A gastric ulcer is a type of peptic ulcer. Peptic ulcers are sores on the lining of the stomach or duodenum, the area of the small intestine into which the stomach opens. When a peptic ulcer is located in the stomach, it is called a gastric ulcer. Each year, 500,000 patients are diagnosed with ulcers in the United States. Gastric ulcers comprise approximately 16 percent of that number, says Penn State College of Medicine. About 70 to 75 percent of gastric ulcers are caused by bacteria called helicobacter pylori, states the "Surgery: Basic Science and Clinical Evidence". Long-term use of nonsteroidal anti-inflammatory drugs or NSAID, including naproxen and ibuprofen, can also cause gastric ulcers. There are five classifications of gastric ulcers.
Type I: Gastric Body on Lesser Curvature
Type I gastric ulcers are the most common. They occur along the fundic and antral mucosa regions of the stomach, the area along the curvature of the upper right side. Normally type I gastric ulcers result because of the secretion of too little stomach acid, a condition called hyposecretion. Gastric ulcers most commonly occur in men ages 55 to 70, says the Penn State College of Medicine. A patient with a gastric ulcer may experience abdominal pain so severe that he awakes at night. Other symptoms include heartburn, indigestion, nausea and weight loss. Antibiotics are the first line of defense against type 1 gastric ulcers. If antibiotics fail, a vagotomy may become necessary. Vagotomy is a surgical procedure that severs the vagus nerves in the stomach.
Type II: Gastric Body and Duodenal Ulcer
Type II gastric ulcers are found in the stomach. They occur in conjunction with duodenal ulcers, located in the upper part of the small intestine. Type II gastric ulcers occur because of the secretion of too much stomach acid, a condition called hypersecretion. Duodenal ulcers are caused by helicobacter pylori bacteria in 90 percent of cases, states the "Surgery: Basic Science and Clinical Evidence". Type II gastric ulcers are treated with antacids and antibiotics.
Type III: Prepyloric Perforation
Type III gastric ulcers also result because of hypersecretion of stomach acid. They are located in the prepyloric region of the stomach, near the pylorus, where the stomach meets up with the small intestine. In an article published in the December 2005 issue of the British Journal of Surgery, Dr. T. Glarborg Jørgensen wrote that 82 percent of patients in a controlled trial had, prior to the perforation, taken drugs known to harm the stomach including corticosteroids, aspirin or phenylbutzone. Nearly 59 percent had taken the drugs no more than 13 hours prior to the perforation.
Type IV: High on Lesser Curvature
Like type I gastric ulcers, type IV occurs because of hyposecretion of stomach acid. Type IV ulcers are located near the top of the stomach's lesser curvature, the left side where it curves inward. In the July 1997 issue of "Gastroenterology," Dr. Emad El-Omar states that chronic H. pylori infection can severely suppress stomach acid. Type IV gastric ulcer patients respond well to antibiotics.
Type V: Anywhere on Stomach
Type V gastric ulcers may occur in any location on the stomach. Type V ulcers are primarily NSAID induced. Patients prescribed NSAIDs for long-term use may also receive a prescription for Misoprostol, a drug than can prevent NSAID-induced gastric ulcers. Antacids prove effective in treating NSAID-induced gastric ulcers.
References
- Penn State College of Medicine: Gastric Ulcer
- "Surgery: Basic Science and Clinical Evidence"; Jeffrey A. Norton; 2008
- "British Journal of Surgery"; Drug Consumption Before Perforation of Peptic Ulcer; T. Glarborg Jørgensen, M.D.; December 2005
- "Gastroenterology"; Helicobacter Pylori Infection and Chronic Gastric Acid Hyposecretion; E.M. El-Omar, M.D.; July 1997
