How Does an Ulcer Form?
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About Gastric Acid and Ulcers
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The stomach produces gastric acid to digest food and kill bacteria entering the body through the upper gastrointestinal tract. In order to keep the gastric acid from damaging the cells of the stomach, the stomach lining produces a layer of thick mucus. The acid can then be neutralized before it permeates the mucus layer. In the case of an ulcer, the mucus layer is rendered ineffective, and the stomach lining is exposed to gastric acid. It is the mucosal erosion itself which is termed an ulcer.
An ulcer anywhere in the gastrointestinal tract is called a peptic ulcer. An ulcer in the stomach is a gastric ulcer, while an ulcer in the duodenum is a duodenal ulcer. Duodenal ulcers are more common than gastric ulcers.
H. pylori Bacteria
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The majority of peptic ulcers are caused by the helicobacter pylori bacterium. Unlike most bacteria, which cannot survive in the acidic environment of the stomach, H. pylori can live in the mucus layer of the stomach. Its spiral shape allows it to permeate the lining of the mucus layer. Once there, it multiplies and produces large amounts of the enzyme urease, which creates ammonium. Ammonium damages the surrounding cells, weakening the mucus layer. Stomach acid can then damage the sensitive stomach lining, and the bacteria itself can also irriate and inflame this lining.
Ulcers caused by H. pylori infection are treated with both an anti-acid medication and antibiotics.
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Other Causes
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Though 60% of gastric ulcers and 90% of duodenal ulcers are the result of H. pylori infection, there are several other causes. The stomach may produce too much acid. The stomach does not produce enough mucus.
The mucus produced does not adequately protect the stomach lining.Ulcers caused by these conditions are all treated with acid-reducing medications. Eating cabbage or fresh cabbage juice can also result in a thickening of the mucosa layer.
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Resources
- Photo Credit Gastric ulcer. Image by Dr. Ed Uthman.
