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What Is an Ulcer?

Ulcer: What Is It?

Ulcers are holes that form in the lining of the upper part of the gastrointestinal (GI) tract. When they occur in the stomach, they are called gastric ulcers. If they form in the first part of your small intestine, the duodenum, they are referred to as duodenal ulcers.

“An ulcer is a wound in the lining of the stomach or duodenum, but really any part of the gastrointestinal tract can ulcerate,” explains Patrick I. Okolo, III, MD, MPH, chief of endoscopy at Johns Hopkins Hospital and assistant professor of gastroenterology and hepatology at Johns Hopkins University School of Medicine in Baltimore. “It’s a chronic injury where the lining has been disrupted. However, when people refer to an ulcer they are usually referring to peptic ulcer disease.” The word peptic refers to digestion. A peptic ulcer is the umbrella term for all types of GI ulcers.

Technically an ulcer is at least 0.5 centimeters wide, but can be much larger. Duodenal ulcers mainly occur in people between 20 and 50 years old and gastric ulcers typically appear in people over age 40. Duodenal ulcers are about four times more common than gastric ulcers.

Ulcer: How It Forms

Your stomach is a very hostile environment because of the acids that help in digestion, acids that are as toxic as car battery acid. The lining of your stomach and duodenum usually is well-protected from these acids by a layer of mucus.

Peptic ulcer disease begins when a weakness in your stomach or intestinal lining allows acid to create an erosion or sore in the lining. It is the most common type of stomach disease, according to the American Gastroenterology Association.

Ulcer Symptoms

At first you may only feel mild discomfort (technically referred to as “epigastric pain”) in the pit of your stomach, about halfway between your ribs and your navel.

Without treatment, your ulcer can continue to grow, become very painful, and may bleed. If not treated early, it may eat entirely through the lining of your stomach or intestine (this is called a perforated ulcer) and need surgery to repair. At its worst, a perforated ulcer may lead to significant bleeding and death.

If you have multiple recurrent ulcers, they can cause swelling and scarring as they heal, which may one day cause problems with your digestion. You may:

  • Lose your appetite and be unable to eat a normal amount
  • Start vomiting because of a complete blockage by scar tissue
  • Shed pounds unintentionally