Ulcer << UHL suhr >> is an open sore in the skin or mucous membrane. During the development of an ulcer, part of the surface tissue breaks down and dies, leaving a raw, inflamed area that heals slowly.
Probably the best-known kinds of ulcers are peptic ulcers, which occur in the digestive system. There are two main types of peptic ulcers. Duodenal ulcers form in the duodenum, the upper part of the small intestine. Gastric ulcers develop in the stomach. During digestion and at certain other times, the stomachs of most people produce hydrochloric acid and an enzyme called pepsin. These powerful digestive juices can eat through the lining of the stomach and duodenum. Normally, mucous secretions protect the stomach and duodenum from the effects of digestive juices. Secretions of bicarbonate into the duodenum also neutralize these juices.
Most people who have peptic ulcers are also infected with Helicobacter pylori, a bacterium that lives in the stomach. Scientists believe that this bacterium is associated with the development of ulcers, but they are uncertain exactly how. The bacterium may cause an increase in stomach acid, or it may produce a toxin that harms the stomach lining. H. pylori infection occurs worldwide, but it is most common in developing countries. In the United States, the bacterium infects 10 to 20 percent of people under the age of 30 and more than 50 percent of people over age 60.
Other agents that increase the risk of getting ulcers include aspirin and nonsteroidal anti-inflammatory drugs. These widely used medications can inhibit function of prostaglandins, chemical compounds found throughout the body. Prostaglandins in the stomach control the production of stomach acid.
Most peptic ulcers cause pain in the upper part of the abdomen. The pain usually occurs when the stomach is empty, either between meals or at night. Medications that neutralize stomach acid or suppress its secretion relieve the pain temporarily. Eating may also ease the pain. If H. pylori is present, doctors may prescribe antibiotics. People can reduce the risk of ulcers by eliminating cigarette smoking and the consumption of alcoholic beverages.
Patients with peptic ulcers may develop such complications as blockage of the stomach or duodenum, internal bleeding, and perforation of the stomach wall. These conditions usually require surgery.
Other kinds of ulcers include chronic leg ulcers, which may result from poor blood circulation caused by diabetes, hardening of the arteries, or varicose veins. Decubitus ulcers, commonly called bedsores, afflict many patients who are confined to bed or a wheelchair. Ulcers also occur in the mouth, in the wall of the bladder, and on the eyes.
