What is a peptic ulcer?
A peptic ulcer is an open painful raw sore in the lining of the stomach or proximal part of the small intestine. Peptic ulcers are caused by gastric acid and pepsin.
Normally, a thick layer of mucus membrane called the gastric mucosa protects the stomach lining from the corrosive effect of its gastric acid. But, some causative factors can reduce this protective layer, allowing stomach acid to damage the stomach lining.
When these ulcers occur in the stomach, they are called gastric ulcers, and when they occur in the first portion of the intestine called the duodenum, they are called duodenal ulcers. Rarely, these ulcers can also develop in the esophagus.
Peptic ulcer disease, therefore, is a composite name given to three types of ulcers:
- Esophageal ulcer
- Gastric or stomach ulcer
- Duodenal ulcer
H. pylori bacteria and certain drugs such as NSAIDs are the two major factors that cause these ulcers.
As the names suggest, the above-mentioned ulcers are found in the esophagus, the stomach, and the duodenum respectively.
A peptic ulcer occurs due to the corrosive action on the inner lining of the esophagus, stomach, and duodenum by the excessively secreted acidic digestive juices in the stomach and the duodenum.
The digestive juice from the stomach contains gastric acid, which contains hydrochloric acid in dilution of 0.5%.
The peptic ulcer normally is preceded by excessive acidity, wherein the person feels one of the classic ulcer symptoms of gnawing stomach pain or a burning sensation in the chest.
Acidity, if not taken care of may manifest into ulcer formation after some period. Furthermore, if the ulcer is ignored, it can lead to some serious complications.
One in ten people develops ulcers. Peptic ulcers are a very common condition throughout the world. In the United States, about 10% of the population will suffer from a peptic ulcer at some point in their lives. Men and women are equally affected.
The proportion of people with peptic ulcer disease increases steadily with age possibly due to the use of aspirin in the aging population. In the United States, peptic ulcer disease affects about 4.6 million men and women annually.
A small percentage of the gastric ulcers may turn malignant while the duodenal ulcers are generally benign. About one person per 10,000 may die of this condition.
These people are mostly those who harbor certain risk factors such as:
- having a family history of peptic ulcer
- commonly using NSAIDs, which are pain killers
- regularly drinking alcohol
- heavy smoking
- eating spicy and chili foods
The main cause of these ulcers is gastric infection with H.pylori bacteria. These bacteria burrow into the lining of the stomach and cause an ulcer.
How is a peptic ulcer diagnosed?
A peptic ulcer is diagnosed by certain tests and procedures. The preferred procedure used is called endoscopy in which a gastroscope is inserted into the stomach through the mouth and the inner lining of the stomach and the duodenum are viewed directly. A gastroscope also has the facility to photograph what is being viewed.
Esophagogastroduodenoscopy ( EGD) is the name given to the scopy wherein the contents of the esophagus, the stomach, and the duodenum are directly viewed.
Most patients are successfully treated and the prognosis is good provided the patient religiously follows the dos and the don’ts advised by his doctor.
Millions are spent every year on the treatment of this problem. However, the incidence has shown a marginal decrease, basically due to awareness and the recent studies which have thrown much light on the major cause of ulcers.