Peptic Ulcer

Around 1 in 10 Australians will suffer with peptic ulcer disease during their lifetime. Stress, spicy foods, coffee, alcohol and cigarettes have at various times thought to be the cause.

The real culprit is a bacteria called Helicobacter. Up to 40% of Australian adults carry the bacteria and if not treated the bacterial infection is life-long.

The bacteria tunnel through the protective mucus layer of the stomach, inflaming and breaking down the lining and causing ulcers. Dr Peter Katelaris, a Consultant Gastroenterologist says that "people who get ulcers get pain and they run the risk of complications with their ulcer such as bleeding or perforation.

The germ also increases the risk of getting stomach cancer but it has to be remembered that people who are infected may not get either of these problems."

The bacteria seems to be most commonly transmitted when the level of hygiene is low. Infection usually occurs in childhood. The symptoms of an ulcer include burning aching/discomfort in the upper abdomen called dyspepsia. Symptoms can be temporarily relieved by taking an antacid or drinking a glass of milk. But not everybody who has these symptoms has a peptic ulcer. The best investigation to help make this diagnosis is an endoscopy. It's expensive but very accurate. The patient is sedated and a flexible telescope is passed into their stomach.

The peptic ulcer may be found in the stomach or the duodenum, which is the first part of the small intestine. A sample is taken, examined and tested for the presence of Helicobacter. If it's present, a simple treatment is available.

A triple pack of two antibiotics and one ulcer healing drug is taken for two weeks. It is proven to eradicate Helicobacter in the majority of cases, resulting in the healing of ulcers and the prevention of their recurrences in the majority of cases.

Not everyone needs an endoscopy. Some patients will only require a simple breath test. The patient swallows a special testing solution, waits half an hour and then breathes into a tube. The test tube is sent to a lab to look for evidence of Helicobacter. If you have symptoms your doctor will advise which tests you need and prescribe treatment accordingly. Fortunately the treatment of peptic ulcers these days is very successful and the future looks even brighter. According to Dr Katelaris, "In the longer term we really do want to have a vaccine.

The promise of a vaccine is that if it's given to young children it can prevent them even acquiring the infection and there's also the possibility that the vaccine may be therapeutic. In other words if it is given to people with the infection it may help their own body clear the infection without drugs and that's the great hope for the future."

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