Ulcers are a common occurrence that affect 1 in 10 people according to the Cleveland Clinic and while they’re excruciating for many and leave them doubled over in pain, others don’t have symptoms or realize they have one. Although it’s been a popular misconception that ulcers are a result of high stress, coffee and spicy foods, experts we spoke with reveal the true causes and share signs you have one. Read on—and to ensure your health and the health of others, don’t miss these Sure Signs You’ve Already Had COVID.

Dr. Terry Simpson, Weight Loss Surgeon and Culinary Medicine Specialist with Dignity Health St. John’s Hospital says, “The vast majority of stomach ulcers are caused by a bacteria called Helicobactor pylori which was discovered in the 1980’s. Prior to this time we thought ulcers were caused by stress, or acid, or many things. For the discovery of this bacteria the Nobel Prize was awarded. Because it is caused by a bacteria, it can be spread by kissing. So even if you get your H pylori treated, if your sweetie doesn’t you can get re-infected. So the risks are those who have the infection, which is present in many people.

Other things that can cause ulcers include a lot of over-the-counter pain relievers such as aspirin and non-steroidal anti-inflammatory drugs (Motrin, Naprosyn, etc). Tylenol does not cause ulcers. Smoking and vaping are high risk behaviors for ulcers. We know from many studies that heavy smokers are more likely to get duodenal ulcers than non smokers. The duodenum is the first bit of bowel past the stomach. Cancers can also cause ulcers. We used to think that dieting caused ulcers, but it doesn’t. Certain foods can be worse for ulcer pain, especially alcohol, spicy foods, and fatty foods.”

Sepehr Lalezari, MD FACS General Surgeon and Gastrointestinal specialist at Dignity Health St. Mary Hospital, CEO of Lalezari Surgical adds, “Anyone can be affected by ulcers but it is more common in patients taking chronic non-steroidal anti-inflammatory medications, corticosteroid medications and smokers.”

Dr. Simpson shares, “If you have H pylori not only do you need to be treated, but so do the people you kiss. Checking for this bacteria can be done from a breath test easily in a doctor’s office. Eating a healthy diet, rich in fruits, vegetables, whole grains, and legumes is associated with a low risk of ulcer formation, even in the presence of the bacteria. Diet cannot prevent the bacteria, H. Pylori from infecting your stomach, but a diet rich in fermented foods can help heal your gut after you get treatment. Yogurt, kimchi, and other fermented foods.”

Dr. Simpson tells us, “Most commonly ulcers manifest themselves with a dull pain. Sometimes it is after meals, because the meals can make the ulcer pain worse. The pain can be anywhere from the belly button to the chest. Ulcers can bleed, very quickly. So if you throw up blood you need to go to the emergency room, dial 911 – this truly is an emergency if you are vomiting blood. Ulcers can perforate, which is a dangerous situation and requires surgery.”

Dr. Lalezari tells us, “Stomach ulcers are a surprisingly common problem that 70% of people who have them may never even show any symptoms. For those that do have symptoms most will have belly pain in the middle of their abdomen just under the ribs.  We all know people who complain about bloating or belching after eating, nausea after a meal or belly pain that worsens with food intake. These are all symptoms that may indicate the presence of an ulcer. Acid reflux is another symptom closely related to ulcer disease.”

 Dr. Lalezari emphasizes, “Left untreated ulcers may progress to life threatening bleeding or even perforation of the stomach. Although it is uncommon, there is also a link to cancer.  People with the typical signs of an ulcer should seek medical attention to be evaluated.”

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Dr. Lalezari says, “Years ago surgery was common for ulcer disease. This was before the advent of a special class of medications called proton pump inhibitors (PPI), the purple pill as the popular advertising campaign called it. Treatment with these acid suppressing medications tend to resolve the ulcer in most patients. Often Times it is a bacteria called Helicobacter pylori which is responsible for ulcer formation. If this is the cause, usually an antibiotic regimen is added to the PPI to help clear the bacteria and resolve the ulcer.” 

Dr. Simpson explains, “Diets can make ulcer symptoms worse, but the only thing that can make an ulcer worse for a diet is alcohol. Otherwise, foods can make you feel worse, like spices or fatty foods. Some foods make them feel better, like yogurt, but they don’t really cure the ulcer.”

Dr. Simpson advises, “First you shouldn’t try to treat an ulcer on your own. If you think you have one see your doctor, and you should undergo a test called an endoscopy where they look into your stomach to see if you have a problem. When they look in your stomach they will take a biopsy to see if you have the bacteria, and if you have it they will use antibiotics to treat it. Drinking more than two drinks a day can also cause an ulcer, by disrupting the mucosa of the stomach.”

According to Dr. Lalezari, “As always an ounce of prevention is better than a gallon of cure so it’s best to follow a healthy diet full of fruits and vegetables and a diet high in healthy fiber to prevent ulcer disease. Avoiding prolonged use of NSAIDS, and smoking will also help prevent ulcers from forming. Lastly, taking a few minutes each day to meditate and exercise can help decrease stress levels and help prevent a pesky ulcer from developing.” 

Dr. Simpson recommends, “If you have pain after eating, you should see a doctor. If you vomit blood you should call 911 and go to the emergency room.”