Peptic Ulcer Disease
One out of eight people in the United States will be diagnosed with Peptic Ulcer Disease (PUD) over the course of their lifetimes. As with many diseases are understanding of the issues and causes of the disease have been evolving in recent years creating the opportunities for more innovative and effective treatments.

What are the Causes Peptic Ulcers?
A Peptic Ulcer is an open sore in the lining of the stomach or intestine. In many ways it is similar to a sore in the mouth. When the ulcer occurs in the stomach it is called a "gastric ulcer". When it occurs in the duodenum it is called a "duodenal ulcer."

The stomach produces a very strong acid that helps digest and break down food. The lining of the stomach and the duodenum (the beginning of the small intestine) is protected from this corrosive acid by a thick protective mucous layer. If this protective lining is damaged then the stomach acids and digestive enzymes such as pepsin can corrode the actual stomach lining causing an ulcer.
For many years, it was common wisdom that most ulcers were caused by stress, diet, and possible genetic factors. However, recent investigations have demonstrated that most peptic ulcers result from a stomach infection caused by the bacteria, Helicobacter pylori.

Helicobacter pylori (H. pylori)
Helicobacter pylori is twisted spiral shape bacteria that infects the mucous layer lining of the stomach. The infection produces gastritis, an inflammation in the stomach wall that can damage the protective mucosal lining. While the majority of the people in the world probably have this bacteria in their intestinal tract, it is not known why some people react to it resulting in peptic ulcers.

Anti-Inflammatory Medication
Another factor for the development of ulcers is the use of anti-inflammatory medicines. These incude common aspirin, as well as buprofen (Advil), Feldene, Naprosyn, Voltaren, Indocin, Aleve, Lodine, and many others. In a percentage of the population, these medications will damage the mucous layer of the stomach.

A few patients produce an over abundance of stomach acid which can lead to ulcers. Other probable causes of ulcers is genetic factors and aging.

Symptoms
Possible ulcers symptoms include:
Gnawing, burning pain in the upper abdomen after a meal..
Burning sensation that occurs during the night that wake the patient.
Intense hunger or bloating.
Antacids and milk usually give temporary relief.
Some patients have no pain but have black stools, indicating that the ulcer is bleeding.

Diagnosis
Ulcer diagnosis is made by an an upper intestinal endoscopy, which allows direct examination of the ulcer or by a barium x-ray of the stomach. Biopsies are taken in the arae of the ulcer to rule out the possibility of a malignancy.

Treatment

Ulcers are treated by providing well-tolerated medicines that suppress the production of stomach acid. These acid-suppressing drugs relieve the symptoms and allow ulcers to heal.

Ulcers caused by anti-inflammatory drugs can be healed by simply avoiding these medicines. recurrence.

Ulcers caused by the H. pylori infection are treated with a course of antibiotics.

Occasionally, a patient needs surgery for an ulcer complication such as perforation, obstruction, or uncontrolled hemorrhaging.

Many doctors feel that dietary and lifestyle changes affect the course of ulcer treatment. Though this opinion is not shared by all physicians.

Caffeine and Alcohol - Both of these stimulate the secretion of stomach acid and should be avoided in the acute phase of an ulcer.
Cigarettes - Nicotine will delay the healing of an ulcer.
Antacids - These agents, purchased over the counter, can be used for relief of peptic ulcer symptoms.
Stress - Stress does not cause an ulcer although it probably can aggravate the symptoms.

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