by Walter Little

Created on: December 30, 2008   Last Updated: January 16, 2009

Peptic Ulcers: Symptoms and Treatment

What causes a Peptic Ulcer? Up until the late 20th century it was believed that Tobacco smoking, not eating properly, spices and other factors contributed to the development of peptic ulcers.1 Researchers now know, however, that these factors are of relatively minor importance in the development of a peptic ulcer.
The Helicobacter Pylori bacterium is considered to be a major causative factor in the formation of peptic ulcers. Research has shown that sixty percent (60%) of gastric ulcers and as much as ninety percent (90%) of duodenal ulcers are the result of the H. Pylori bacterium colonizing (i.e. settling there after entering the body) in the antral mucosa resulting in chronic inflammation. Despite the presence of antibodies the immune system is unable to clear the infection. The end result is that the bacteria causes a chronic active gastritis (known as Type B Gastritis) which, in turn, causes a defect in the regulation of gastrin production which can eventually lead to the formation of ulcers. Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) have also been shown to have a detrimental affect on ulcers. The gastric mucosa protects itself from the gastric acid with a layer of mucus which is stimulated by certain postaglandins (hormones)2. Production of these hormones is hampered by NSAIDS because they (NSAIDS) block the function of Cyclooxygenase 1 (Cox-1) which are essential for the production of postaglandins. It should be noted, however, that newer NSAIDS such as Celecoxib and Rofecoxib only inhibit Cox-2 which is less essential in the gastric mucosa and, therefore, roughly cuts in half the risk of gastric ulceration. What are the symptoms of an ulcer? Peptic ulcers are unusual in that they do not always exhibit symptoms and patients have been known to have them for a long time without being aware of it. Usually, however, they can be quite painful causing a burning or stabbing sensation at the point of inflammation. Common symptoms of a peptic ulcer include: Difficulty swallowing food. Nausea or vomiting. Vomiting blood or brown, lumpy vomit Black or tar-color feces. Unexplained weight loss. Sudden and severe abdominal pain. How are ulcers diagnosed? An Esophagogastroduodenscopy (EGD) also known as a gastroscopy is normally used in patient's where a peptic ulcer is suspected. Direct visual allows for the location and severity of an ulcer to be determined. Perhaps even more important is the fact that if an ulcer is not found

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