Ulcer or tapeworm?

Dear Alice,

How does one get an ulcer or a tapeworm?

— Stomachache

Dear Stomachache,

A person gets a peptic ulcer or a tapeworm in two very different ways, although the symptoms of both are sometimes similar. A peptic ulcer is a raw area that occurs in the gastrointestinal tract, where it is bathed in gastric juice. Tapeworms, also called cestodes, are ribbon shaped parasitic worms that live in human or animal intestines and they are typically acquired from eating undercooked meat or fish.

Ulcers are formed by a variety of factors related to the gastric glands in the lining of the stomach that secrete acid and the enzyme pepsin, which help break down food. The acid and pepsin would quickly eat away the stomach and duodenum if other cells in the lining did not secrete protective mucus. Peptic ulcers may be caused by one or more of the following: increased acid secretion, reduced mucus production, a bacteria called Helicobacter pylori (H. pylori), or factors that irritate the lining such as alcohol or other drugs. Some medications, such as those of the aspirin group, act as irritants and reduce mucus production. If damaging influences overcome the protective factors in the stomach or duodenal lining, the mucous layer and mucus secreting cells are eroded and an ulcer forms. Stress is generally not considered a primary cause of ulcers but may aggravate an existing ulcer. While some people may have no symptoms of an ulcer, those with symptoms may experience:

  • A burning or gnawing pain in the abdomen that is relieved by eating
  • Diarrhea
  • Loss of appetite
  • Belching
  • Feeling bloated
  • Weight loss
  • Nausea
  • Vomiting

Tapeworms, on the other hand, are parasitic creatures that take up residence in the gastrointestinal track of host organisms. They can grow to be 20 or even 30 feet long and occur worldwide, although they are much less common in developed countries. Despite their size, the tapeworms rarely cause symptoms, except mild abdominal discomfort and diarrhea. Segments of the worm may detach and emerge through the anus or may appear in feces.

Because the causes and treatments are very different between these two intestinal issues it's good for a concerned individual to consult their health care provider. Keep in mind that both conditions are treatable with modern medicine, but may cause damage if left untreated for long periods of time.

Take care,

Last updated Jul 28, 2015
Originally published Dec 16, 1994

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