Types of Ulcer

Types of Ulcers

Ulcer is a problems occurring in digestive system. There can be many reasons for ulcer and some reasons can be quite simple whereas some can be quite complex. Digestive tract in human being consist of mouth, stomach, esophagus, duodenum  and  intestines. Wound starts appearing in the lining of digestive track in human being. Ulcer can be there in any part of our digestive system for various reasons but most of the time ulcers are located in the duodenum. Most common types of ulcer are peptic ulcer, gastric ulcer and duodenal ulcer. By the location within the body, this ulcer are named.

Types of Ulcer-

1. Peptic Ulcer

Pepsin exposed ulcer are called peptic ulcer. This broad term includes sores of digestive tract in stomach or duodenum. Previously, it was believed that if anyone developed these types of sores due to spicy food and stress. A new research has shown that these are just the aggravating factor. Main causative agents are infection caused by H. pylori bacteria and reaction to certain medicine like non-steroidal anti inflammatory drugs (NSAID). The symptoms include abdominal discomfort and pain 2-3 hours after one has taken a meal or when on empty stomach. Other symptoms include weight loss, nausea, vomiting, poor appetite and bloating. 

2. Gastric Ulcer

When a peptic ulcer occurs in stomach, is called a gastric ulcer. This ulcer is usually due to NSAID use. A bacterium called Helicobacter pylori (H. pylori) cause this type of ulcer. In gastric ulcer antacid is used as a treatment option. In general the patient starts to feel well after two three weeks of using antacid.

3. Duodenal Ulcer

Duodenal ulcers occur in the duodenum that is the first part of small intestine. This kind of ulcer is mostly commonly caused by bacterial infection of Helicobacter pylori (H. pylori). But if the test of the patient shows negativity for H. pylori infection or NSAID use then serum gastrin level should be checked.

Some less common types are following- 

4. Esophageal Ulcer

Esophageal Ulcer usually occurs in the lower end of the esophagus of a patient. This kind of ulcer caused by the harmful bacteria and that is why most doctors will recommend their patients to use antibiotics to kill these harmful bacteria. Patient with esophageal ulcer may also feel a lot of pain some times and this pain will increase as the Ulcer will come in contact with the acid present in stomach. In this case, patient may also feel difficulty in swallowing and may not eat normally.

5. Bleeding Ulcer

Sometime internal bleeding is caused by a peptic ulcer if that ulcer has been left untreated for a long time called bleeding ulcer and is the most dangerous type of ulcer. And this requires an immediate treatment.

6. Refractory Ulcer

Simple peptic ulcer that has not healed after at least 3 month of treatment are called refractory ulcer.

7. Stress Ulcer

Stress ulcers consist of a group of lesions and usually found in esophagus, stomach or duodenum. Stress Ulcer is normally present in the people who have other illness.  This kind of ulcer will usually go automatically once the stress level goes down. Among all, some of these ulcers are called Curling and Cushing's ulcer. Curling ulcer happens after a burn injury and a Cushing's ulcer can occur after severe head trauma.  The main mechanism of these ulcer is thought to be due to acute tissue hypoxia.

8. Cameron Ulcer

Cameron ulcers are linear erosions in the gastric mucosa that occur secondary to a hiatal hernia. This ulcer is proposed to be due to injury done by the surrounding diaphragm. Hiatal hernia is a part of the stomach pushing out of diaphragm.

9. Idiopathic Ulcer

Some ulcer have an unknown etiology. This kind of ulcer occurs secondarily to certain drugs, conditions, or the environment. Cigarette smoking is associated with increased incidence of peptic ulcer disease.

10. Mouth Ulcer

Sores that develop in the inner lining of the mouth are referred to as mouth ulcer. Common causes of sores in the mouth are measles, anemia, oral candidiasis, viral infection, chronic infection, throat cancer, mouth cancer and also deficiency of vitamin B. Mouth sore is white, yellow or gray in color and round or oval in shape. It causes pain and discomfort usually during eating or drinking. This ulcer can be cured within 10-14 days. In severe cases, it may take several weeks for these to heal completely.

11. Pressure Sores

These lesions are caused in patients who are confined to bed due to some debilitating illness or are on their way to recovery, they are called decubitus ulcer. The bedsore is also called pressure sores as they are caused due to pressure being exerted on skin for long time. In early stage a bedsore manifests itself as a persistent area of red skin that hurt and feel warm. This is also be accompanied with itching. There is loss of upper layer of skin and subsequent damage to the underlying tissue by increasing severity. It occurs on parts like back, hip, shoulder and buttock that are in contact with the bed as one lies down.

12. Genital Ulcer

These are caused due to sexually transmitted diseases like syphilis, thrush or genital herpes. Non-sexual causes of genital ulcer is infection caused by scabies, yeast, genital trauma and Behcet's disease. This ulcer can be  manifest as single or multiple ulcer which is mostly painful.  It may also be associated with rashes and itching sometimes.

Ulcer and its Cause

Reason behind Ulcer Formation The stomach is a bag of muscle that crushes and mixes food with the digestive "juices" hydrochloric acid and pepsin.  If the lining of the stomach (or duodenum) is damaged in one place or another, then pepsin and the acid go to work on the lining as they would on food, break it down as though to digest it. A peptic ulcer is an area of damage to the inner lining of the stomach, esophagus, or duodenum . Over 25 million Americans will have a peptic ulcer at some point in their lifetime. The people of all ages can suffer from ulcer. And also men and women are equally affected. An ulcer is the result of an imbalance between aggressive and defensive factor. On one hand, too much acid and pepsin can damage the tissue of the stomach lining and cause ulcer formation. On the other hand (more commonly), this damage comes first from some other causes, makes the stomach lining susceptible to even an ordinary level of gastric acid. A peptic ulcer is a sore in the lining of stomach or duodenum, the first part of small intestine. Stomach burning pain is the most common symptom. This kind of pain starts between meals or sometimes during the night, stops when eating or taking antacid, may lasts for minute to hour, also comes and goes for several days or weeks. The most common symptom of a peptic ulcer is abdominal pain.  Peptic ulcers include: Gastric ulcer-that occur on the inside of the stomach. Esophageal ulcer-that occur inside the hollow tube (esophagus) that carries food from throat to stomach. Duodenal ulcer-that occur on the inside of the upper portion of small intestine (duodenum).

Ulcer formation in different location

 

Factors playing a role in the development of ulcer may include:

1.      Helicobacter pylori (H. pylori)
Research shows that most ulcer formation is a result of infection with a bacterium called Helicobacter pylori (H. pylori).  The bacterium produces substances that weaken the stomach's protective mucus and make it more susceptible to the damaging effects of acid and pepsin, so, produce more acid.

The bacterium Helicobacter pylori (H. pylori) was established as the leading cause of peptic ulcers in the early 1980s.  It was also found to cause gastritis (inflammation of the stomach lining for damaged tissue).

H. pylori is a spiral-shaped bacterium that can live and grow on the lining tissue of stomach. It has seen that some people are infected with H. pylori and do not show any symptom of infection or sometimes never develop an ulcer. In other people, the organism may persist for years before any symptoms develop.

It remains unclear why some people develop symptoms of infection and some do not. It is also not very clear exactly in which way H. pylori is transmitted from person to person.  In United States, H. pylori infection is more common among the elderly.

              When H. pylori bacteria cause ulcers, physicians think it happens like below:

a)      At first Bacteria weaken the protective coating of the stomach and upper small intestine.

b)     The acid in the stomach then gets through to the sensitive tissue lining the digestive system underneath.

c)      And finally, acid and bacteria directly irritate this lining resulting in sores or formation of ulcer.

2.      Smoking
Studies show smoking increases the chances of getting an ulcer. Smoking slow the healing process of existing ulcer and contributes to ulcer recurrence. And this is another health-related reason for children and teenagers who smoke to quit.

3.      Caffeine
Caffeine seems to stimulate acid secretion in the stomach, that can aggravate the pain of an existing ulcer. Although, the stimulation of stomach acid cannot be attributed solely to caffeine.

4.      Stress
Though motional stress is no longer thought to be a cause of ulcer, people with ulcer often report that emotional stress increases ulcer pain.  Physical stress may increase the risk of developing ulcer, mainly in the stomach.  For example, people with injuries (such as severe burns) and people undergoing major surgery often require rigorous treatment to prevent ulcer and ulcer complications.

5.      Acid and pepsin
It is believed that the inability of stomach to defend itself against the powerful digestive fluid, hydrochloric acid and pepsin, contributes to ulcer formation.

6.      Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAID (such as aspirin, naproxen, ibuprofen) can make the stomach vulnerable to the harmful effects of acid and pepsin. These are present in many non-prescription medications used for treatment of fever, headache, and minor aches and pain.

7.      Miscellaneous Syndromes and Disorders.

  Fewer than 5% of peptic ulcer are due to these disorder. They include Zollinge Ellison syndrome, a disorder in which small tumor, called gastrinomas, secrete a hormone (gastrin) that stimulates the production of digestive juice.  Because of this excess secretion, this kind of disorder is sometimes called hypersecretory syndromes.