There has been a radical change in the belief about 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 or risk 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 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, they start 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 utensils. You can get this infection even from the saliva of another infected person. The H. pylorus infection is acquired usually in 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, 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
A risk factor is something that makes the person more prone to get the disease. A person can develop a peptic ulcer even without any risks. However, the more risks a person has, the greater are the chances of him getting a peptic ulcer.
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 that 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 ulcers. 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 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 neutralizes the gastric acid in the duodenum. As mentioned above, the duodenum is also a site for peptic ulcers. Smokers are more prone to develop duodenal ulcers.
Smoking also interferes with the action of the drugs given for peptic ulcers, thereby delaying the healing of the ulcer.
3. Alcohol aggravates an 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’s pain increases after a bout of alcohol.
Moderate and occasional consumption of alcohol, which is diluted with water is okay. Chronic excessive drinking of alcohol or alcohol abuse 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. Alcoholic beverages can erode the protective mucosal lining of the gastrointestinal tract and cause more inflammation and bleeding of the 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. Spicy foods may aggravate ulcer symptoms, but they do not cause ulcers.
However, spicy foods may worsen your existing acid reflux, irritable bowel syndrome, and gastritis. They may interfere with digestion and give you heartburn.
The caffeine that is present in tea and coffee is known to stimulate acidic secretion and aggravate an existing ulcer.
Both caffeinated and decaffeinated coffee can increase gastric acid production and aggravate the symptoms of ulcers.
6. Mental stress causes peptic ulcer
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. Some people also develop heartburn from radiation given to the chest such as for breast cancer. This side effect of radiation usually begins during the second or third week of treatment. It can last until about 2 weeks after your radiation is completed.
These treatments cure the cause of the peptic ulcer, which is the H. Pylori bacterial infection, and alienate you from the above-described risk factors. If left untreated, ulcers can cause further complications.