An ulcer is an open sore that develops on the inner lining of your stomach or the first part of your small intestine, known as the duodenum. These sores can cause significant discomfort, often manifesting as a burning or gnawing pain in the abdomen. The question of whether ulcers are hereditary is complex; while genetic factors can influence susceptibility, they are not the sole cause.
The Primary Culprit: H. Pylori
A major cause of peptic ulcers is infection with the bacterium Helicobacter pylori (H. pylori). This spiral-shaped bacterium thrives in the stomach’s acidic environment. It penetrates the protective mucous layer of the stomach lining, causing inflammation and damage, which can lead to ulcer formation.
H. pylori infection is widespread, affecting approximately half of the world’s population, with higher rates in developing countries. The bacterium is typically acquired through close contact or contaminated food and water.
Diagnosis of H. pylori can involve invasive methods like biopsies during endoscopy, or non-invasive tests such as urea breath tests and stool antigen tests. Treatment usually consists of a combination of antibiotics, such as amoxicillin and clarithromycin, along with acid-suppressing medications like proton pump inhibitors (PPIs), typically for a period of 10 to 14 days. Eradicating the infection is crucial for healing ulcers and preventing recurrence.
The Role of Genetics
While H. pylori is a primary cause, genetics can play a role in an individual’s susceptibility to ulcers. Ulcers are not directly inherited; instead, a genetic predisposition or increased risk can exist. For example, a family history of peptic ulcers may suggest shared genetic vulnerabilities.
Certain genes might influence an individual’s risk by affecting stomach acid production, the integrity of the stomach lining, or the immune response to infections like H. pylori. Genes related to immunity, inflammation, mucosal protection, and gastric acid secretion can influence ulcer development. Studies on twins have shown a higher prevalence of peptic ulcers in monozygotic (identical) twins compared to dizygotic (fraternal) twins, further supporting a genetic component. Genetic predisposition increases the risk but does not guarantee ulcer development, often interacting with other factors like H. pylori infection or lifestyle choices.
Other Contributing Factors
Beyond H. pylori and genetic predispositions, other factors can significantly contribute to ulcer formation. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, naproxen, and diclofenac, is a common cause. These medications can damage the stomach’s protective lining by inhibiting certain enzymes, making it more vulnerable to stomach acid. Approximately 15% of individuals on long-term NSAID treatment may develop a peptic ulcer.
Lifestyle choices also play a part. Smoking is known to increase the risk of developing stomach ulcers and can hinder their healing. Excessive alcohol consumption can also contribute to ulcer development. While stress and spicy foods do not directly cause ulcers, they can worsen existing symptoms and slow the healing process.
Reducing Your Risk and Managing Ulcers
To reduce risk, minimize unnecessary or prolonged use of NSAIDs. If NSAIDs are necessary, taking them with food or discussing alternative pain relievers like acetaminophen with a healthcare provider can be beneficial.
For individuals with H. pylori infection, medical diagnosis and treatment with antibiotics and acid suppressants are recommended to eradicate the bacteria and promote healing. Proton pump inhibitors (PPIs) and H2-receptor antagonists reduce stomach acid production, allowing the ulcer to heal. PPIs are generally more potent and used for chronic conditions, while H2 blockers offer faster, short-term relief. Lifestyle modifications, including quitting smoking, moderating alcohol intake, and managing stress through various techniques, also support ulcer healing and prevention. Seek medical attention if symptoms persist or worsen, as complications like bleeding or perforation can occur.