What Is a Peptic Ulcer? What Causes Peptic Ulcers? A peptic ulcer is a hole in the lining of the stomach, duodenum, or esophagus. An ulcer is a sore or erosion that forms when the lining of the digestive system is corroded by acidic digestive juices. It is estimated that between 5% and 10% of adults globally are affected by peptic ulcers at least once in their lifetimes. When a peptic ulcer affects the stomach it is called a gastric ulcer, one in the duodenum is called a duodenal ulcer, while an esophageal ulcer is an ulcer in the esophagus. When the lining of these organs is corroded by acidic digestive juices secreted by stomach cells peptic ulcers can form. According to Medilexicon's medical dictionary , a peptic ulcer is "an ulcer of the alimentary mucosa, usually in the stomach or duodenum, exposed to acid gastric secretion." Etymologies of peptic and ulcer The English word "peptic" comes from the Latin word pepticus which comes from the Greek word peptikus which comes from the Greek word peptein , meaning "to digest". The English word "ulcer" comes from the Latin word ulcus (genitive: ulceris) , meaning "a sore, a wound, an ulcer". Meanings of peptic and ulcer The English word peptic means relating to digestion or promoting digestion . The English word ulcer means an area of tissue erosion . The term peptic ulcer literally means tissue erosion in the digestive system. What are the signs and symptoms of peptic ulcers? A symptom is something the patient feels and reports, such as a stomachache, while a sign is something other people, including the doctor detect, such as a rash. The first symptom of pepticulcer is usually stomach pain - caused by the ulcer and intensified by stomach acid coming in contact with it. However, it is not uncommon for people to have a peptic ulcer and no symptoms at all. Even though stomachache is the first symptom, most stomach aches are not serious and do not mean the individual is ill. The most common signs or symptoms of peptic ulcers are: *. Indigestion-like pain. The pain can.. -be felt anywhere from the belly button to the breast bone -last from a couple of minutes to a number of hours -be more severe when the stomach is empty -be worse during the night (during sleeping hours) -be temporarily relieved after eating certain foods -go away and return for afew days or weeks - Difficulty getting food down (swallowing it) - Food that is eaten regurgitates (comes back up) - Retching after eating - Feeling unwell after eating - Weight loss - Loss of appetite Ulcers can cause severe signs and symptoms, such as(much less common): - Vomiting blood - Black and tarry stools, or stools with dark blood - Nausea and vomiting These symptoms should be treated as medical emergencies When you should see a doctor: A peptic ulcer should be treated with your doctor's help. OTC (over-the-counter) medications may temporarily provide some pain relief, but will not provide comprehensive treatment. If you have the signs and symptoms described above you should see your doctor. What are the causes of peptic ulcers? Peptic ulcers are usually caused by either Helicobacter pylori ( H pylori ) bacteria or non-steroidal anti-inflammatory drugs (NSAIDs). H Pylori bacteria are responsible for about four-fifths of all gastric ulcers and 95% of duodenal ulcers, while NSAIDs are known to cause about 20% of gastric ulcers and 5% of duodenal ulcers. *. H pylori Over 25% of people in Western Europe and NorthAmerica carry H pylori . Experts are not certain why the bacteria do not cause ulcers in all people who carry H pylori . The bacterium spreads throughfood and water. As it is present in human saliva it can spread through mouth-to-mouth contact, such as kissing. It lives in the mucus that coats the lining of the stomach and duodenum and produces (urease) , an enzyme that neutralizes stomach acid by making it less acidic. To compensate for this the stomach makes more acid, which irritates the stomach lining. H pylori also weakens the defense system of the stomach and causes inflammation . Patients with peptic ulcers caused by H pylori need treatment to get rid of the bacterium from the stomach to prevent recurrences. - NSAIDs (non-steroidal anti-inflammatory drugs) These are medications for headaches , period pains , and other minor pains. Examples include aspirin and ibuprofen. Many NSAIDs are OTC medications, while others, such as diclofenac,naproxen and meloxicam can only be acquired with a doctor's prescription. Non-steroidal anti-inflammatory drugs lower the stomach's ability to make a protective layer of mucus,making it more susceptible to damage by stomach acids. NSAIDs canalso affect the flow of blood to the stomach, undermining the body's ability to repair cells. - Genetics - a significant number of individuals with peptic ulcers have close relatives with the same problem, suggesting that genetic factors may also be involved. - Smoking - people who regularly smoke tobacco are more likely to developpeptic ulcers compared tonon-smokers. - Alcohol consumption - regular heavy drinkers of alcohol have a higher risk of developing peptic ulcers. - Mental stress - mental stress has not been linked to the development of new peptic ulcers. However, people with ulcers who experience sustained mental stress tend to have worse symptoms. How are peptic ulcers diagnosed? A patient's description of symptoms will usually make the doctor suspect a peptic ulcer. Some tests will be ordered so that diagnosis can be confirmed, such as: # Blood test - a blood test can determine whether H pylori bacteria are present. However, a bloodtest cannot determine whether the patient had past exposure or is currently infected. Also, if the individual has been taking antibiotics or proton pump inhibitors a blood test can give a false-negative result. # Breath test - a radioactive carbon atom is used to detect H pylori . The patient drinks a glass of clear liquid containing radioactive carbon as partof a substance (urea) that the H pylori will break down. An hour later the patient blows into a bag which is subsequently sealed. If the patient is infected with H pylori the breath sample will containradioactive carbon in carbon dioxide. The breath test is also useful in checking to see how effective treatment has been in eliminating H pylori . # Stool antigen test - this test determines whether H pylori is present in the feces (stools). This test is also useful in determining how effective treatment has been in getting rid of the bacteria. # Upper gastrointestinal X-ray (upper GI X-ray) - the test outlines the esophagus, stomach and duodenum. The patient swallows a liquid which contains barium. The barium coats the digestivetract and shows up on the X-ray, making the ulcer easier to see. Upper GI X-rays are only useful in detecting some ulcers. The patients should try as much as possible †̥ see their doctors for further investigation and treatment.