PEPTIC ULCER DISEASE

The gut have several mechanisms that help prevent ulcers from developing, including  a protective coating of mucus layer and certain chemicals produced by the stomach  to protect the cells lining the stomach.
If the mucous layer is damaged or if acid neutralizing substances are not present in normal amounts, digestive juices can cause breakdown of the lining stomach or duodenum, causing ulcers to form.

Peptic ulcers affect more than 4 million people each year in the United States.
Most ulcers heal while others can be serious or even life-threatening.

SYMPTOMS

Pain or discomfort (usually in the upper abdomen)
Throwing up blood or passing dark stool
Early sense of fullness with eating
Lack of appetite
Nausea
Vomiting
Anemia

Not everyone with ulcer symptoms has an ulcer.
Similar symptoms can be caused by acid reflux, gallbladder problems, and stomach cancer.

CAUSES

The two most common causes of peptic ulcers are:
Helicobacter pylori, a bacteria that is frequently found in the stomach
Nonsteroidal anti-inflammatory drugs (NSAIDS) such as aspirin
Helicobacter pylori infection
Helicobacter pylori, also known as H. pylori, is the most common chronic bacterial infection in humans. H  pylori is now recognized to be an important cause of gastric and duodenal ulcers.
H pylori disrupts the mucous layer and causes the release of certain enzymes and toxins injure the cells of the stomach or duodenum.
Nonsteroidal anti-inflammatory drugs  such as ibuprofen ,naproxen  etc
The risk of developing an ulcer depends upon the specific type of NSAID, the dose and duration of use, and individual factors

Other factors
Duodenal ulcers patients  are more likely to have family members with duodenal ulcers
Tobacco
Alcohol abuse
Certain viral infections (eg, cytomegalovirus, herpes virus )

DIAGNOSIS

The most common test is an upper endoscopy, in which a small flexible tube with a camera is passed through the mouth to examine the lining of the stomach and the duodenum.

TREATMENT

Most ulcers can be healed with medications.
Surgery is rarely needed, except when complications have developed.
People who have H. pylori are treated with multiple antibiotics and a medication that reduces acid production.
Smoking,NSAIDs   and caffeine-containing foods (such as coffee, tea, and chocolate ) should be discontinued.
For more information , please see

www.nlm.nih.gov/medlineplus/healthtopics.html
www.niddk.nih.gov/
www.cdc.gov/
www.gastro.org
www.acg.gi.org
www.helico.com/