Up to 45 million people in the U.S. have an open sore in the lining of their gastrointestinal tract known as an ulcer.  An ulcer can occur in the upper portion of the small intestine (duodenal ulcer), the stomach (gastric ulcer), and the esophagus (esophageal ulcer).  Ulcers are often referred to as “peptic ulcers” to indicate they occur in the digestive tract.

Causes of ulcers

At one time it was believed that the cause of ulcers was due to stress, spicy foods or smoking.  Now, according to the CDC, the overwhelming majority of ulcers are due to the bacteria Helicobacter pylori.  This particular type of bacteria is responsible for up to 80 percent of stomach ulcers and more than 90 percent of ulcers in the duodenum of the small intestine.  What the bacteria does is damage the protective mucosal barrier of certain areas within the gastrointestinal tract.  When this happens, it makes it easier for acidic digestive fluids to injure and inflame the gut’s lining. 

Other causes can be from the chronic use of nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen (Advil), naproxen (Aleve), and aspirin, any of which can cause damage to tissues within the intestinal tract.  Even though stress, spicy foods and smoking are not considered causes of ulcers, they can aggravate an existing ulcer.

Symptoms of ulcers

Symptoms of an ulcer can range from mild abdominal pain to vomiting and bleeding.  There can be several symptoms that may indicate an ulcer which can include the following:

· A burning, aching pain or gnawing feeling

· Pain that feels like hunger between the navel and breastbone

· Pain may extend to the back

· Belly pain that can last from a few minutes to a few hours but will usually go away after taking an antacid or acid reducer

· Vomiting, sometimes with blood

· Bloating

· Dark, tar-like stools

· Unintended weight loss

Treatment for ulcers

Since an ulcer is a sore, just like any sore on or in the body, they need to heal.  Depending on what is causing the ulcer will determine how a doctor will treat it. 

Ulcers that develop due to H. pylori bacteria can be diagnosed with a blood or breath test and treated with antibiotics and drugs that reduce the production of stomach acid.

If the cause of the ulcer is by a certain medication, then a person will be advised to stop taking the medication. 

Managing symptoms of an ulcer

There are several things a person can do to help manage the symptoms of an ulcer:

· Limit foods and beverages that make ulcer symptoms feel worse.  This can include spicy foods made with chilies, cayenne, black or hot pepper.  This would include any other foods causing the ulcer symptoms to increase such as chocolate.

· Limit alcohol as it can increase stomach acid and may interfere with some medications used to treat ulcers. 

· Limit caffeine to no more than 400 mg per day which is about 3 cups.  Both caffeinated and decaffeinated coffee can increase acid production worsening symptoms

How to prevent an ulcer

Ways to prevent an ulcer to begin with include the following lifestyle habits:

· Consume a high fiber diet especially of foods rich in soluble fiber which include oats, psyllium husk, legumes, flax seeds, barley, nuts and certain fruits and vegetables such as oranges, apples, and carrots.

· Include good food sources of vitamin A as studies have shown diets rich in vitamin A from all sources might reduce the development of duodenal ulcers.  In addition, animal studies have demonstrated that vitamin A increases the production of mucus in the gastrointestinal tract which may protect the development of ulcer disease.  Good sources of vitamin A include liver, carrots, broccoli, sweet potatoes, kale, spinach, and collard greens.

· Consume foods rich in flavonoids such as green tea, garlic, onions, and colorful fruits and vegetables such as cranberries, strawberries, blueberries, broccoli, carrots, and snap peas.

· Cranberry juice cocktail may reduce the risk of H. pylori overgrowth in the stomach.  A 2005 study showed cranberry juice helps by either not allowing the bacteria to attach itself or by disengaging it from the body once it is attached and prevents inflammation.