- Key People:
- Barry J. Marshall
- Robin Warren
- Related Topics:
- stomach
- ulcer
- gastrectomy
- gastric ulcer
peptic ulcer
-
What is a peptic ulcer?
A peptic ulcer is a lesion in the mucous membrane of the stomach or duodenum caused when the lining cannot resist gastric juice's acidic effects. Helicobacter pylori infection and long-term use of NSAIDs are major causes.
H. pylori neutralizes the acidic environment by converting urea into ammonia and carbon dioxide, weakening the mucosal lining. This makes it susceptible to gastric acid, leading to ulcer formation. NSAIDs can also lead to peptic ulcers.
Symptoms include burning pain in the upper abdomen, one to three hours after meals or several hours after retiring. Complications include bleeding and abdominal wall perforation. Treatments involve antibiotics for H. pylori-induced ulcers, proton pump inhibitors, and H2 blockers.
2 Britannica SourcesCreated from Britannica articles using AI. AI can make mistakes, so verify using Britannica articles. -
Where in the body do peptic ulcers commonly form?
Peptic ulcers commonly occur in the mucous membrane of the stomach or duodenum (the upper segment of the small intestine). Duodenal ulcers account for 80% of all peptic ulcers. Gastric ulcers usually occur halfway up the inner curvature of the stomach.
These lesions arise when external factors compromise the mucosal lining's ability to withstand gastric juice, a mix of digestive enzymes and hydrochloric acid. The two main causes are long-term use of NSAIDs and infection by the bacterium Helicobacter pylori.
2 Britannica SourcesCreated from Britannica articles using AI. AI can make mistakes, so verify using Britannica articles. -
What causes peptic ulcers to develop?
Peptic ulcers primarily arise from two main factors: infection with Helicobacter pylori (H. pylori) and prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs). H. pylori neutralizes stomach acid, impairing the mucosal lining's ability to withstand gastric acid, leading to ulcer formation. NSAIDs can also reduce the stomach's ability to resist acid.
Other factors can worsen ulcers. These include smoking, which impairs healing, and conditions like Zollinger-Ellison syndrome, which increases gastric acid secretion. Though once believed to be major causes, stress and spicy foods do not cause ulcers, but they can aggravate them, as can alcohol and caffeinated drinks.
3 Britannica SourcesCreated from Britannica articles using AI. AI can make mistakes, so verify using Britannica articles. -
How do peptic ulcers affect the tissues of the stomach or intestines?
Peptic ulcers primarily affect the mucous membrane of the stomach or duodenum when factors weaken the mucosal lining's ability to resist gastric juice digestive enzymes and hydrochloric acid). Helicobacter pylori can cause the mucosal lining to break down, and in its weakened state, it cannot withstand the corrosive effects of gastric acid, leading to ulcer formation. Lesions confined to the superficial layers are called erosions; those extending deeper are ulcers.
2 Britannica SourcesCreated from Britannica articles using AI. AI can make mistakes, so verify using Britannica articles. -
What are some symptoms or problems that peptic ulcers can cause?
Peptic ulcers, lesions in the stomach or duodenum, can cause several symptoms and complications. The primary symptom is a burning or gnawing pain in the mid-upper abdomen, typically felt one to three hours after meals or at night.
Complications include hemorrhage, which may manifest as bloody vomit or tar-colored stools, and perforation of the abdominal wall, leading to intense pain and shock. Another complication is obstruction of the stomach outlet due to scarring, causing vomiting and malnutrition.
2 Britannica SourcesCreated from Britannica articles using AI. AI can make mistakes, so verify using Britannica articles. -
How can peptic ulcers be diagnosed and treated by doctors?
Peptic ulcers, affecting 10ā15% of people globally, are diagnosed via esophagogastroduodenoscopy (EGD), where an endoscope visually examines the esophagus, stomach, and duodenum for abnormalities.
Until the 1980s, the causes of peptic ulcers were unclear; however, researchers discovered that the bacterium Helicobacter pylori and long-term use of NSAIDs are major causes. Recommended treatments for H. pylori-induced ulcers include antibiotics (tetracycline, metronidazole, amoxicillin, clarithromycin), drugs that halt stomach acid secretion, proton pump inhibitors (omeprazole, lansoprazole), and H2 blockers (cimetidine, ranitidine). Bismuth subsalicylate may also protect the stomach lining from acid.
5 Britannica SourcesCreated from Britannica articles using AI. AI can make mistakes, so verify using Britannica articles.
peptic ulcer, lesion that occurs primarily in the mucous membrane of the stomach or duodenum (the upper segment of the small intestine); it is produced when external factors reduce the ability of the mucosal lining to resist the acidic effects of gastric juice (a mixture of digestive enzymes and hydrochloric acid). Until recently the factors responsible for peptic ulcers remained unclear; a stressful lifestyle and rich diet commonly were blamed. Evidence now indicates that infection with the bacterium Helicobacter pylori and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) are the two major causes of peptic ulcer.
Between 10 and 15 percent of the worldās population suffers from peptic ulcer. Duodenal ulcers, which account for 80 percent of peptic ulcers, are more common in men than in women, but stomach ulcers affect women more frequently. The symptoms of gastric and duodenal ulcer are similar and include a gnawing, burning ache and hungerlike pain in the mid-upper abdomen, usually experienced from one to three hours after meals and several hours after retiring.
In the early 1980s two Australian researchers, Barry Marshall and J. Robin Warren, challenged previous theories of ulcer development with evidence that ulcers could be caused by H. pylori. This theory was greeted with skepticism because it was thought that no organism could live in the highly acidic conditions of the stomach and duodenum. H. pylori overcomes this obstacle by converting the abundant waste product, urea, into carbon dioxide and ammonia, creating a more neutral local environment. Although the mechanism is not completely understood, this process causes the mucosal lining to break down. In its weakened condition the lining cannot withstand the corrosive effects of gastric acid, and an ulcer can form.
" height="20" alt="HEW Logo">
Infection with H. pylori is the most common bacterial infection in humans; it is pervasive in the Third World, and in the United States it affects about a third of the population. Among those who suffer from peptic ulcers, as many as 90 percent of those with duodenal ulcers and 70 percent with gastric ulcers are believed to be infected with H. pylori. Evidence also exists that untreated H. pylori infection may lead to stomach cancer. The recommended treatments for H. pylori-induced ulcers are antibiotics, such as tetracycline, metronidazole, amoxicillin, and clarithromycin, and drugs that stop the secretion of stomach acid, including proton pump inhibitors (omeprazole or lansoprazole) and H2 blockers (cimetidine and ranitidine). Bismuth subsalicylate may also be used to protect the lining of the stomach from acid.
Most peptic ulcers not caused by H. pylori infection result from the ingestion of large quantities of NSAIDs, which often are prescribed for conditions such as rheumatoid arthritis. Withdrawal of NSAID treatment usually allows the ulcer to heal, but if this is not possible the ulcer can be managed with the H2 blockers cimetidine and ranitidine (marketed as Tagametā¢ and Zantacā¢, respectively) or with the proton pump inhibitors lansoprazole (Prevacidā¢) and omeprazole (Losecā¢ or Prilosecā¢). A small proportion of peptic ulcers results from the Zollinger-Ellison syndrome, an uncommon disease associated with a tumour of the duodenum or pancreas that causes an increase in gastric acid secretion. Cigarette smoking has been found to have an adverse effect on peptic ulcers, slowing healing and promoting recurrence. Complications of ulcers include bleeding, perforation of the abdominal wall, and obstruction of the gastrointestinal tract.