The liquid from the stomach that refluxes into the esophagus damages the cells lining the esophagus. The body responds in the way that it usually responds to damage, which is with inflammation (esophagitis). The purpose of inflammation is to neutralize the damaging agent and begin the process of healing. If the damage goes deeply into the esophagus, an ulcer forms. An ulcer is simply a break in the lining of the esophagus that occurs in an area of inflammation. Ulcers and the additional inflammation they provoke may erode into the esophageal blood vessels and give rise to bleeding into the esophagus. Occasionally, the bleeding is severe and may require transfusions of blood and endoscopic (a procedure in which a tube is inserted through the mouth into the esophagus) or surgical treatment.
What causes ulcers?
The direct cause of peptic ulcers is the destruction of the gastric or intestinal mucosal lining of the stomach by hydrochloric acid, an acid normally present in the digestive juices of the stomach.
Infection with the bacterium Helicobacter pylori is thought to play an important role in causing both gastric and duodenal ulcers. Helicobacter pylori may be transmitted from person to person through contaminated food and water. Antibiotics are the most effective treatment for Helicobacter pylori peptic ulcers.
Injury of the gastric mucosal lining, and weakening of the mucous defenses are also responsible for gastric ulcers. Excess secretion of hydrochloric acid, genetic predisposition, and psychological stress are important contributing factors in the formation and worsening of duodenal ulcers.
Another major cause of ulcers is the chronic use of anti-inflammatory medications, such as aspirin. Cigarette smoking is also an important cause of ulcer formation and ulcer treatment failure.
The major symptom of an ulcer is a burning or gnawing feeling in the stomach area that...