What is Peptic Ulcer Disease?
Peptic ulcer disease (PUD) involves damage (ulcers) to the lining of different parts of the digestive system. The most common types of PUD are gastric ulcers (GU) and duodenal ulcers (DU).
About 10% of people will develop a peptic ulcer. When the damage occurs in the stomach, it is referred to as a gastric ulcer (GU). A duodenal ulcer (DU) refers to damage found in the first part of the intestine just below the stomach
What are the symptoms of a peptic ulcer?
Symptoms vary depending on the person and where the ulcer occurs. Some people have ulcers but don’t experience any symptoms at all!
A common complaint when a person has an ulcer is the feeling of a hunger type pain or burning in the stomach area. This pain can occur before or after meals, as well as at night. Other symptoms may include bloating, vomiting, and blood in the stool.
What are the risks?
- Helicobacter pylori infections
- Medications such as aspirin or certain types of arthritis drugs (NSAIDs)
- Smoking
- Increased age
- Stress
- Alcohol
Traditional Treatment Methods
Medications that have been commonly used to treat peptic ulcer disease included antacids and anti-ulcer drugs. These medications required 4 to 8 weeks to work effectively. In many cases however, the ulcer would return within a year after treatment. People had to be retreated, and some even needed anti-ulcer medications regularly as a form of prevention.
What’s New?
Helicobacter pylori (HP) Bacteria
The discovery that Helicobacter pylori (HP) bacteria may be linked to the development of peptic ulcers has changed the way peptic ulcer disease is treated.
Helicobacter pylori, also referred to as H. pylori is a bacteria that researchers have found inside the stomach of many people with peptic ulcer disease.
Why doesn’t stomach acid destroy HP?
The stomach wall is coated by a protective mucous lining to help prevent acid damage. Helicobacter pylori bacteria takes advantage of this defense system by living in the space between the stomach wall and the lining. In addition, HP is able to neutralize any stomach acid that may get through the mucous lining by using an enzyme it produces called urease. Once a person is infected, the bacteria will likely survive indefinitely unless eliminated by antibiotics. It is very unusual for the body to get rid of this bacteria on its own.
Who has Helicobacter pylori?
Anyone can have this bacteria, both young and old. Like many infections, it is suspected that Helicobacter pylori bacteria is transmitted from one person to another.
Most people who are infected will have an inflammation in the stomach (gastritis), but many will not feel any symptoms. Only 20% of HP infected people will develop an ulcer.
The more important finding is that almost all people with duodenal ulcer are infected with Helicobacter pylori. In the case of gastric ulcer, close to 80% are infected. These percentages are expected to increase as scientists continue to learn more about the relationship between ulcers and HP.
How do you know if you have Helicobacter pylori?
There are 3 main methods of finding out if you have this bacteria:
- Stomach biopsy
- Special breath test
- Special blood test
Ask your doctor or pharmacist for more information about these tests.
Why is it important to get rid of HP?
For people who have peptic ulcer disease not due to aspirin or NSAID use, elimination of an Helicobacter pylori infection can help to encourage ulcer healing as well as prevent relapse.
What treatments are used for HP infected people diagnosed with peptic ulcer disease?
Treatment includes a combination of medications:
One or more antibiotics (used to destroy HP) and stomach acid suppressing drugs or drugs that coat the stomach (to increase the effectiveness of the antibiotics)
There are different combination therapies currently being used to treat this condition. The perfect one has not yet been identified, but some combinations have shown success rates of over 90%. Ask your doctor or pharmacist for more information.
What next?
Contact your doctor or pharmacist if:
- You have been diagnosed and suffer from a peptic ulcer not due to aspirin or NSAIDs, and have never been treated or tested for Helicobacter pylori.
- You are currently taking anti-ulcer medications regularly to prevent the return of a peptic ulcer
- You suffer from pain regularly in your stomach area and have never spoken to your doctor or pharmacist in the past about this condition.
Jennifer is a clinical pharmacologist. She helps doctors of all medical specialties choose medications. Jennifer consults about drug dosage, interactions, and side effects.