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Alternative namesUlcer - peptic; Ulcer - duodenal or gastric; Duodenal ulcer
Ulcers are erosions in the lining of the stomach or duodenum (the first part of the small intestines). An ulcer in the stomach is called a gastric ulcer . An ulcer in the duodenum is called a duodenal ulcer. Together, ulcers of the stomach and duodenum are referred to as peptic ulcers.
Most ulcers are erosions of the first layer of the inner lining. If the hole goes all the way through, this is called a perforation of the intestinal lining. This can cause shock and is a medical emergency.
Causes, incidence, and risk factors
Normally, the lining of the stomach and small intestines have protection against the irritating acids produced in your stomach. For a variety of reasons, the protective mechanisms may become faulty, leading to a breakdown of the lining. This results in inflammation ( gastritis ) or an ulcer.
The most common cause of such damage is a bacterium called Helicobacter pylori . Most people with peptic ulcers have this organism living in their gastrointestinal (GI) tract. On the other hand, many people have this organism living in their GI tract but they don't get an ulcer.
Other factors can make it more likely for you to get an ulcer, including:
In addition, if you have a family history of ulcers or you are blood type 0, you are more likely to get a duodenal ulcer. There is also a rare condition called Zolliger-Ellison syndrome in which a tumor in the pancreas secretes a substance that causes ulcers throughout the stomach and duodenum.
A once popular belief was that stress causes ulcers. This is not true. Stress may make you experience more pain from an ulcer and it may make it more difficult to heal from an ulcer. But, stress does not cause an ulcer.
Abdominal pain is the main symptom. It may awaken you at night, occur 2-3 hours after you eat, or get worse if you skip a meal. The pain may be relieved by antacids or milk.
Other possible symptoms include:
It is important to note that you may have no symptoms at all from an ulcer.
Signs and tests
To diagnose an ulcer, your doctor will order one of the following tests:
During an EGD, the doctor may take a biopsy from the wall of the intestines to test for H. pylori . Other less accurate ways to test for this organism include a blood test and a breath test.
Your doctor may also order:
You should see a doctor if you have symptoms of an ulcer. Treatment often involves a combination of medications to kill the Helicobacter pylori bacteria, reduce acid levels, and protect the GI tract. This combination strategy allows your ulcer to heal and reduces the chance it will come back. Take all of your medications exactly as prescribed.
The medications may include one or more of the following:
Peptic ulcers tend to come back if untreated. If you follow the treatment instructions from your doctor and take all of your medications, the Helicobacter pylori infection will be eliminated and you are much less likely to get another ulcer. Your symptoms will also improve if you follow some preventive lifestyle steps.
Calling your health care provider
Call 911 if you:
Call your doctor if:
Update Date: 9/9/2003Jacqueline A. Hart, M.D., Department of Internal Medicine, Newton-Wellesley Hospital, Boston, Ma. and Senior Medical Editor, A.D.A.M., Inc. Previously reviewed by Andrew J. Muir, M.D. M.H.S., Division of Gastroenterology, Duke University Medical Center, Durham, NC. Review provided by VeriMed Healthcare Network (12/3/2001).
Last updated: Tue, 06 Jan 2009 00:20:03 GMT