There has been a radical change in the belief of what causes peptic ulcer disease. Until a few years ago, the factors which were believed to be the causes of peptic ulcers, such as stress, alcohol, smoking and other lifestyle habits are today not enumerated as causes, but as aggravating factors.
It was in 1982 that the scientists discovered the Helicobacter pylori bacteria and found that they were the cause of the stomach ulcer.
A peptic ulcer is a composite name for ulcers that occur in the esophagus, stomach and the duodenum.
How you get a peptic ulcer disease and the risk factors that predispose to an ulcer are explained below.
Peptic Ulcer Cause – H. Pylori
Today, it is firmly believed that the cause of peptic ulcer is an infection in the stomach and the duodenum caused by a bacteria called Helicobacter Pylori (H Pylori, in short). The word “pylori” incidentally comes from the word “pylorus” which is the name given to the sphincter, which is present between the stomach and the duodenum. More than 50% of the world’s population is infected with H. pylori but only 5 to 10% develop ulcers.
How H. Pylori Causes Peptic Ulcer
The H. pylori bacteria enter the stomach through the oral route. Once the bacteria have entered the stomach, it starts burrowing through the inner lining of the stomach to escape the acidic medium. Its spiral form helps it in this process. It is the inner lining of the stomach, which protects the gastric mucosa from the acidic digestive juices.
Once it reaches the mucous lining, it parks itself there as it finds the neutral medium comfortable. This burrowing action and the acidic corrosive action of the digestive juices on the now burrowed lining give rise to an ulcer.
You can get infected with H. pylori from the food, water, and the utensils. You can get this infection even from the saliva of another infected person. The H. pylorus infection is acquired usually in the childhood, but adults too can get it. It can take years for the symptoms to develop after you get infected.
The esophageal ulcer is caused by the reflux of the acidic contents from the stomach into the esophagus. The causative factor is, of course, the H. Pylori. This happens in Gastroesophageal Reflux Disease ( GERD, in short).
However, all people infected with H. Pylori do not develop an ulcer. Why this is so, is not yet known. It probably depends on the individual’s habits, his resistance and his exposure to the predisposing factors. There are still uncertainties, which have yet to be discovered.
Peptic Ulcer Risk Factors
1. Certain medicines
Regular use of certain drugs can give you ulcers. Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen and naproxen are known to interfere with the functioning of prostaglandins, which help in resisting the corrosive action of the acidic digestive juices. NSAIDs directly contribute to ulcer formation. Steroids, too, are potential contributors to the formation of an ulcer.
Cigarette smoking is a risk factor for the formation and recurrence of peptic ulcer. It also delays the healing of an existing ulcer.
How does smoking contribute to the formation of an ulcer? Evidence suggests that smoking increases the production of the gastric acid secretion in the stomach over time and reduces the bicarbonate secretion from the pancreas.
Bicarbonate is a natural antacid in the body, which neutralises the gastric acid in the duodenum. As mentioned above, the duodenum is also a site for the peptic ulcer. Smokers are more prone to develop duodenal ulcers.
Smoking also interferes with the action of the drugs given for peptic ulcer, thereby delaying the healing of the ulcer.
There is no connection found with alcohol directly contributing to the formation of an ulcer. However, it aggravates an existing ulcer by its irritating action as is evident by the fact that an ulcer pain increases after a bout of alcohol.
Moderate and occasional consumption of alcohol, which is diluted with water is okay. Excessive drinking of alcohol irritates and erodes the inner lining of the stomach causing its inflammation and making it more prone to ulcer formation. Drinking alcohol can also cause a delay in the healing of an existing ulcer.
4. Spicy foods – not a risk factor
Once believed to be one of the causes of peptic ulcers, it is now established that spicy foods do not cause ulcers nor is it a risk factor.
Caffeine, which is present in tea and coffee is known to stimulate the acidic secretion and aggravate an existing ulcer.
6. Mental stress
Psychological stress and tension are also known to increase the acidic secretion in the stomach and ulcer patients often complain of pain during times of mental stress.
7. Radiation therapy
Stomach ulcers are a common side effect of radiation therapy given for abdominal cancers.
It is, therefore, H. Pylori that causes an ulcer, which gets aggravated by risk factors mentioned above.