A peptic ulcer is a hole in the lining of the stomach, duodenum, or esophagus. These organs are lined by the mucosa, a thick layer of mucous which contains glands that produce digestive juices. Digestive juices include acid and a protein digestive enzyme called pepsin. Peptic ulcers occur when the protective role of the mucosa is compromised and digestive juices injure the walls of the organ.

It was believed for a long time that excess stomach acid was the cause of peptic ulcers. It is now believed that the majority of peptic ulcers are caused by the presence of bacteria known as H. Pylori. Other known causes of peptic ulcers include chronic use of non-steroidal anti-inflammatory pain medications (NSAIDS) such as aspirin, ibuprofen and naproxen. Cigarette smoking is also a known cause of peptic ulcer formation and treatment failure.

H. Pylori infection is very common, affecting an estimated half of the U.S. population over age 60. Infection persists for many years and results in peptic ulcers in 10% to 15% of cases. The way that H. Pylori causes peptic ulcers is not well understood nor is it understood why only some of those infected develop peptic ulcers.

NSAIDS are commonly used to control chronic pain conditions such as arthritis. These medications reduce inflammation by reducing the production of chemicals known as prostaglandins. Prostaglandins are also involved in the protective role of the mucosa. It is believed that NSAID-related prostaglandin inhibition is the cause of peptic ulcers associated with NSAID use.

Cigarette smoking not only increases the risk of peptic ulcer formation but also increases the risk of complications such as bleeding, obstruction and perforation. It is not known exactly how cigarette smoking leads these risks.

Pain is a common symptom of peptic ulcer disease, but it varies tremendously from patient to patient. Some patients report no pain at all and are not diagnosed with peptic ulcer disease until serious complications occur. Others report severe pain even after an ulcer is completely healed.

Treatment is aimed at reducing pain and the risk for complications. Antacids (Tums, Maalox), anti-H2 anti-histamines (Pepcid, Zantac), and proton pump inhibitors (Prilosec, Prevacid) are drugs used to reduce or neutralize acid. Sucralfate (Carafate) and misoprotol (Cytotec) are used to improve protection of the organ wall. Combination antibiotic therapy is used effectively to treat H. Pylori infection. Much as symptoms vary in patients, so do responses to treatments.

Taos Pharmacy staff pharmacist, Melissa Golladay, will conduct a one-hour seminar on gastrointestinal health. Discussion will include the use of nutritional supplements and enzymes to help prevent and treat common GI disorders including peptic ulcers. The seminar will be held at the Total Health and Wellness Center of Taos next to Taos Pharmacy on Friday, February 20, 2009, from 5 p.m. to 6 p.m. The cost is $10. Highlighted products will be available for purchase. The seminar fee will be credited to purchases. Call Melissa at (757) 758-3342 for more information. Sign up for the seminar at Taos Pharmacy.

Reference: http://www.medicinenet.com/peptic_ulcer/article.htm, http://digestive.niddk.nih.gov/ddiseases/pubs/yrdd/.

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