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    Ulcer

    ul·cer — UL-ser

    Definition

    An ulcer is an open sore or lesion that develops on the skin or mucous membranes when the tissue's protective surface is eroded, exposing underlying layers. While ulcers can occur anywhere in the body (skin ulcers, mouth ulcers, corneal ulcers), the term most commonly refers to peptic ulcers — sores that develop in the lining of the stomach (gastric ulcers) or the upper portion of the small intestine (duodenal ulcers).

    Peptic ulcers affect approximately 10% of the world's population at some point in their lives. The two primary causes are infection with the bacterium Helicobacter pylori (H. pylori), which is present in about 50% of the world's population, and regular use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, and naproxen. Contrary to popular belief, stress and spicy foods do not cause ulcers, though they can worsen symptoms in someone who already has one.

    Symptoms of peptic ulcers include burning stomach pain (often worse when the stomach is empty), bloating, nausea, and in severe cases, vomiting blood or passing dark, tarry stools (signs of internal bleeding). The discovery that H. pylori causes most peptic ulcers — by Barry Marshall and Robin Warren, who won the Nobel Prize in 2005 — revolutionized treatment, transforming ulcers from a chronic condition requiring surgery to one that can often be cured with a course of antibiotics.

    Also Known As

    Peptic ulcerGastric ulcerDuodenal ulcer

    Key Facts

    • •H. pylori infection and NSAID use account for the vast majority of peptic ulcers — not stress or spicy food.
    • •Barry Marshall famously drank a culture of H. pylori to prove it caused ulcers, developing gastritis within days.
    • •Peptic ulcers are typically diagnosed by upper endoscopy (EGD) and/or testing for H. pylori.
    • •H. pylori ulcers are treated with 'triple therapy' — a proton pump inhibitor plus two antibiotics for 14 days.
    • •Complications of untreated ulcers include bleeding, perforation (hole in the stomach wall), and gastric outlet obstruction.

    How It Relates To Your Health

    If you experience persistent burning stomach pain, especially when hungry or at night, consult your healthcare provider for evaluation. Testing for H. pylori (through breath test, stool test, or blood test) is the first step, as treatment with antibiotics can cure H. pylori-related ulcers. If you regularly use NSAIDs, your doctor may recommend gastroprotective medications like proton pump inhibitors.

    Prevention involves judicious use of NSAIDs (taking the lowest effective dose for the shortest duration, with food), treating H. pylori infection when detected, and avoiding excessive alcohol and smoking — both of which impair mucosal healing and increase ulcer risk.

    Sources

    1. Peptic Ulcer Disease — National Institute of Diabetes and Digestive and Kidney Diseases (NIH)
    2. Peptic Ulcer — Mayo Clinic
    3. Peptic Ulcer Disease — StatPearls / PubMed

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