Ulcers and the Bacteria That Causes Them

IMAGE Ulcers were believed to be caused by stress, smoking, anxiety, and/or a diet rich in spicy foods. However, research has shown that most ulcers are caused by a spiral-shaped bacterium known as Helicobacter pylori (H. pylori). The other common cause of ulcers is nonsteroidal anti-inflammatory drugs (NSAIDs).

Anatomy of an Ulcer

When we eat, food passes down the esophagus (throat) and into the stomach. There, hydrochloric acid and pepsin (an enzyme) continue the digestive process that started with the saliva in your mouth. Next, food passes to the duodenum (small intestine) where the digestive process continues. An ulcer is an area of stomach or duodenum that has been damaged by the digestive enzymes and stomach acid. How H. pylori causes ulcers is not yet fully understood. We do know that:
  • The bacteria can live in the stomach because they attach to cells and produce an enzyme that stops the corrosive effects of stomach acid.
  • The bacteria damages the protective mucous layers of both the stomach and the duodenum.
  • Not everyone who has the bacteria will develop an ulcer.
  • Being infected with the bacteria is also a risk factor for developing stomach cancer.
An ulcer that goes untreated can cause several problems in the abdomen, such as:
  • Internal bleeding
  • Perforation (a hole) in the stomach or duodenum allowing food and bacteria to spill into the abdomen and cause infection and irritation
  • Blockage of the opening between the stomach and duodenum due to chronic inflammation that leads to swelling and scarring

Discovering the Causes of Ulcers

The story behind the discovery of the H. pylori bacteria and its relationship to ulcers is an unusual one. In 1982, two Australian researchers, Drs. Barry Marshall and Robin Warren, detected the bacteria in the stomach lining of people suffering from gastritis. When further study demonstrated the presence of the bacteria in nearly 100% of patients with duodenal ulcers and 80% of people with stomach ulcers, Drs. Marshall and Warren proposed that it might be the cause. When their hypothesis was met with a great deal of skepticism, Dr. Marshall ingested a teaspoonful of the bacteria. Within 24 hours, he developed severe gastritis. Further research by Dr. Marshall, Dr. Warren, and others established that it does in fact cause 50% of stomach ulcers and 90% of the much more common duodenal ulcers. Of the ulcers that are not caused by H. pylori, most are caused by NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen, and naproxen. NSAIDs block the production of mucous in the stomach that protects the lining from the damaging effects of the stomach acid.

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