You may remember your dad drinking buttermilk, taking antacids, denying himself rich, spicy foods and grumbling under his breath about his ulcers when he was under stress.
It’s now known that ulcers are not caused by stress or a rich, spicy diet — although stress and spicy foods might make symptoms worse if you already have ulcers. Buttermilk, milk and cream are no longer part of ulcer treatment and may make matters worse and stimulate acid production.
An ulcer, by definition, is an open sore. Pepsin is a digestive enzyme that combines with hydrochloric acid to help break down protein in the stomach. The stomach fluid that results is occasionally acidic enough to break down the protein of the organ itself, creating an ulcer.
You could have an ulcer for some time without knowing it. The major symptom, though, is a gnawing or burning pain in the middle or upper abdomen, usually occurring at night or between meals. You might also experience heartburn, bloating, nausea or vomiting.
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The pain comes from the ulcer itself and from the irritation that results when stomach acids come in contact with the ulcerated area. Some patients report that it usually goes away when they eat.
Since the late 1970s, ulcer patients have had very effective drugs to inhibit acid production — H2 blockers such as Tagamet, Pepcid or Zantac and proton pump inhibitors such as Nexium, Prevacid and Prilosec.
In the early 1980s, Australian doctors Barry Marshall and Robin Warren discovered that 80 to 90 percent of ulcers are caused by an infection with H. pylori bacteria. Exactly how these bacteria are transmitted from person to person is not known. But they are widespread; it’s estimated that half of Americans age 60 and older are infected.
Not all persons infected with H. pylori develop ulcers, but nearly all have gastritis at one time or another. They also have an increased risk of gastric cancer and MALT lymphoma as well as peptic ulcers.
Ulcer patients should be tested for H. pylori and treated with antibiotics, if they are infected. Treatment usually involves a combination of antibiotics taken for two weeks or longer plus additional medications to reduce stomach acid.
Dr. Brenda J. Jobson is a gastroenterologist with Baptist Health Medical Group Gastroenterology in London.