These small holes in the stomach or intestinal lining can create some big problems if not treated promptly.
By some estimates, close to four million adults in the United States have an ulcer — this means that about one in 50 of your friends, family members, and co-workers are battling an ulcer right now.
In fact, peptic ulcers create a significant economic burden in the United States, costing close to $6 billion a year lost due to:
Missed work
Hospitalization
Doctor visits
Ulcer: What Is It?
Ulcers are holes that form in the lining of the upper part of the gastrointestinal (GI) tract. When they occur in the stomach, they are called gastric ulcers. If they form in the first part of your small intestine, the duodenum, they are referred to as duodenal ulcers.
“An ulcer is a wound in the lining of the stomach or duodenum, but really any part of the gastrointestinal tract can ulcerate,” explains Patrick I. Okolo, III, MD, MPH, chief of endoscopy at Johns Hopkins Hospital and assistant professor of gastroenterology and hepatology at Johns Hopkins University School of Medicine in Baltimore. “It’s a chronic injury where the lining has been disrupted. However, when people refer to an ulcer they are usually referring to peptic ulcer disease.” The word peptic refers to digestion. A peptic ulcer is the umbrella term for all types of GI ulcers.
Technically an ulcer is at least 0.5 centimeters wide, but can be much larger. Duodenal ulcers mainly occur in people between 20 and 50 years old and gastric ulcers typically appear in people over age 40. Duodenal ulcers are about four times more common than gastric ulcers.
Ulcer: How It Forms
Your stomach is a very hostile environment because of the acids that help in digestion, acids that are as toxic as car battery acid. The lining of your stomach and duodenum usually is well-protected from these acids by a layer of mucus.
Peptic ulcer disease begins when a weakness in your stomach or intestinal lining allows acid to create an erosion or sore in the lining. It is the most common type of stomach disease, according to the American Gastroenterology Association.
“We know that ulcers occur because there has been a disruption in the balance of factors that injure the digestive tract and those factors that protect it from injury,” says Dr. Okolo.
Basically, the factors that injure your stomach lining become stronger or more numerous than those that protect it.
The cause of about two out of every three ulcers is the bacterium Helicobacter pylori. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, and aspirin are another common ulcer cause; they damage the protective mucus layer of the GI tract.
Symptoms of stomach ulcer
The most common symptom of a stomach ulcer is a burning or gnawing pain that develops in your abdomen (tummy). The pain can also travel up to your neck, down to your navel (belly-button) or through to your back.
The pain associated with a stomach ulcer is caused by the ulcer itself and stomach acid that comes into contact with the ulcer and irritates it.
The pain can last from a few minutes to a few hours.
You may find pain starts soon after eating a meal. If the ulcer is in your small intestine (duodenal ulcer), pain may start two to three hours after eating so it may wake you up during the night.
Eating more food and taking antacids (indigestion medication) can often help relieve the pain of a duodenal ulcer, but not usually the pain of a stomach ulcer.
Less common symptoms of a stomach ulcer include:
indigestion
heartburn
loss of appetite
being sick
Some people also find they can no longer tolerate eating fatty foods.
At first you may only feel mild discomfort (technically referred to as “epigastric pain”) in the pit of your stomach, about halfway between your ribs and your navel.
Without treatment, your ulcer can continue to grow, become very painful, and may bleed. If not treated early, it may eat entirely through the lining of your stomach or intestine (this is called a perforated ulcer) and need surgery to repair. At its worst, a perforated ulcer may lead to significant bleeding and death.
If you have multiple recurrent ulcers, they can cause swelling and scarring as they heal, which may one day cause problems with your digestion. You may:
Lose your appetite and be unable to eat a normal amount
Start vomiting because of a complete blockage by scar tissue
Shed pounds unintentionally
