Ulcers of the stomach and intestines have long ceased to be a disease that mainly affects the elderly. If earlier the peak incidence ranged from 55 to 65 years, today often pain, nausea and signs of complications of ulcerative lesions are found in young people and adolescents. Ulcer provocateurs are some medications that patients take, bad habits, nutritional problems and unfavorable heredity play a significant role. What else do we know about peptic ulcer disease? 

Who is more likely to have stomach and intestinal ulcers?

It is believed that the average age of ulceration on the walls of the stomach or duodenum is 40-50 years. But doctors are increasingly saying that the ulcer is getting younger and its manifestations are quite possible at 30, or even at 20-25 years. The percentage of patients is growing steadily with age. This is partly because older people are at greatest risk of contracting the bacteria Helicobacter pylori , one of the main causes of ulcers. H. pylori infection occurs in more than 60% of patients who have a stomach ulcer or duodenal ulcer. It is believed that half of the country’s population over the age of 50 is infected with H. pylori , but symptoms of peptic ulcer disease appear in only 10-15% of patients.  

Peptic ulcer risk factors: who is at risk?

Heredity plays a significant role in the genesis of peptic ulcer disease. If the next of kin have a peptic ulcer, the patient’s chance of developing an ulcer is much higher than in the population. Approximately 20-50% of patients with duodenal involvement report a family history of ulceration in the same location. People with stomach ulcers also have other family members with stomach ulcers.

Unsatisfactory living conditions and unsanitary conditions in a certain way affect the development of the disease. People living in areas without safe drinking water are at increased risk of contracting H. pylori and hence the risk of peptic ulcer disease.

In people who have drug-associated ulcers located on the lining of the stomach or intestines, triggering risk factors include old age, a history of previous chronic illness, and concomitant use of corticosteroids and blood thinners. In addition, these patients suffer from serious systemic disorders such as arthritis, which require frequent medication.

Stomach damage: pain and dyspepsia

While the symptoms of peptic ulcer disease vary greatly from patient to patient, the most common are abdominal discomfort, stomach pain, and nausea. The discomfort or pain is sometimes described as stabbing with needles, daggers, or intense burning. Antacids can provide temporary relief, but pain usually returns within a fairly short time. Pain that signals the presence of an ulcer is usually aggravated by food, especially spicy or fatty foods. But provoking foods or drinks that cause ulcer pain vary greatly from patient to patient. Many patients with stomach pain refuse to eat and therefore lose weight.

Damage to the duodenum

On the contrary, pain emanating from the duodenum is significantly reduced and relieved by food. Patients with ulcerative lesions of this localization may gain weight. The severity of pain does not have a clear relationship with the prevalence and depth of defects, as well as the threat of dangerous complications. In some patients, pain persists, even if the ulcer is completely healed under the influence of drugs. Some people do not experience any pain at all, although the ulcers recur and are quite deep. Ulceration often occurs and disappears spontaneously, if a person does not know about it, or a single defect forms serious complications.

Symptoms of serious complications of ulcers can be more dangerous than the manifestations of the defect itself, as they usually require urgent treatment. Symptoms of serious complications include black stools (bloody), severe abdominal pain, vomiting, or bleeding.

Exacerbation prevention methods: the role of drugs

There is no proven way to prevent peptic ulcer disease. But some lifestyle changes can reduce the risk of ulcers.

It is important to limit the use of drugs of the NSAID group (non-steroidal anti-inflammatory drugs). They provoke ulcers by interfering with the body’s production of prostaglandins, hormone – like compounds that protect the stomach lining. If possible, you should avoid these medications or use the lowest possible dose for as short a time as possible. The label on most NSAIDs recommends using the medication for no more than 10 consecutive days. If the patient feels that you need to control pain longer, you should discuss treatment with your doctor.  

You need to get tested for H. pylori . If the patient is over 50 years old, has had an ulcer before, or has a hereditary predisposition, it is worth asking a doctor to be tested for infection with the bacterium, which is the main cause of ulcers. There are several tests for H. pylori , the patient and the doctor can decide together which one to choose.

The role of bad habits and stress

Bad habits such as smoking and drinking alcohol can negatively affect your stomach health. Smokers are about twice as likely to suffer from ulcers as non-smokers. Bad habits can increase your susceptibility to H. pylori , provide a better environment for bacteria to grow, or reduce the protection of your stomach lining.

It is important to control alcohol consumption, the harm of this habit is also pronounced. Contrary to popular belief, alcohol, coffee, cola, spicy foods, and caffeine have not been proven to play a role in ulcer formation. But, as you know, alcohol, like smoking, increases the risk of developing ulcers and aggravates pain.  

There is conflicting evidence about the role of psychological stress in peptic ulcer disease, but it can worsen ulcers rather than cause them. Acute stress increases heart rate, blood pressure and anxiety, triggering active acid secretion. Relaxation exercises, meditation, and other stress-reducing strategies have been shown to lower blood pressure and slow heart rate. While they cannot prevent ulcers from forming, dealing with stress can help reduce risks.

How to help patients?

The goal of peptic ulcer treatment is to eliminate conditions that aggravate it and provoke a relapse. In people whose ulcers are associated with the use of non-steroidal anti-inflammatory drugs, this means looking for another way to relieve pain. For people who smoke, this means giving up the bad habit. In patients whose condition worsens due to stress, this means looking for new ways to reduce stress.

Since most ulcers are caused by the H. pylori bacterium , eradicating this infection is critical to preventing recurrences of the disease. All patients with ulcers should be tested for H. pylori infection and treated if necessary.