An ulcer is a sore. 

An ulcer is a sore inside your belly. 

Sometimes the sore feels like a burn. It might hurt when you eat. It might also hurt when you are hungry.
Tiny germs can cause these sores. Some medicines can also cause them. 
Doctors can help you feel better. They may give you medicine to help.
It is good to know about your body.
An ulcer is a sore on the inside of your body. 

Many people feel a burning or dull ache in their belly. If the sore is in the stomach, eating might make it hurt more. If the sore is in the intestine, eating might help the pain go away. Some people feel pain at night when they are sleeping. 
Two main things can cause these sores. One is a germ called Helicobacter pylori. This germ lives in the stomach. Another cause is using certain medicines called NSAIDs. These are medicines like aspirin. These drugs can stop the body from making a layer of mucus. This mucus helps protect the stomach lining from acid.
Doctors can find ulcers using a tool called an endoscopy. This tool lets them look inside the body. To help, doctors may give medicine to lower stomach acid. They may also use antibiotics to kill the germs.
Peptic ulcer disease is a condition where sores form on the inner lining of the body. 
Ulcers work by damaging the protective layer of the stomach. 
People feel different things depending on where the sore is located. 
Doctors have learned a lot about these sores over many years.
Knowing about ulcers helps us understand how our bodies stay healthy. 
Peptic ulcer disease is a medical condition involving damage to the gastric mucosa. This is the inner lining of the stomach. Ulcers can also form in the lower esophagus or the duodenum. The duodenum is the first part of the small intestine.
The mechanism of an ulcer involves the breakdown of the protective mucosal layer. The stomach uses mucus and bicarbonate to shield itself from strong acid. One major cause is infection by the bacterium Helicobacter pylori. This bacterium secretes an enzyme called urease to create an alkaline environment. This helps the germ survive in the acidic stomach. The bacteria use proteins called adhesins to attach to the stomach lining. They also release virulence factors like CagA and PicB. These factors cause inflammation in the mucosa. 
Another common cause involves non-steroidal anti-inflammatory drugs, or NSAIDs. These include medicines like aspirin. The stomach protects itself using prostaglandins. These are substances that help stimulate mucus secretion. NSAIDs work by inhibiting an enzyme called cyclooxygenase, or COX-1. This enzyme is essential for making prostaglandins. When COX-1 is blocked, mucus secretion decreases. This reduces the integrity of the stomach lining. NSAID-related ulcers often dig deeper into the tissue more quickly than other types. This can lead to complications even if the person does not feel much pain. 
Symptoms often depend on the location of the ulcer. A duodenal ulcer typically causes pain about three hours after eating. This pain often wakes people up at night. Interestingly, eating a meal can sometimes relieve this pain. A gastric ulcer behaves differently. The pain from a gastric ulcer may worsen when a person eats. This happens because acid production increases when food enters the stomach. Most people describe the sensation as a burning or dull ache. Other symptoms include nausea, vomiting, or weight loss. About one-third of older people with ulcers show no symptoms at all. 
Complications from peptic ulcers can be severe. The most common complication is gastrointestinal bleeding. This occurs in as many as 15% of cases. Sudden, large bleeding events can be life-threatening. Another serious issue is perforation. This is when the ulcer creates a hole in the wall of the digestive tract. If a gastric ulcer perforates, it can cause acute peritonitis. This is an inflammation of the abdominal cavity. Perforation requires immediate surgery. 
Medical understanding of ulcers has changed greatly over time. For nearly 100 years, doctors believed stress and spicy food caused ulcers. The first description of a perforated ulcer was recorded in 1670 regarding Princess Henrietta of England. However, the true causes were found much later. Barry Marshall and Robin Warren identified H. pylori as a cause in the late 20th century. Their discovery changed how we treat the disease. They were awarded the Nobel Prize in 2005 for this work. In 2015, new ulcers were found in approximately 87.4 million people worldwide.
Doctors use several methods to diagnose and treat the disease. They may use an endoscopy to look inside the stomach. An endoscopy is a procedure where a tool is used to view the lining. They can also use a barium swallow for imaging. To find H. pylori, doctors may use a urea breath test or a stool test. Treatment often involves medications to decrease stomach acid. These are called proton pump inhibitors (PPIs) or H2 blockers. For H. pylori infections, doctors prescribe a combination of antibiotics like amoxicillin and clarithromycin. 
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