What Causes Ulcer?

Are ulcers a common medical condition? In a gathering of scores, you can find at least one person with an ulcer or had one before. Despite being common, many do not know the causes; and there is much misinformation about it.

Ulcers are open sores that develop on the stomach lining, small intestine, or oesophagus and can cause significant discomfort. These sores occur when the protective mucous layer that shields the gastrointestinal (GI) tract is damaged, allowing stomach acid to eat away at the tissue underneath. 

Types of Ulcers

Ulcers are classified into three main types: 

• Gastric ulcers (in the stomach)
• Duodenal ulcers (in the upper part of the small intestine)
• Oesophageal ulcers (in the oesophagus). 

Understanding the primary causes of ulcers is crucial to preventing and effectively treating them.

Symptoms of Ulcers

The symptoms of ulcers can vary in severity and may come and go, but they often include:

1. Burning or Gnawing Pain
2. Bloating
3. Heartburn or Acid Reflux
4. Nausea 
5. Vomiting that may contain blood or look like coffee grounds, is a sign of bleeding in the stomach. 
6. Loss of Appetite
7. Weight Loss
8. Dark or tarry stools are a sign of bleeding in the digestive tract.

If you experience any of these symptoms, especially bloody vomit or stools, it’s important to seek medical attention immediately, as these could indicate a more severe condition.

Common Causes of Ulcer

Helicobacter Pylori Infection

The most common cause of ulcers is infection with Helicobacter pylori (H. pylori). The spiral-shaped bacterium is known to thrive in the stomach’s acidic environment. Once it infiltrates the stomach lining, it weakens the mucous barrier that protects the tissue from stomach acid. As a result, the stomach lining becomes more susceptible to damage from digestive acids, which can lead to ulcer formation.

If left untreated, an H. pylori infection can lead to chronic gastritis, ulcers, and in severe cases, stomach cancer. This is treatable with antibiotics and acid-reducing medications once diagnosed through a breath test, stool test, or endoscopy.

Abuse of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to treat pain, inflammation, and fever, but abuse or prolonged use is a leading cause of ulcers. Medications like aspirin, ibuprofen, and naproxen reduce the production of prostaglandins, the chemicals that protect the stomach lining from acid. With lower levels of prostaglandins, the mucous lining becomes thinner, exposing the stomach and small intestine to irritation and potential ulceration.

Long-term NSAID use can also cause complications, including gastrointestinal bleeding and perforation (holes in the stomach or intestinal lining). Patients who regularly use these medications should take them cautiously, ideally under medical supervision, and consider alternatives if they are prone to ulcers.

Excessive Alcohol Consumption

Drinking alcohol in excess is another significant factor that increases the risk of developing ulcers. Alcohol irritates and inflames the stomach lining, making it easier for acid to cause damage. Over time, heavy drinking weakens the mucosal barrier, leaving the stomach vulnerable to ulcers and other gastrointestinal issues such as gastritis (inflammation of the stomach lining).

In addition to its direct effects on the stomach lining, alcohol can also hinder the healing process in individuals who already have ulcers. Reducing alcohol intake is often advised for those at risk of ulcers or those currently suffering from them.

Smoking

Smoking is a well-established risk factor for ulcers, particularly for duodenal ulcers. The chemicals in tobacco smoke reduce the stomach's ability to produce bicarbonate, which neutralizes stomach acid. Smoking also increases the production of stomach acid and impairs blood flow to the stomach lining, both of which can make the stomach more susceptible to ulcers.

Research has shown that smokers are more likely to develop ulcers and less likely to experience full recovery after treatment. Additionally, smoking increases the risk of ulcer recurrence. 

Medical Conditions

Certain medical conditions can also lead to ulcer formation. One such condition is Zollinger-Ellison syndrome, a rare disorder that causes tumours in the pancreas or duodenum to produce excessive amounts of gastric acid. This excessive acid overwhelms the protective mechanisms of the stomach and intestines, leading to recurrent ulcers.

Additionally, conditions like Crohn’s disease, which causes chronic inflammation of the GI tract, can result in ulcers forming in the stomach or intestines. 

Does eating spicy foods cause ulcers? 

Contrary to popular opinion, eating spicy foods does not directly cause ulcers. But it can worsen the symptoms or trigger abdominal pain in people who already have them. 

Conclusion

Ulcers can occur from bacterial infections, medication use, lifestyle habits, and underlying medical conditions. The most common causes—H. pylori infection and NSAID use—can be effectively managed with proper medical intervention. Meanwhile, reducing alcohol consumption and quitting smoking can help prevent ulcers and promote healing.

If you experience symptoms of an ulcer, it’s essential to seek medical advice. Early diagnosis and treatment are crucial to preventing complications.