Gastric and Duodenal Ulcers

An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body. When the ulcer is in the stomach, it is called a gastric (peptic) ulcer. When the ulcer is in the duodenum, it is called a duodenal ulcer.

In the past lifestyle factors, such as stress and diet, were believed to cause ulcers. Later, researchers determined that stomach acids contributed to ulcer formation. Today, research shows that most ulcers (80 percent of gastric ulcers and 90 percent of duodenal ulcers) develop as a result of infection with a bacterium called Helicobacter pylori (H. pylori).

Although all three of these factors — lifestyle, stomach acid and H. pylori — are believed to play a role in ulcer development, H. pylori is considered to be the primary cause.

Factors suspected of playing a role in the development of stomach or duodenal ulcers are Helicobacter pylori, the bacteria producing substances that weaken the stomach's protective mucosa and make it more susceptible to the damaging effects of acid and pepsin.

Smoking. Smoking increases the chances of getting an ulcer, slows the healing process of existing ulcers, and contributes to ulcer recurrence.

Caffeine. Caffeine seems to stimulate acid secretion in the stomach, which can aggravate the pain of an existing ulcer

Alcohol. Ulcers are often linked to heavy alcohol consumption.

Stress. Although emotional stress is no longer thought to be a cause of ulcers, people with ulcers often report that emotional stress increases ulcer pain.

Acid and pepsin. The stomach's inability to defend itself against gastric acids - hydrochloric acid and pepsin - is believed to contribute to ulcer formation.

Non-steroidal anti-inflammatory drugs. These drugs (such as aspirin, ibuprofen and others) make the stomach vulnerable to the harmful effects of acid and pepsin.

The most common ulcer symptom is a gnawing or burning pain in the abdomen between the breastbone and the navel. The pain often occurs between meals and early in the morning. It may last from a few minutes to a few hours. Less common ulcer symptoms include belching, nausea, vomiting, bloody or dark tarry stools, poor appetite, loss of weight, malaise, and fatigue.

People with ulcers may experience serious complications. The most common problems include bleeding, perforation, narrowing and obstruction of intestinal opening, peritonitis.

Recommended treatment may include:

Lifestyle changes. People with ulcers should avoid spicy, fatty, or acidic foods. Smoking has been shown to delay ulcer healing and has been linked to ulcer recurrence; therefore, people with ulcers should not smoke.

Medications. Gastric and duodenal ulcers are treated with several types of medications to reduce the amount of acid in the stomach. When treating H. pylori, these medications are often used in combination with antibiotics.

Surgery. In most cases, anti-ulcer medicines heal ulcers quickly and effectively, and eradication of H. pylori prevents most ulcers from recurring. However, people who do not respond to medication or who develop complications may require surgery.

Exercise 6. Complete the sentences and answer them:

1 What ulcers are called...?

2 What lifestyle factors were believed...?

3 What is the... cause of ulcers?

4 How does H. pylori affect the stomach and cause...?

5 Why does smoking play a role in...?

6... increases ulcer pain?

7 What complications...?

8... should people with ulcers avoid?

9 What types of medications...?

10 When may a surgical operation...?

Exercise 7. Look through the text and find out expressions synonymic to the given ones:

The major cause, to make pain worse, bad effects, acid production, to decrease the amount of acid, alcohol intake, need the operation, hemorrhage, medicines for ulcer.