DEAR Doctor K: I’ve been diagnosed with a peptic ulcer. What does that mean? And what’s the treatment?
DEAR READER: A peptic ulcer is a sore or hole that forms in the lining of the stomach or upper part of the small intestine (called the duodenum).
What causes the ulcer? For many decades, doctors thought they knew the answer: It was acid. Stress and psychological problems led a person to make too much stomach acid.
It was a reasonable theory. Your stomach does make acid to help you digest food. The acid also could digest your stomach if it weren’t protected. But it is: Your stomach is lined with a layer of special cells and mucus. The mucus protects the lining of the stomach and duodenum from damage by acid and digestive enzymes.
The “acid theory” held that peptic ulcers were caused either by too much stomach acid, or by a failure in the production of protective mucus, or both. Almost everyone was convinced the acid theory was correct, even though there was little evidence for it.
Beginning in the early 1980s, two young Australian doctors – Barry Marshall and Robin Warren – pursued a very different theory. They found an unusual kind of bacteria, Helicobacter pylori, inside many peptic ulcers. They argued that these bacteria cause inflammation, weakening the stomach lining and the protective mucus. When stomach acid got into the ulcer, it made the ulcer worse.
Another common cause of stomach lining irritation and ulcers is nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen and naproxen. NSAIDs block the formation of certain chemicals that normally help protect against ulcers.
Treatment of ulcers depends on their cause. Ulcers caused by H. pylori are treated with antibiotics and acid-suppressing medication. Successfully killing the H. pylori bacteria will greatly reduce your chances of developing another ulcer.
If your ulcer was caused by an NSAID, the treatment is to stop taking it. Your ulcer will begin to heal almost immediately.
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