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Gastroenterology and Health

Peptic ulcer, Duodenal ulcer

Will you get an ulcer this Christmas?

By Dr. W. Gifford Jones

December 9, 2000

During this hectic festive season do partygoers face an increased risk of developing a peptic ulcer? Many people will suffer from headaches and gastritis after overindulging. But can too many martinis, rich foods and stress trigger a duodenal ulcer? As the holiday season begins it's time to separate fact from fiction.

Contrary to popular belief most peptic ulcers do not occur in the stomach. 75 per cent start in the duodenum, the U-shaped uppermost part of the small bowel, into which the stomach empties. The majority of ulcers range from the size of a pea to a 25 cent coin. And males are twice as likely to develop one.

Duodenal ulcers cause a burning pain in what is commonly called, "the pit of the stomach", usually when the stomach is empty. Eating a meal, drinking a glass of milk or swallowing an antacid pill eases the discomfort caused by excess hydrochloric acid.

It's been a popular notion for years that stress triggers an ulcer. Too many physicians rely on the rationale, "lay the blame on stress if you can't point your finger at any other cause".

But I see patients every day in my office who have lead lives of quiet desperation for years without developing duodenal ulcers. Dr. Jon I Isenberg, Professor of Medicine at the University of California, a world authority on ulcers, similarly sees people who battle great stress without developing ulcers.

For example, it's well known that air traffic controllers are under constant tension. But Eisenberg claims they do not suffer from more duodenal ulcers than the rest of the population.

Eisenberg cites another study that challenges the role played by stress. Army recruits are subjected to considerable stress during basic training. But a study of 2,000 recruits revealed only one developed an ulcer.

This X-Mass, unless you're attending very unusual parties, stress is not going to cause an ulcer, with one exception. Partygoers may start to feel a burning pain in the stomach if they already have a predisposition for this disease.

It's also a common belief that saying "no" to spicy foods will guard against peptic ulcer. But there's no persuasive evidence that highly seasoned foods are the culprit. Or that they are responsible for recurrence of ulcers.

Studies show that vegetarians and meat eaters suffer from the same number of ulcers. There's no evidence that the ethnic groups which traditionally consume spicy foods have a greater number of duodenal ulcers than the general population.

Some partygoers believe they have less chance of developing a crater in their duodenum if they join the "Temperance Union". Part of this theory is justified. Research shows that moderate drinkers have less chance of developing duodenal ulcers than teetotalers. Heavy drinkers, however, are more likely to be headed for an ulcer.

Few people mention the role of heredity as a cause for ulcers. But be grateful if you come from a family that's never complained of ulcer pain. Eisenberg believes heredity is the single most important factor in determining who gets an ulcer. He claims the children and siblings of ulcer patients have three times the chance of suffering ulcer pain as those unrelated to ulcer patients.

If heredity and excessive partying do, nevertheless, trigger an ulcer this Christmas, what is the best treatment? Doctors often prescribe histamine receptor inhibitors, such as cimetidine and rantidine. Histamine stimulates the cells lining the stomach to secrete hydrochloric acid. These drugs lower the amount of hydrochloric acid, in the stomach and quickly stop the pain and heal the ulcer.

Antacids are also commonly used to heal duodenal ulcers by neutralizing the acid. Depending on the active ingredient however, antacids may cause either constipation or diarrhea. And since the components of antacids are eliminated through the kidneys, use should be medically supervised, if you have kidney disease.

A new class of anti-ulcer medication called barrier shields act by forming a barrier to the digestive action of acid. Anticholinergics may also be used to block the vagus nerve which stimulates acid secretion. But undesirable side effects has limited the use of anticholinergics.

Doctors rarely prescribe a "bland diet" any more, as little scientific evidence exists to incriminate the diet. Instead, use common sense . If a particular food causes trouble, stop eating it. And remember this holiday season what Samuel Johnson once remarked," He who does not mind his belly will hardly mind anything else."

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of Harvard. Dr. Walker's website is:

My book, �90 + How I Got There� can be obtained by sending $19.95 to:

Giff Holdings, 525 Balliol St, Unit # 6,Toronto, Ontario, M4S 1E1

Pre-2008 articles by Gifford Jones
Canada Free Press, CFP Editor Judi McLeod