The truth about ulcers

What the signs are, when to be worried, and how to get relief.

By Pam Harrison

Causes of ulcers

We used to think that spicy food, alcohol and a stressful lifestyle could turn on the acid switch in the stomach and that excess acid caused ulcers. These sores -- also referred to as peptic ulcer disease -- occur most commonly in the first part of your small intestine, or duodenum, but can also develop in the lining of the stomach. But in 1982, doctors (who recently won a Nobel Prize for their work) discovered that a common bacteria known as Helicobacter pylori (H. pylori) is the real culprit behind most ulcers. Since then, our focus has shifted from ulcers as a lifestyle issue to ulcers as a treatable -- and curable -- disease.

Here's what you need to know about ulcers.

Not everyone infected with H. pylori gets ulcers.
Although about 20 per cent of North Americans under the age of 40 (and about half of those over the age of 60) become contaminated with H. pylori through environmental exposure, only about 10 per cent develop an ulcer at some point in their life.

Why doesn't everyone infected with H. pylori bacteria end up with an ulcer? Partly because the H. pylori bacteria are not all the same and their ability to cause damage varies, says Dr. David Armstrong, an associate professor of medicine at McMaster University in Hamilton. Also, some people tolerate infection better than others and don't develop symptoms.

Yet another explanation is that while lifestyle factors such as smoking and being under stress don't actually cause ulcers, they may influence why you get an ulcer while your neighbour doesn't. Finally, if you're infected with H. pylori, you're more likely to develop an ulcer -- especially in the stomach -- if you take either acetylsalicylic acid (ASA) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.

Family and general practitioners manage most ulcers without the need for extensive testing. Your physician will need to know the nature of your symptoms. "If it's predominantly heartburn," says Armstrong, "this suggests reflux disease (acid backing up into the esophagus)." If, on the other hand, you experience pain or discomfort in the upper abdomen that comes on either with meals or two to three hours afterward, you're more likely to have an ulcer. If you're not taking ASA or NSAIDs (both can cause ulcers), the most likely explanation for this pain is an ulcer.


Page 1 of 2 -- On page 2, learn what you can do to cope with and cure ulcers.

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