What Are Gastric and Duodenal Ulcers?
A peptic ulcer is an open sore. They are usually found in
the lining of the stomach, esophagus, or upper small intestine. Ulcers that
occur in the stomach are called gastric ulcers. Ulcers that occur in the upper
area of the small intestine, which is called the duodenum, are called duodenal
In the U.S., about 25 million people develop gastric and duodenal
ulcers at least once during their lifetime. (Lucile
Packard Children's Hospital at Stanford, 2013).
What Causes Gastric and Duodenal Ulcers?
People once believed that stress and spicy foods were the
main causes of these ulcers. Now, research has shown they usually are caused by
a bacterium known as H. pylori. How this bacteria spreads remains unclear. Some
believe it is spread by close contact such as kissing or even through food and
Naturally occurring stomach acids may also bring on peptic
Repeated use of aspirin or other over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) may
also cause these ulcers.
Who Is at Risk for Gastric and Duodenal Ulcers?
Women and older people are more likely to develop these
ulcers. However, a recent study shows that young men are more likely to
experience duodenal ulcers, while older women have more gastric ulcers. This
has been linked to aspirin use (Thorsen,
et al., 2013).
High intake of aspirin also increases risk.
Some experts believe that alcohol, tobacco, and caffeine use
contribute to the prevalence of the ulcers. There is very little research to
back this up. Still, most doctors agree that people already experiencing the
ulcers should stay away from these substances (Medscape,
Cancer patients can be at risk for these ulcers when
undergoing radiation treatment or chemotherapy. The ulcers can sometimes go hand
in hand with other infections. Conditions such as cystic fibrosis, hepatic
cirrhosis, Crohn's disease, and HIV can also cause them.
If you've had an ulcer once, you are susceptible to having
What Are the Symptoms of Gastric and Duodenal Ulcers?
The usual signs of a peptic ulcer are a sensation of
gnawing, burning, or hunger in the stomach. Some patients also report a feeling
Many people who suffer from peptic ulcers experience nausea.
Vomiting often helps. Sometimes, however, the vomit can be bloody.
Other symptoms include bloody or tarry stools, weight loss, and
Testing for Gastric and Duodenal Ulcers
To check for peptic ulcers, doctors look for the presence of
the H. pylori bacteria when performing tests. They can find it by analyzing a
patient’s blood, stool, or breath.
It is also necessary to conduct an endoscopy (insertion of a
camera with light) down the throat to examine the upper digestive system. This
can help doctors understand the type of ulcer and whether it may be malignant.
They can also see if the ulcer has perforated the stomach, which can be a very
An endoscopy is commonly used because biopsies can be taken
during the procedure. Sometimes, an upper GI series of traditional X-rays is
How Are Gastric and Duodenal Ulcers Treated?
There are many treatments for gastric and duodenal ulcers.
Usually, only medication is required.
A doctor may prescribe antibiotics to kill the H. pylori
bacteria. But some strains are resistant to antibiotics.
There are medications that stop acid production. Proton pump
inhibitors, omeprazole, and others help people whose ulcers come from taking
too much aspirin.
There are also medications that heavily coat the stomach's
lining. These make peptic ulcers less likely to occur. In mild cases, an
over-the-counter antacid can provide temporary relief.
Sometimes surgery is needed, usually if an ulcer is bleeding,
is cancerous, or has caused a perforation.
Recent research shows that as time lapses between peptic
ulcer perforation and surgery, morbidity and mortality rates increase. Every
hour counts (Surapaneni,
et al. 2013).
What Is the Outlook for Gastric and Duodenal Ulcers?
Medication usually takes care of the problem. If surgery is
done quickly, the prognosis usually is good.
How Can You Prevent Gastric and Duodenal Ulcers?
One of the best ways to prevent peptic ulcers is to use
common sense when taking aspirin or other NSAIDs. The American College of
Gastroenterology issued guidelines for taking these medications in 2009.
Above all, the guidelines call for an H. pylori test before
starting an aspirin regimen. If the test is positive, aspirin or NSAID use
should be discontinued. If that is not possible, other medications can be used
to prevent the onset of the ulcers (Lanza,
et al., 2009).
People who know their ulcers are caused by aspirin should
switch to acetaminophen or another pain reliever.