Peptic ulcers are caused by the cell wall being eaten away and are commonly found in the stomach and duodenum. The stomach is lined with mucin, a secretion which protects it from being dissolved by the hydrochloric acid used in digestion. When the mucin does not function the stomach lining will dissolve and a peptic ulcer will appear. This can be caused by the bacteria H. pylori, which increases the acidity of the stomach to such a level that the mucin can no longer protect the stomach wall.
Peptic ulcers can often form in otherwise healthy people who do not have higher levels of acid in their stomach. The cause of this is still unknown, although researchers have found that people with the blood group A are more likely to suffer from a peptic ulcer in the stomach, while people with the blood group O often find them in the duodenum.
Peptic ulcers in the stomach occur equally in men and women, usually after the age of 35 and often as a complication of another disease, particularly conditions of the nervous system and lungs. Duodenal ulcers are much more common in men, first occur between the ages of 15 and 25 and are not usually a complication of a secondary disease. Sufferers have pain in the upper part of the abdomen which usually starts in early morning, stops after eating and returns one or two hours later after the stomach has emptied. This may occur for a few days or last for weeks, often with increased levels of pain.
As the ulcer continues to eat away at the lining of the stomach or duodenum there is inflammation and the patient may begin to vomit up large amounts of undigested food. If the ulcer hits an artery large amounts of blood will be vomited as blood leaks into the digestive tract. This is called penetration and requires immediate emergency surgery.
Peptic ulcers are a common disease in the western world, affecting 10% of all men and 2% of women over the age of 50. They can usually be managed by antacid tablets and eating regularly. The ulcer will become more painful when the body is under stress, either from emotional tension, being tired or from another disease.
Very serious cases can be treated by surgery, in stomach ulcers the affected section of the stomach wall is removed. This method does not work in the duodenum, in this case the nerves that stimulate the production of hydrochloric acid are removed. The death rate for peptic ulcers in western countries in about 4 per 100 000, although with effective treatment most suffers live without excessive levels of pain or discomfort.
