What Are Ulcers?
The term ‘ulcer’ means, in the most general sense, a lesion anywhere but more often in the digestive tract. It’s often used, though, as a shorthand term for the phrase ‘peptic ulcer’. The latter isn’t a condition of the colon - the major portion of the large intestine - at all. It affects the stomach usually, but may also occur in the duodenum (the first section of the small intestine), or even the esophagus (the section leading from the throat or pharynx to the stomach).
General ulcers or lesions that occur in the colon are typically part of other IBDs or inflammatory bowel diseases, such as Crohn’s or ulcerative colitis. By contrast, peptic ulcers are sores in the stomach or duodenum lining where the holes cause contact between its contents and inner tissues.
That contact can be both painful and lead to secondary complications. Here’s how…
The digestive system is not, strictly speaking, a closed system with a hole at each end. The epithelial tissue lining it evolved mechanically and biochemically into what is known as a permeable membrane. That is, materials can pass through it selectively, with water and nutrients or vitamins produced in the digestive tract moving into the body.
However, when stomach acid (a type of hydrochloric acid), bile, and actual semi-digested food pass through the stomach or intestines, pain and disease can result. Toxins, for example, then pass directly into the bloodstream rather than being moved down and eliminated. Looking at the other direction, when blood passes out of the surrounding tissues and into the digestive system, the result is pain and abdominal cramping, bleeding, and bloody stools, with resulting anemia.
Both circumstances have serious health consequences and ulcers are the lesions that make such inappropriate movements of material possible. They are the ‘holes’ through which the substances pass.
The causes of ulcerative colitis, Crohn’s and other diseases involving colon lesions are not known. However, in the case of peptic ulcers in the stomach there is very strong evidence about the cause: infection. Once thought to be the result of stress and diet (in the form, for example, of spicy foods), research now strongly favors the view that bacteria are the culprit.
In fact, one organism in particular is thought to be the main culprit in most peptic ulcers: Helicobacter pylori or H. pylori. It lives and multiplies within the mucous layer that lines the stomach and small intestine, a substance that provides it with a ‘good’ growth medium.
There are other possible causes, however, such as overuse of pain relievers. NSAIDs (non-steroidal anti-inflammatory drugs), such as aspirin (Bayer, and others), ibuprofen (Advil, Motrin), and naproxen (Aleve) can produce lesions in the stomach lining or small intestine.
Buffering helps but coated aspirin, for example, only delays dissolving the drug so that it occurs not in the stomach but in the small intestine. That can benefit some, in particular by changing the site at which the drug begins to act, but some individuals are more sensitive in the intestine than the stomach.
Short-term, occasional lesions are a normal occurrence, even when unpleasant, and the body typically heals itself within a day or two. Long-term problems, such as ulcerative colitis, Crohn’s, or chronic peptic ulcers require professional diagnosis and treatment. See your physician for guidance.
