A peptic ulcer, also known as PUD or peptic ulcer disease, is the most common ulcer of an area of the gastrointestinal tract that is usually acidic and thus extremely painful. It is defined as mucosal erosions equal to or greater than 0.5 cm. As many as 70–90% of such ulcers are associated with Helicobacter pylori, a spiral-shaped bacterium that lives in the acidic environment of the stomach; however, only 40% of those cases go to a doctor. Ulcers can also be caused or worsened by drugs such as aspirin, ibuprofen, and other NSAIDs.
Four times as many peptic ulcers arise in the duodenum—the first part of the small intestine, just after the stomach—as in the stomach itself. About 4% of gastric ulcers are caused by a malignant tumor, so multiple biopsies are needed to exclude cancer. Duodenal ulcers are generally benign.
Symptoms of a peptic ulcer can be
abdominal pain, classically epigastric with severity relating to mealtimes, after around three hours of taking a meal (duodenal ulcers are classically relieved by food, while gastric ulcers are exacerbated by it);
bloating and abdominal fullness;
waterbrash (rush of saliva after an episode of regurgitation to dilute the acid in esophagus - although this is more associated with gastroesophageal reflux disease);
nausea, and copious vomiting;
loss of appetite and weight loss;
hematemesis (vomiting of blood); this can occur due to bleeding directly from a gastric ulcer, or from damage to the esophagus from severe/continuing vomiting.
melena (tarry, foul-smelling feces due to oxidized iron from hemoglobin);
rarely, an ulcer can lead to a gastric or duodenal perforation, which leads to acute peritonitis. This is extremely painful and requires immediate surgery.
Bacteria that cause stomach ulcers and cancer could also be giving us bad breath, according to research published in the December issue of the Journal of Medical Microbiology. For the first time, scientists have found Helicobacter pylori living in the mouths of people who are not showing signs of stomach disease.
The mouth is home to over 600 different species of bacteria, some of which can cause disease. Helicobacter pylori has recently been shown to cause stomach ulcers and is also responsible for a large proportion of gastric cancers. Scientists estimate that between 20 and 80 % of people in the developed world and over 90 % of people in the developing world carry the bacterium.
"Recently, scientists discovered that H. pylori can live in the mouth," said Dr Nao Suzuki from Fukuoka Dental College in Fukuoka, Japan. "We wanted to determine whether the bacteria can cause bad breath, so we tested patients complaining of halitosis for the presence of H. pylori."
The researchers found the bacteria in the mouths of 21 out of 326 Japanese people with halitosis (6.4%). In these people, the concentration of a bad breath gas and the level of oral disease was significantly higher. In patients with periodontal (gum) disease, 16 of 102 people (15.7%) had H. pylori in their mouths.
