1. An Ulcer is a Hole in the Lining of Your Stomach
A stomach ulcer is a hole, or sore, in the lining of your stomach or in the duodenum, which is the part of the small intestine that adjoins your stomach. Under certain conditions, stomach acid and digestive juices can bypass the stomach's usual protection and seep into the stomach lining, causing sores or ulcers. Symptoms include stomach pain that comes and goes. People describe this pain variously as gnawing, soreness, burning, aching, or a chronic hungry or empty feeling.
2. A Bacterial Infection with Helicobacter pylori is Linked to Most Ulcers
Nearly 100% of people with stomach ulcers are infected with a bacterium called Helicobacter pylori. This organism is uniquely adapted to live in the stomach because it can protect itself from the high acid concentration with a layer of bicarbonate. By infecting the lining of the stomach, H pylori infection causes gastritis, which is an inflammation of the stomach lining. Once gastritis sets it, the stomach lining has a more difficult time maintaining its natural defenses against stomach acids.
Antibiotics that kill H pylori are used to treat ulcers. Drugs that block the secretion of stomach acid are also required. And doctors sometimes suggest using bismuth subsalicylate, which is available over-the-counter as Pepto Bismol, as well, to reduce stomach acid and speed healing. Treatment typically takes 4 to 8 weeks.
3. Only 10% of People with Helicobacter pylori Infection Get Ulcers
Not all the blame for stomach ulcers belongs to H pylori. Some scientists think that H pylori infection is the most common bacterial infection in humans. In developing countries, up to 100% of people are infected. In developed countries, as many as 80% of people born before 1950 are infected, and at least 20% of people born after 1950 are infected. Here's the kicker: Only 10% of people who have H pylori infection have stomach ulcers. Something else is going on here to cause stomach ulcers.
4. Stress Can Interact with Helicobacter pylori Infection to Cause Ulcers
Some scientists think that stress does not contribute to the risk of ulcers. Others present evidence that stress does increase the risk. For many years before scientists discovered the role of H pylori infection, people assumed that emotional stress contributed to the development of ulcers. They made this connection simply by observing people who had ulcers. Scientific studies have shown that the risk of ulcers increases during financial collapses and when people experience severe job or family stress. The rate of ulcers increased among residents of London during the World War II air raids.
One of several possible mechanisms linking stress and ulcers is the production of stomach acid. We all tend to secrete more stomach acid when stressed, and some studies have shown that people with ulcers secrete even more acid---as much as 10 to 20 times more acid than when they are not deeply stressed.
5. Pain Medications Can Complicate the Stress-Ulcer Connection
Certain pain medications, especially aspirin and NSAIDs, irritate the stomach lining and can also contribute to the development of ulcers independently of stress. And if you're getting achy when stressed by a job or family problem, you may end up taking more of these medications, contributing to a vicious cycle.
