Gastroenterology

Stomach ulcer

In France, 90,000 new cases of ulcers are diagnosed every year. It is estimated that 0.2% of the adult population is affected, women are as much concerned as men. (1)

Stomach or duodenal ulcer (peptic ulcer): definition and causes

A peptic ulcer is a deep sore that forms in the inner lining of the stomach or first part of the small intestine called the duodenum. It results from the aggression of the mucous membrane by the acidity of the gastric liquid. (1)

  • Gastric ulcer can be linked to the bacterial infection by Helicobacter pylori, present in the digestive tract. This bacterium is mostly contracted by mouth during childhood. (1)
  • This infection causes a stomach inflammation (gastritis) that usually goes unnoticed. Over time, it can progress to an ulcer or more rarely to a stomach cancer. (2)
  • Furthermore, taking nonsteroidal anti-inflammatory drugs (NSAIDs), including aspirin, can cause gastroduodenal ulcers. Indeed, these products are aggressive for the stomach lining. (1)

Symptoms and diagnosis of peptic ulcer disease

The peptic ulcer is manifested by pain in the epigastrium (upper and middle abdomen). It feels like a cramp or a painful feeling of hunger. These pains usually occur three hours after a meal and can also occur at night. (3)

It can also cause more atypical manifestations, such as a simple discomfort in the ribs or a pain independent of any food intake. (3)

And finally, some ulcers are asymptomatic. (3)

The diagnosis of a peptic ulcer disease is confirmed by upper endoscopy, which allows to see inside the stomach and the duodenum by using a small camera. The ulcer appears as a crater with raised, red edges. (3)

The doctor investigates if the patient is infected or not with H. pylori :

  •  By gastric biopsy (histological and bacteriological analysis). (3)
  • By looking for specific antibodies in patient’s blood. (3)
  • By looking for antigens in patient’s stools. (3)

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