Gastritis and Peptic Ulcer Disease: Symptoms and Risk Factors

Gastritis refers to irritation and inflammation of the lining of the wall of the stomach. An ulcer (also known as a peptic ulcer) is a deep crater in the wall of the stomach. Gastritis and ulcers affect up to 50 percent of adult populations in Westernized countries.

These disorders result from an imbalance between gastric acid, which irritates the stomach lining, and the mucus barrier, which protects the stomach lining.

In the past, gastritis and ulcers were thought to be due to emotional stress. However, in recent years, researchers have found that, while stress may play a minor role, infection by bacteria called Helicobacter pylori, or H. pylori, are the cause of most cases worldwide. These bacteria damage the protective mucus barrier, making the stomach more vulnerable to acid damage and inflammation.

An additional common cause of gastritis and ulcers is nonsteroidal anti–inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, and others. Other causes include aspirin, steroids, alcohol, tobacco, severe trauma or burns, and major surgery.

Symptoms

• Upper abdominal pain, which may also be felt in the back
  
• Nausea and vomiting
  
• Weight loss and loss of appetite
  
• Indigestion
  
• In advanced cases when an ulcer results in bleeding from the stomach, symptoms may include vomiting of blood, rectal bleeding, dark black stools, and anemia
  
• The sudden onset of severe pain may signify a perforation (a hole in the stomach), which is a surgical emergency.

Risk Factors

• Increasing age: Ulcers typically occur in individuals over 40 years old.
• Helicobacter pylori infection: One in six individuals exposed to these bacteria will develop an ulcer.
• Nonsteroidal anti–inflammatory drugs (e.g., ibuprofen)
• Tobacco use: Nicotine increases acid production and reduces the protective mucus layer of the stomach
• Alcohol use: Alcohol can cause gastritis by increasing acid secretion and damaging the mucus barrier
• Major surgery or severe illness
• Family history: More than 25 percent of ulcer patients have a family history of ulcers, compared with 5 percent of non–ulcer patients.