Peptic Ulcer Disease is a source of confusion for both doctors and patients, so your question is a common one. In general the thinking around ulcer disease has changed dramatically in the last decade, and is still in a state of flux.
Ulcers are extremely common and 5-10% of the population will experience this disease in their lifetime. 350,000 new cases are diagnosed each year in the USA with men outnumbering women 2 to 1. They tend to occur between the ages of 40 - 50.
In general, most ulcer's are thought to be due to one of two factors:
Anti-inflammatory medications (Asprin, Advil, Ibuprofin, Naproxen etc)
A newly discovered bacteria called, affectionately Helicobacter pylori.
Medications called Non-Steroidal Anti-Inflammatory Drugs (NSAIDS in fancy doctor lingo), are among the most common drugs prescribed by doctors, and are common over-the-counter preparations. This class of medication includes Aspirin, ASA, Advil, Naproxen, Voltarin, Motrin, and several thousand others. These medications are extremely effective in reducing pain and swelling in conditions such as arthritis. However, they do have a side effect of reducing the normal protective coating in the stomach. Once this coating is reduced, it gives the stomach acids free access to the stomach wall, and sets up a nasty reaction called an ulcer. NSAIDS can also cause ulcers in the first part of the small intestine (the duodenum), by a similar mechanism.
Ulcers caused by Helicobacter pylori are a somewhat different story. By mechanisms mostly unknown, these bacteria take up residence in the stomach, and in interaction with the stomach acid cause a reaction leading to an ulcer. As of yet, we don't know how they get there, why they do, or exactly what they hope to gain from the whole event. As of yet, no way of preventing Helicobacter pylori infection is known, however a vaccination is being investigated in the United Kingdom.
Ulcer treatment drugs fit (with some squeezing) into three categories:
1. Drugs to reduce stomach acid - (Ranitidine, Famatodine, Cimetidine, Omeprazol)
2. Drugs to protect the stomach wall - (Sucralfate, Misoprostil, or bismuth--pepto bismal)
3. Drugs to KILL Helicobacter pylori bacteria - (Amoxicillin, Tetracycline, and other antibiotics)
Ulcer treatment varies from situation to situation, and is rapidly changing as medical research attempts to sort out this confusion.
In Summary, the exact cause of Ulcer disease is unknown, but we do know that NSAIDS and Helicobacter pylori are significant factors. Treatment is highly individualized. For anyone who cannot tolerate a certain treatment due to side effects, alternatives are available, and should be discussed with the family doc.
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