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Digestive System

What causes ulcers?

The causes of ulcers are :

  • Helicobacter pylori
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Smoking
  • Stress
  • Chronic liver disease
  • Zollinger-Ellison syndrome
  • Genetic factors
  • Excessive alcohol use
  • Close contact with infected persons

What is a peptic ulcer?

What causes ulcers

A peptic ulcer is an ulcer formation in the upper GI tract that affects the lining of the stomach which is a “gastric ulcer”, duodenum which is a “duodenal ulcer”, or the lower part of the esophagus.

Around 4% of the population has pectic ulcers.

Internal bleeding, blockage of the stomach, and perforation are the complications of peptic ulcer disease. Bleeding occurs in as many as 15% of people with the condition.

What are the types of peptic ulcers?

There are three types of ulcers they include:

  1. Gastric ulcer: the ulcer that occurs on the inside of the stomach
  2. Esophagus ulcer: the ulcer that develops inside the esophagus
  3. Duodenal ulcer: the ulcer that occurs in the upper and first part of the small intestine, known as the duodenum.

What causes ulcers?

A peptic ulcer occurs when the inner surface of the digestive tract is eroded by the acidic juice that the cell of the stomach lining secrets.

Our digestive tract is coated with a mucous layer and it protects against acid. An increase in the amount of the acid and decrease in the amount of the mucous can create a painful open sore which is ulcers.


The major causes of ulcers are:

1) Helicobacter pylori (H. pylori)

It is a bacteria that lives in the mucous layers that cover and protect the tissues lining the stomach and the small intestine.

This bacteria often causes no problems. But, in others, it can raise the amount of the acid, break down the protective mucous layer, and irritate the digestive tract producing an ulcer.

The bacteria are transmitted from one person to another by close contacts such as kissing, and also through unclean water and food.

2) Frequent use of certain pain relievers

Such as aspirin and other NSAIDs such as ibuprofen (Advil, Motrin, others), naproxen sodium (Aleve, others ), ketoprofen.

Another type of pain meds like acetaminophen will not lead to peptic ulcers.

The major causes of ulcers are :

  • Helicobacter pylori
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Smoking
  • Stress
  • Chronic liver disease
  • Zollinger-Ellison syndrome
  • Genetic factors
  • Excessive alcohol use
  • Close contact with infected persons

What is the pathophysiology of ulcers?

  1. Gastric ulcer: The gastric ulcer is due to a decrease in the mucosal protection against gastric acid.
  2. Duodenal ulcer: It is due to an increase in the secretion of gastric acid and pepsin and there is a decrease in mucosal protection.

What are the risk factors of peptic ulcers?

  • Smoking
  • Drinking too much alcohol
  • Upper abdominal radiotherapy
  • Liver cirrhosis
  • Crohn’s disease

Eating a lot of spicy foods does not cause peptic ulcers but they can aggravate the symptoms.

What are the symptoms of peptic ulcer disease?

  • Burning abdominal pain
  • Heartburn
  • Nausea
  • Fatty food intolerance
  • Bloating or abdominal fullness
  • Blood in the stool or dark stool
  • Changes in appetite
  • Vomiting of blood
  • Unintended weight loss

Clinical features of gastric ulcer

  • Epigastric pain greater with meal
  • Weight loss
  • Lab findings: decreased H+ secretion, increased gastric levels

Clinical features of duodenal ulcer

  • Epigastric pain decreases with meals
  • Weight gain
  • Lab findings: increased H+ secretion

What is the diagnosis of ulcers?

  1. At first, the doctor takes a medical history for the diagnosis of peptic ulcers and performs a physical examination then checks for bloating in the belly and checks the pain.
  2. To know for sure that there is an ulcer the doctor may perform an upper endoscopy. For this procedure, the doctor inserts a long tube with a camera down your throat and into the stomach and small intestine to examine your digestive system and look for an ulcer. If the doctor detects an ulcer then he will remove the small tissue for examination in the laboratory.
  3. An upper gastrointestinal series also called a barium swallow may also be carried out. Doctor asks you to drink a thick liquid which is called barium to perform this procedure. This liquid coats the digestive tracts which makes your doctor view and treat your ulcer easily.
  4. The doctor may recommend breath, stool, or blood test to determine if the H. pylori bacteria are present in your stomach. This is done because the bacteria is a cause of the peptic ulcer.

What are the treatments of ulcers?

  • The treatments of ulcers depend on the cause of the ulcer. Treatment will involve killing the bacteria, reducing the use of NSAIDs, and helping the ulcer heal.
  • If the bacteria are present, the doctor will prescribe a combination of antibiotics medicines to kill them. These may include tinidazole(Tindamax), amoxicillin (Amoxil), clarithromycin (Biaxin), and others.
  • Proton pump inhibitors (PPIs) medication to block stomach acid.
  • Acid blockers such as ranitidine(Zantac), famotidine (Pepcid) to reduce the amount of stomach acid released into the digestive tract.
  • Medications such as sucralfate (Carafate) to coat and protect the lining of the stomach and small intestine.

Frequently Asked Questions (FAQs)

What does an ulcer feel like?

  • The most common symptom of the peptic ulcer is abdominal pain.
  • Irrespective of pain, the peptic ulcers may also cause severe signs and symptoms such as:
  • vomiting of blood,
  • dark blood in the stool,
  • nausea,
  • vomiting,
  • unexplained weight loss, and
  • change in appetite.

What causes stomach ulcers?

The cause of stomach ulcer are :

  • Helicobacter pylori
  • Non-steroidal anti-inflammatory drugs (NSAIDs)
  • Smoking, Excessive alcohol use
  • Stress
  • Chronic liver disease
  • Zollinger-Ellison syndrome
  • Genetic factors
  • Close contact with infected persons

What are the symptoms of an ulcer?

The Symptoms of an ulcer are :

  • Burning abdominal pain
  • Heartburn
  • Nausea
  • Fatty food intolerance
  • Bloating or abdominal fullness
  • Bloody or dark stool
  • Changes in appetite
  • Vomiting of blood
  • Unintended weight loss


How long it takes an ulcer to heal depends largely on the cause?

  • Peptic ulcers are caused in one of the two ways: bacteria, or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Examples of NSAIDs include aspirin and ibuprofen.
  • When you start to stop taking NSAIDs, ulcers that are caused by NSAIDs start to heal in a short period of time. Your doctor will suggest that you take anti-acid medicine for 2-6 weeks to relieve pain and promote healing.
  • When the bacteria are killed then the bacterial infections start to heal. Expect to take antibiotics along with acid-suppressing medicines for two weeks. After that, you should continue by taking an acid-suppressant for another four to eight weeks.
  • There is a possibility of a bacterial ulcer to heal itself without antibiotics temporarily.
  • However, if the bacteria are not completely killed, the ulcer tends to reoccur, or another ulcer forms nearby.

Are ulcers contagious?

Ulcers are not contagious but peptic ulcers are contagious. The H.pyloric bacteria is transmitted from one person to another by close contact such as kissing.

What to eat when you have an ulcer?

When you have a stomach ulcer you can eat :

1) Cabbage:

Vitamin U present in cabbage is the factor that can heal the ulcer.


2) Radishes:

Contains fiber that aids in digestion and absorbs zinc and other minerals.


3) Cauliflower:

Contains sulforaphane that helps in fighting with Helicobacter Pylori Bacteria.


4) Apples:

Apples contain flavonoids that inhibit the growth of H.pyloric bacteria


5) Yoghurt:

Yogurt contains probiotics, lactobacillus, and acidophilus that help in treating stomach ulcers.


6) Carrots:

vitamin A in carrots helps in warding off stomach ulcers, gastric inflammation, or indigestion.


7) Broccoli:

Broccoli contains sulforaphane that can eliminate the bacteria that cause stomach ulcers.

8) Honey:

Honey inhibits bacterial growth and relieves a stomach ulcer.


9) Blueberries:

Blueberries are a rich source of antioxidants and nutrients which help to improve your immune system.


10) Olive oil:

Olive oil contains phenol that can act as an anti-bacterial agent, which prevents from Helicobacter pylori.

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