Peptic Ulcers explained

What is an ulcer?

An ulcer is the term used to describe a break in the lining of any part of the body. This can occur most visibly in the skin, but many people will suffer from mouth ulcers affecting their tongue or gums.

What are peptic ulcers?

Ulcers in the lining of the stomach are called gastric ulcers. In the lining of the duodenum, which is part of the intestine immediately below the stomach, they are called duodenal ulcers. The term peptic ulcer includes both gastric and duodenal ulcers.

What causes a peptic ulcer?

One of the important functions of the stomach is to produce acid and a chemical called pepsin, which are important in starting the digestion of food and preparing it to be absorbed (taken up) into the body. Acid and pepsin are not only strong enough to help digest food, but they are also capable of attacking the lining of the stomach and duodenum. In a healthy stomach or duodenum the lining defends itself by producing a protective layer of sticky mucous and fluid that protects the lining. An ulcer occurs when the acid and pepsin overcome these natural defences and cause a break in the lining.

The two most important factors that upset the balance between attack and defence are infection with a bacterium called Helicobacter pylori (also known as H pylori ) and taking non-steroidal anti-inflammatory drugs (NSAIDs) and aspirin.

What is Helicobacter pylori and how does it cause ulcers?

Helicobacter pylori is a bacterium, which is the main cause of peptic ulcers throughout the world. It produces ulceration by:

• Infecting and inflaming the stomach and duodenal lining which weakens their defences.

• Disturbing the mechanism which normally switches off acid and pepsin production after a meal has been digested. 

Do all of those infected with Helicobacter pylori get ulcers?

No – the great majority of people infecte with Helicobacter pylori have no ulceration or symptoms. Why some people get ulcers and others do not is still the subject of research.

How are NSAIDs and aspirin involved?

These drugs are very commonly prescribed. NSAIDs (such as Neurophen) are used for treating painful conditions whilst aspirin, particularly in low doses, is widely prescribed to protect the blood vessels of the heart and the circulation around the brain. Unfortunately, both interfere with the gastric and duodenal defences, increasing the risk of ulceration.

In most developed countries the numbers of people infected with H pylori have steadily decreased and in some parts of the world NSAIDs are the main cause of peptic ulcers.