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Ulcers are large sores that develop in the lining of the stomach, at the beginning of the small intestine in the duodenum or in the esophagus. Collectively these ulcers are known as peptic ulcers. Our abdomen produces acids to aid in the process of digestion. Peptic ulcers are of three kinds depending upon which part of the digestive system they have affected.
  • Gastric ulcer: This ulcer forms in the stomach.
  • Duodenal ulcer: It develops in the first part of the small intestine, which is also known as duodenum.
  • Esophageal ulcer: It occurs in the lower section of your esophagus.


Causes
The inner side of the stomach is protected from the acids by a lining of mucous. When this protective lining of the stomach gets damaged, inflammation may occur. The lining of the stomach or the duodenum may bleed if the inflammation is severe. This condition is known as bleeding ulcer. Earlier, an ulcer was believed to be a result of consuming extremely spicy food, however, this cause was proved inaccurate with the finding of the real cause; Helicobacter pylori bacterium. H. pylori is a gastrointestinal infection that disrupts the mucous layer, inflaming the stomach lining, resulting in an ulcer. This bacteria lives in the mucous layer.

Besides this major cause, there are other factors also that lead to the development of this condition. They include the use of non-steroidal anti-inflammatory drugs (NSAIDs) and pain relievers. Smoking and drinking alcohol increases the concentration of stomach acid, and causes damage to the mucus lining. Stress does not cause an ulcer, but leads to its aggravation. When ulcers are deep and chronic, and not superficial, they cause bleeding. A rare condition of gastrin-secreting tumors may also cause multiple ulcers.

Symptoms
Pain in the stomach with a feeling of bloating and abdominal fullness are the first symptoms of an ulcer. When it is a bleeding ulcer, the symptoms may include dark stool with traces of blood, blood in vomit, and/or unexplained weight loss and loss of appetite.

Treatment
Untreated bleeding ulcer may cause more complications like internal bleeding, spread of infection towards the liver or pancreas, or scarring tissues that obstruct the food passage through the digestive tract causing severe vomiting. Treatment depends upon the severity of the symptoms. The treatments that are prescribed and recommended to treat this condition are:
  • Acid blockers: Acid blockers or histamine (H-2) blockers decrease the quantity of hydrochloric acid released into the digestive tract. They help relieve the pain, and promote healing.
  • Antacid: Mostly prescribed with other medications, antacids aid in neutralizing the acid already present in the stomach, thereby providing relief.
  • Proton pump inhibitors: Proton-pump inhibitors reduce the stomach's capacity to produce acid by blocking the action of acid pumps.
  • Antibiotics: They ensure that the infection is cured, thereby reducing the chances of the ulcers to reoccur.
  • Endoscopy: In the endoscopy method, the surgeon uses electricity, heat, etc. to stop the ulcer from bleeding. Once the bleeding ulcer is contained, adrenaline and fibrin glue is injected into the ulcer to reduce the chances of bleeding.
  • Surgery: Surgery is recommended in very severe cases where the bleeding is intense and may cause a hemorrhage. The bleeding vessel and the ulcer is stitched closed in this surgery.
The treatment also includes reduction in smoking and alcohol consumption. Avoidance of excessive use of NSAIDs will also help reduce the chances of developing a bleeding ulcer.