Define what a peptic ulcer is, and describe the major causes of peptic ulcers and common treatments ...

A peptic ulcer is an area in the GI tract that has been eroded away by a combination of hydrochloric acid and the enzyme pepsin. In almost all cases, it is located in the stomach area (gastric ulcer) or the part of the duodenum closest to the stomach (duodenal ulcer). It causes a burning pain in the abdominal area, typically one to three hours after eating a meal. In serious cases, eroded blood vessels bleed into the GI tract, causing vomiting of blood or blood in the stools, as well as anemia. If the ulcer entirely perforates the tract wall, stomach contents can leak into the abdominal cavity, causing a life threatening infection.

The bacterium Helicobacter pylori (H. pylori) plays a key role in development of most peptic ulcers, which include both gastric and duodenal ulcers. Almost all people have this bacterium in their GI tracts. It appears that H. pylori infects about 20% of people younger than 40 years of age and about 50% of people older than 60 years of age. Most people with H. pylori infection do not develop ulcer, and the reason for this is not known.

Because of the role of H. pylori in ulcer development, treatment usually involves antibiotics and other types of medications to reduce gastric secretions. Antacids are used to weaken the gastric acid, and the same medications used to treat GERD can be used to treat peptic ulcers. Special diets are not recommended as often as they once were because they do not reduce acid secretion. In fact, we now know that ulcers are not caused by stress or eating spicy foods.

Although most peptic ulcers are caused by H. pylori infection, some are caused by prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs); these drugs include pain relievers, such as Aspirin, ibuprofen, and naproxen sodium. Acetaminophen use does not cause ulcers. The NSAIDs appear to cause ulcers by preventing the stomach from protecting itself from acidic gastric juices. Ulcers caused by NSAID use generally heal once a person stops taking the medication.