How do you determine if you have an ulcer and what is the best medicine for it?

— Rip torn

Dear Rip torn,

Ulcers can be a real pain! An ulcer is an open sore in the stomach or intestinal lining resulting from destroyed surface tissue. They are often uncomfortable and may eventually prompt heavy bleeding. Approximately half a million Americans develop an ulcer each year. Although ulcers are not restricted by age, they are uncommon in teenagers and especially children. Peptic ulcers, the most common, occur in the stomach (gastric or stomach ulcer) and in the duodenum (duodenal ulcer). Stomach ulcers are more common in women than men and duodenal ulcers are more common in men than women.

Most research today shows that an infection with the bacteria Helicobacter pylori leads to the majority of ulcers. Another cause of ulcers is an increase in the digestive fluids, hydrochloric acid and pepsin, especially in the presence of large doses of aspirin, ibuprofen or other non-steroidal anti-inflammatory drugs (NSAID). These can increase the risk of ulcers because they make the stomach vulnerable to the digestive fluids. Certain lifestyle concerns, such as long-term stress; excess food and/or alcohol; spicy foods; smoking; caffeine consumption; and other behaviors are do not cause ulcers, but may worsen symptoms and/or slow the healing process.

Not all people have symptoms from an ulcer, but when they do, the most common is a burning pain in the abdomen. It usually happens early in the morning, late at night, and/or between meals (when your stomach is empty). Sometimes, a person will feel nauseous, vomit, lose her/his appetite and weight. And for some, the ulcer may be a bleeding ulcer, with blood appearing in vomit or in the stool.

If you are concerned that you may be developing or have developed an ulcer, the first step is to see your health care provider. Only through proper diagnosis can any course of treatment be determined (ranging from medication to simple changes in lifestyle). Make an appointment with your school's health service or your health care provider to discuss options for treatment.

Many believe that the best prevention of ulcers is to modify one's lifestyle. Avoiding tobacco use and limit alcohol use may help prevent ulcers. If you have to, take small doses of NSAID's, but never on an empty stomach. You might consider taking acetaminophen instead.Finally, don't wait until you have an ulcer to do something about creating a healthier lifestyle.

For more information on ulcers, check out the National Digestive Diseases Information Clearinghouse.

Here's hoping that you've got nothing to worry about!


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