Peptic Ulcer

The food we eat travels from the mouth down the food pipe into the stomach, and from there into the small intestine. To digest food, the stomach produces a strong acid called hydrochloric acid. This acid softens food and helps to break it down. A healthy stomach has an inner lining that can stand up to its own acid. But when too much acid is made for too long, or the lining becomes weak, the acid starts to wear away the lining itself and an open sore forms. This sore is called a peptic ulcer. Many people simply call it a stomach ulcer.

A cut on the skin can be seen, cleaned and bandaged. A peptic ulcer is hidden inside the body, so it cannot be seen from outside. The only clues are signs such as stomach pain and vomiting. Knowing how it forms, what causes it and how to avoid it is the best protection we have, because most of its causes are everyday habits that we are able to change.

A peptic ulcer forms in the parts of the digestive system that stomach acid can reach. There are three such places:

• the lower part of the food pipe, where it joins the stomach
• the stomach itself
• the duodenum, which is the first part of the small intestine

Stomach acid sometimes splashes back up into the lower end of the food pipe. When food flows on from the stomach, acid travels with it into the duodenum. This is why these two parts are at risk of a sore just as the stomach is.

Gastritis does not appear overnight. It grows slowly out of daily habits. Its main causes are:

• not eating meals on time
• eating a lot of oily and spicy food on an empty stomach
• taking antibiotics and other medicines

Once gastritis has set in, the stomach begins to release hydrochloric acid in large amounts. When gastritis becomes serious, a sore forms step by step:

• Poor eating habits cause gastritis.
• The inflamed stomach releases a large amount of hydrochloric acid.
• This extra acid does not stop. It keeps coming, day after day.
• The acid wears away the inner lining of the stomach, the food pipe and the mouth of the small intestine.
• A sore forms where the lining has worn away. This sore is the peptic ulcer.

Think of Sunita, who leaves for school without breakfast. By midday she is hungry, so she buys spicy crisps and instant noodles from a shop and eats nothing else until the evening meal. If this goes on for months, her empty stomach is hit again and again with spicy, oily food. First she may develop gastritis. If her habits do not change and the gastritis is not treated in time, extra acid keeps pouring out, and in time it can wear a sore into her stomach.

In recent years peptic ulcer has been growing more common day by day in urban areas. The main reasons are:

• unhealthy eating
• a comfortable lifestyle with little physical activity
• the use of drugs
• smoking

Many people in cities are busy. With little time to cook, they eat ready-made food from the market, and their mealtimes are irregular. More people also sit at a desk all day and do little physical work. Add smoking and drug use to this, and the chance of the stomach making too much acid rises even further.

The causes of peptic ulcer fall into three groups: personal causes, environmental causes, and social and cultural causes. Personal causes belong to a person's own body or habits. Environmental causes come from the food and water around us. Social and cultural causes come from the eating customs of the community we live in.

The first personal cause is gastritis. A germ called Helicobacter pylori can infect the stomach and cause a sore. People whose bodies cannot digest milk products, a condition called lactose intolerance, are also at risk. Taking painkillers and antibiotics on an empty stomach, eating a lot of oily and spicy food, using drugs and smoking are personal causes too.

Environmental causes are linked to food that is easy to find around us. Eating unhealthy ready-made market food such as instant noodles, biscuits, salty snacks and samosas again and again makes the stomach release more acid. Food and vegetables grown with pesticides, and polluted water, have the same effect. The extra acid then leads to a sore.

Social and cultural causes come from the eating customs of a community. Where it is normal to eat very oily, spicy, salty and heavily spiced food, a lot of meat, and roasted, fried and deep-fried dishes, the stomach produces acidic juice in large amounts. For example, during festivals and feasts, days of eating only fried and spicy dishes put a heavy load on the stomach.

A person with a peptic ulcer may show these signs:

• pain in the chest or the upper part of the abdomen
• stomach pain that goes on after eating and also when the stomach is empty
• vomiting again and again
• blood appearing in the vomit
• sour water coming up into the mouth

These signs follow directly from acid and a sore. When acid touches the sore, the upper abdomen hurts with a burning pain. Eating makes the stomach release more acid, and on an empty stomach the acid falls straight onto the sore, so the pain comes at both times. When acid rises, sour water comes into the mouth. If the sore bleeds, blood shows in the vomit.

Since most causes of a peptic ulcer are habits, changing those habits is the way to avoid it. The main ways to prevent it are:

• Do not eat a large amount of food at one time.
• Avoid food that is very spicy, strong, sour or salty.
• Avoid food that is very hot or very cold.
• Do not take on too much worry and mental stress.
• Exercise regularly.
• Do not stay awake late into the night.
• Stay away from drugs and smoking.
• Get gastritis treated in time.
• Drink only milk from which the fat has been removed.

Look closely and each of these measures blocks one of the causes. The table below puts a harmful habit beside the habit that should replace it:

Go back to Sunita. If she eats even a small breakfast before school, brings a home-made snack instead of buying spicy crisps, sleeps on time and plays or exercises every day, her stomach has no reason to pour out extra acid. And if her stomach does begin to burn, she should not ignore it but get it treated in time.