The surprising thing about ulcers isn't how common they are—about 25 million American adults are expected to have an ulcer at some point in their lives, and approximately 350,000 new cases are diagnosed each year. What's surprising is that we don't get them more often.
Every time you eat, your stomach bathes foods in acids to continue digestion that was begun in the mouth. The same acids that break down protein and fat are actually strong enough to damage the stomach and the duodenum, the portion of the small intestine nearest the stomach. The only reason they don't is that the tissues are coated with a protective, spongelike mucous lining that resists the acidic onslaught.
Sometimes, however, the tissues break down. Most ulcers—small, painful sores that are generally about the size of a pencil eraser—occur when a corkscrew-shaped bacterium called Helicobacter pylori bores through the lining of the duodenum or stomach and allows acids to damage the delicate tissue underneath. Over-the-counter medications such as aspirin and ibuprofen can strip away the stomach's protective lining and cause similar problems.
Gastric and duodenal ulcers often may go away on their own within 1 to 3 weeks once aspirin or other tissue-damaging medications are stopped. Ulcers can recur sporadically unless the bacteria are treated, which lowers the recurrence rate to less than 3 percent. The pain in the meantime, however, can be intense. Here's some advice to stop the pain of ulcers and prevent recurrences.
If you're having ulcer symptoms—such as stomach pain, a "gnawing" feeling between meals or at night, a burning sensation beneath the breastbone, or black, tarlike stools—ask your doctor to test for the presence of the Helicobacter pylori bacterium. The infection can be detected with blood or breath tests. If you test positive, your doctor will probably put you on antibiotics for 1 to 2 weeks. In about 97 percent of cases, the ulcer never comes back.
The truth is, about 90 percent of ulcers clear up with home remedies on their own, but without medical treatment they nearly always come back. In severe cases, ulcers will extend all the way through the stomach or intestinal wall, causing a medical emergency, says Philip Miner, M.D.
It's common for people with ulcers to have "sewer breath" long before they have other symptoms, Dr. Miner adds. If your breath has an unusually foul odor, it could be because you're infected with the H. pylori bacterium, and you'll probably need antibiotics to knock it out. Call your doctor.
Samuel Meyers, M.D., is a gastroenterologist and clinical professor of medicine at the Mount Sinai School of Medicine of New York University in New York City.
Philip Miner, M.D., is a gastroenterologist and the president and medical director of Oklahoma Foundation for Digestive Research in Oklahoma City.