Peptic Ulcer: Role Of H. Pylori Bacteria

Approximately 25 million Americans suffer from peptic ulcer disease at some point in their lifetime. Each year there are 500,000 to 850,000 new cases of peptic ulcer disease and more than one million ulcer-related hospitalizations. A peptic ulcer is a sore on the lining of the stomach or duodenum, which is the beginning of the small intestine.

Ulcers can develop at any age, but they are rare among teenagers and even uncommon in children. Duodenal ulcers occur for the first time usually between the ages of 30 and 50 years. Stomach ulcers are more likely to develop in people older than 60 years. Duodenal ulcers occur more frequently in men than women; stomach ulcers develop more often in women than men.

The most common ulcer symptom is a gnawing or burning pain in the abdomen between the breastbone and the navel. This pain typically occurs when the stomach is empty, between meals and in the early morning hours, but it can also occur at other times. It may last from minutes to hours and may be relieved by eating or by taking antacids. Less common ulcer symptoms include nausea, vomiting and loss of appetite and weight. Bleeding from ulcers may occur in the stomach and duodenum. Sometimes people are unaware that they have a bleeding ulcer, because blood loss is slow and blood may not be obvious in the stool. These people may feel tired and weak. If the bleeding is heavy, blood will appear in vomit or stool. Stool containing blood appears tarry or black.

Although we used to think that spicy food, acid and stress were the major causes of ulcers, but we now know that nine out of ten ulcers are caused by H. pylori, a type of bacteria. H. pylori weakens the protective mucous coating of the stomach and duodenum, which allows acid to get through to the sensitive lining beneath. Both the acid and the bacteria irritate the lining and cause an ulcer. Medicines that reduce stomach acid may make you feel better, but your ulcer may recur. Here's the good news: Since most ulcers are caused by this bacterial infection, they can be cured with the right antibiotics.

Diagnosing H. pylori infection

Several methods may be used to diagnose H. pylori infection. Blood, breath and stomach tissue tests may be performed to detect the presence of H. pylori

Treatment regimens for H. pylori

If you have an ulcer, you should be tested for H. pylori and if it's infected, you should be treated with antibiotics. Antibiotics are the new cure for ulcers; therapy is 1-2 weeks of one or two antibiotics and a medicine that will reduce the acid in the stomach. This treatment is a dramatic medical advance because eliminating H. pylori with antibiotics means that there is a greater than 90 percent chance that the ulcer can be cured for good.

In most cases, anti-ulcer medicines heal ulcers quickly and effectively. Eradication of H. pylori prevents most ulcers from recurring. However, people who do not respond to medication or who develop complications may require surgery. While surgery is usually successful in healing ulcers and preventing their recurrence and future complications, problems can sometimes result.

Emergency Symptoms

If you have any of these symptoms, call your doctor right away:

Bleeding From A Peptic Ulcer

As an ulcer eats into the muscles of the stomach or duodenal wall, blood vessels may also be damaged, which causes bleeding. If the affected blood vessels are small, the blood may slowly seep into the digestive tract. Over a long period of time, a person may become anemic and feel weak, dizzy or tired. If a damaged blood vessel is large, bleeding is dangerous and requires prompt medical attention. Symptoms include feeling weak and dizzy while standing up, vomiting blood or fainting. The stools may become a tarry black color from the blood. Most bleeding ulcers can be treated endoscopically -- the ulcer is located and the blood vessel is cauterized with a heating device or injected with material to stop bleeding. If endoscopic treatment is unsuccessful, surgery may be required.

Perforation Of Peptic Ulcer

Sometimes an ulcer eats a hole in the wall of the stomach or duodenum. Bacteria and partially digested food can spill through the opening into the sterile abdominal cavity (peritoneum). This causes peritonitis, an inflammation of the abdominal cavity and wall. A perforated ulcer that can cause sudden, sharp, severe pain usually requires immediate hospitalization and surgery.

Narrowing and obstruction Of Peptic Ulcer

Ulcers located at the end of the stomach where the duodenum is attached, can cause swelling and scarring, which can narrow or even close the intestinal opening. This obstruction can prevent food from leaving the stomach and entering the small intestine. As a result, a person may vomit the contents of the stomach. Endoscopic balloon dilation, a procedure that uses a balloon to force open a narrow passage, may be performed. If the dilation does not relieve the problem, then surgery may be necessary.

Although ulcers may cause discomfort, rarely are they life threatening. With an understanding of the cause and proper treatment, most people find relief. Eradication of H. pylori infection is a major medical advance that can permanently cure most peptic ulcer disease.

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