Finish eating at least 2-3 hours before bedtime.
A long gap between meals. Eat you meals regularly! Letting the stomach go empty without any foods for long periods of time can significantly raise your stomach acid.
about prognosis and outlook of the disease? Ulcer in the stomach usually will
go away without leaving serious problems – though in a few cases it may fail to
prompt treatment, stomach ulcer will heal within several weeks (for more
information about how long it takes to heal completely, see more here).
be careful, it may return months or years afterwards if you don’t reduce your
risk of having the recurrence such as cigarette smoking and overuse of
painkillers (especially NSAIDs). And if you drink, do it in moderation (limit
it to 2 drinks a day, or no more than 1 drink a day for women)!
protect yourself from H-pylori infection. Although the way of how H-pylori
bacterium spreads is not fully understood, it’s always worth a try to maintain
personal hygiene such as frequently washing your hands (especially after going
to the toilet) and cook your foods properly! For examples – poultry, pork,
burgers, kebabs, offal, and sausages must be cooked thoroughly.
for stomach ulcer are now much better than before. Surgery is rarely used,
typically only suggested when serious complications of the disease (such as
perforation) have occurred.
there is also a chance for the open sore fails to heal. Stomach ulcer that
fails to heal after treatment is also called as refractory ulcer. This may occur due to the following reasons: