Peptic Ulcers: The Myths and The Management

One of the most enduring myths regarding health and medicine is that stress due to work and spicy foods can cause peptic ulcers. In fact, we now know that a bacterial infection or some medications are the culprit in most cases. The offending agent, helicobacter pylori bacteria, commonly live in the mucous layer that covers and protects tissues that line the stomach and small intestine.

Peptic ulcers are open sores that develop on the inside lining of your esophagus, stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is a burning abdominal pain. The pain is aggravated by stomach acid coming in contact with the ulcerated area.

What you may not know about the pain is that it may

·         Be felt anywhere from your navel up to your breastbone

·         Be worse when your stomach is empty

·         Flare at night

·         Often be temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication

·         Disappear and then return for a few days or weeks

Other, less common symptoms include:

·         The vomiting of blood

·         Dark blood in stools or stools that are black or tarry

·         Nausea or vomiting

·         Unexplained weight loss

·         Changes in your appetite

The time to see a doctor is when the relief you get from over-the-counter antacids is short-lived. Understand that certain pain relievers -- such as aspirin, ibuprofen, naproxen, and ketoprofen – can actually aggravate the problem. In fact, peptic ulcers are more common in people who regularly take these medications frequently.

Your doctor can easily test to see whether or not you are harboring the H. pylori bacterium. If you are older or have experienced a dramatic recent weight loss, your doctor is likely to prescribe an endoscopy. 

A two-week regimen of antibiotics is the usual prescription for treating H. pylori. You will also be directed to some antacids to relieve the pain, or histamines which will actually reduce the amount of stomach acid released into your digestive tract. In some cases, your doctor may prescribe medications called cytoprotective agents that help protect the tissues that line your stomach and small intestine.

Occasionally, doctors will encounter “refractory ulcers” – ones that do not heal. The causes for these include a history of tobacco use, a history of pain reliever usage, and Zollinger-Ellison syndrome – the overproduction of stomach acid.