Ulcers

Ulcers

Ulcers are sores or craters in the lining of your digestive tract that can form in tow main areas, the duodenum (the space where the stomach meets the small intestine) and in the stomach itself. Traditionally, ulcers were thought to be causes by too much acid made by the stomach, but we now know that this is only part of the story, Besides the presence of acid ( which is still necessary to cause an ulcer), there must also be a breakdown in the stomach’s normal defense against acid, which is a thin mucous layer that coats the stomach. We now know that a bacterial infection with the organism H. pylori can cause such a breakdown in the stomach’s defenses, allowing acid free exposure to the lining of the stomach and duodenum, and resulting in an ulcer. H. pylori  is actually the commonest infection in the world. We can certainly heal ulcers just by turning acid off with medication like proton pump inhibitors (Nexium, Aciphex, Prevacid, etc.), but unless we also treat and eradiciate the H.pylori infection, the ulcers will come back again and again.

We have many ways to diagnosis the presence of H.pylori (blood tests, stool tests, breath tests, and biopsies during an endoscopic exam) and once it is discovered, several regimes to cure it consisting of 10-14 days of acid suppression and antibiotics. The third leading cause of ulcers of the upper digestive tract, besides too much acid and H.pylori, are a class of medications often used to treat arthritis, called NSAIDS (Non Steroidal Anti Inflammatory Drugs) Such as aspirin, ibuprofen, etc.

Besides causing pain, ulcers can also result in more serious complications such as bleeding, perforation (a localized rupture of the stomach or duodenum), or obstruction (a blockage within the digestive tract). Happily, the frequency of these complications, as well as the incidence of these ulcers themselves, has decreased considerably in this era of very effective acid suppressive medications.