Ulcers cause abdominal pain that often starts one to three hours after finishing a meal. The pain may awaken you from sleep, and it may travel from your stomach to your back. Eating something or taking an antacid may alleviate the discomfort. But some days these remedies will work, and on others, they may not. Somewhere between 30% to 80% of ulcer patients complain that the pain wakes them from sleep, especially if they have eaten a bedtime snack. The pain may last for a few minutes or a couple of hours.
Ulcer symptoms tend to come and go. You may feel the pain regularly for weeks or months, then it will subside for a while, only to start back up again.
Other symptoms include bloating, belching, nausea, vomiting, blood in the stool, decreased appetite, unexplained weight loss, or pain in the upper back. These symptoms occur less frequently than gnawing pain in the upper abdomen. Because ulcers sometimes bleed, you may notice blood in the stool. The blood will cause your stool to be very dark, and have a tar-like appearance.
Sometimes, peptic ulcers do not produce digestive-tract symptoms. Ulcers caused by NSAIDs often do not cause any discomfort or noticeable changes. But these ulcers may bleed. If this occurs, the only symptoms you may experience are fatigue or shortness of breath. Talk to your doctor if you take NSAIDs and develop these symptoms.
The H. pylori infection can be passed between people. Table 01. It appears H. pylori spreads through ingestion of bacteria that has been eliminated from another human body, most likely through vomit. However, it can also be transmitted through stool. Eating food touched by someone who has not washed his or her hands after a bowel movement may be one way in which H. pylori passes from one person to another.
Approximately 20% of young adults in the U.S. are infected, as are 50% of people older than age 60. Poverty increases the risk of infection. This may be due to poorer sanitation and crowded living conditions. Close person-to-person contact seems to increase the spread of H. pylori. People typically pick up the bacteria during childhood.
H. pylori infection occurs more frequently in developing countries. About 80% of those living in developing counties harbor the bacteria.
Table 1. Risk Factors for H.pylori Bacterial Infection
Starting life in a developing country Being born before 1950 Low socioeconomic status Sharing a house with a baby Living in close contact with many family members Exposure to stomach contents (vomit) of someone with the infection Drinking three or more cups of coffee per day
Taking traditional NSAIDs, which include aspirin, ibuprofen, and many other over-the-counter pain relievers, increases the risk of ulcers. As many as 20 million Americans regularly take NSAIDs. Between 15% and 25% of these people develop ulcers visible during an examination of the gastrointestinal tract. Drinking alcohol or smoking adds to the danger. Doctors believe that a new type of NSAID, called a COX-2 inhibitor, is less likely to cause ulcers than older types of NSAIDs because it does not damage the protective mechanisms of the stomach.
Nonsteroidal anti-inflammatory drugs pose a greater risk for older people, those with a history of ulcers, and for patients using steroids or anticoagulant drugs. Among chronic users of NSAIDs, the prevalence of ulcer is 15% to 30%. Development of ulcers in these patients is related to the dose and potency of the drug. Between 6% and 12% of patients who were started on chronic NSAID therapy developed gastric ulcer after eight weeks of treatment. Among the elderly, about 30% of peptic ulcers are caused by NSAIDs. Use of NSAIDs either alone or in combination with steroids and anticoagulant drugs increases life-threatening complications of peptic ulcers.
Having a close relative who has peptic ulcer disease increases your risk.
Twice as many African-Americans and Hispanics develop the condition in comparison to Caucasians.
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