Ulcers

Ulcers are open sores of either the skin, eyes or some mucous membrane, usually caused initially by abrasion or other trauma, and perpetuated by an infection of the wound, or some other medical condition that prevents it from healing. In more technical terms, it might be described as a macroscopic discontinuity of the epithelium

Excess pressure and impeded blood flow can also sometimes cause ulcers to develop. Symptoms of an ulcer, other than the presence of the ulcer itself, are weakness (depending on the location and seriousness of the ulcer), bleeding, and secondary infection.

Peptic ulcer disease, shortened to PUD, is a disease in which one more more peptic ulcers form along the gastrointestinal tract, which can prove extremely painful. The vast majority of peptic ulcers are caused by the bacteria Helicobacter pylori, which usually lives harmoniously in the stomach. Only around twenty percent of people who experience peptic ulcers consider their condition serious enough to warrant visiting a doctor.

Sometimes ulcers can be caused by things other then helicobacter pylori, such as non-steroidal anti-inflammatory drugs, or NSAIDS, with aspirin being the worst offender, and most are located in the small intestine rather than the stomach itself, though they may still be colloquially known as stomach ulcers.

All symptoms of a peptic ulcer should be investigated by a medical professional as a matter of urgency, since somewhere in the region of four percent of stomach ulcers are caused by malignant tumors. Duodenal ulcers tend to be benign.

Classic symptoms of a peptic ulcer include abdominal pain, particularly in the period following a meal, a feeling of fullness and bloating, nausea, vomiting, regurgitation and loss of appetite. In some cases a patient may vomit or excrete blood.
Some people may be at greater risk of developing peptic ulcers, particularly if they have a history of gastrointestinal problems, heartburn, or particularly heavy use of certain medications.

Drugs that may be associated with increased risk of peptic ulcers include aspirin and other non-steroidal anti-inflammatory drugs, as well as the majority of glucocortocoids wich as prednisolone and dexamethasone.

If a patient experiences one of more of the above symptoms for more than a couple of weeks, urgent medical help should be sought, as complications due to untreated peptic ulcers can be very serious.

Some clue as to whether a suspected ulcer may be gastric or duodenal in nature can be gleaned from the timing of the manifestation of a patient’s symptoms with respect to their mealtimes. Gastric ulcers are much more likely to cause a person pain during a meal and in the few hours following it, as the amount of gastric acid in the stomach increases.

A duodenal ulcer on the other hand is more likely to cause pain before a meal, when more acid is being passed from the stomach to the duodenum, particularly if a patient is hungry (and therefore producing excess acid).

Treatment for mild symptoms of ulceration is mostly in the form of antacids, which will resolve the immediate situation in many cases and allow the patient to recover without having to visit a doctor.

Patients who have been or are taking non-steroidal anti-inflammatory drugs such as aspirin may also be prescribed some form of prostaglandin analogue, such as misoprostol, in order to stave off the threat of developing a peptic ulcer.

Where bacterial involvement, usually H. pylori, is suspected, treatment is usually given by way of administering antibiotics alone or on combination. Suitable antibiotics for this purpose include Tetracycline, Ampicillin and Amoxicillin. Proton pump inhibitors can also be very effective when used in combination with antibiotic treatment.

Ulcers caused by the H. pylori bacteria can usually be completely cured in a relatively short period of time, although if an ulcer does re-occur under these conditions, a doctor may need to prescribe a different antibiotic to reduce the risk of tolerance and failure becoming a factor. Surgical intervention in the event of a bacterial ulcer is extremely uncommon.

Any internal ulcer that is found to be bleeding needs emergency medical assistance to somehow stop the bleeding. Left untreated, a perforated peptic ulcer can spell death for a patient.

Oral ulcers are open sores inside the mouth usually caused by damage to the mucous membrane or the epithelium. This can be due to a variety of factors, from simple trauma, to infection, to cancer or some other illness. Such an ulcer may be prevented from healing by secondary infection or physical agitation, particularly if it is in a specially aggravating spot. If an ulcer persists for more than a week or two, medical help should be sought.

An oral ulcer typically presents as a whitish/yellowish oval with a red border due to inflammation, and may also cause the lymph nodes to become painful and swollen. Sometimes an oral ulcer will cause other parts of the mouth to become irritated and inflamed, and painful.

Most ulcers need to be treated by addressing the root cause of the ulcer, such as bacterial infection, physical abrasion, or excessive acid production in the stomach. This will likely not only cure the ulcer and relieve symptoms, but also help to prevent a recurrence of the ulcer and any associated side-effects.