A peptic ulcer is an open sore that develops on the inner lining of the stomach or the first part of the small intestine (the duodenum). These sores form when strong digestive acids overcome the protective mucosal layer. An ulcer located in the stomach is specifically known as a gastric ulcer. Gastritis is a related but distinct condition defined as the inflammation, erosion, or irritation of the stomach lining. While alcohol is a known cause of gastritis, its connection to peptic ulcers is more complex and indirect.
The Relationship Between Alcohol and Ulcers
Alcohol consumption, particularly heavy and prolonged use, is not considered a primary, direct cause of peptic ulcers. The vast majority of ulcers are caused by two other factors. However, alcohol acts as a significant risk factor that increases the likelihood of developing an ulcer and can severely worsen an existing one.
Drinking heavily over time causes chronic inflammation of the stomach lining, known as chronic gastritis. This inflammation creates an environment more susceptible to ulcer formation. For individuals who already have an ulcer, alcohol delays the healing process and exacerbates symptoms. Alcohol also increases the risk of ulcer recurrence even after successful treatment.
How Alcohol Damages the Stomach Lining
Alcohol is a direct irritant to the stomach’s protective barrier, known as the gastric mucosal barrier. This barrier consists of a thick layer of mucus and bicarbonate that shields the underlying tissue from the highly acidic environment.
When alcohol contacts the stomach lining, it dissolves lipids in the cell membranes, breaking down the integrity of the protective mucous layer. This erosion causes inflammation (gastritis) and leaves the sensitive tissue exposed to corrosive hydrochloric acid (HCl).
Alcohol also stimulates the production of stomach acid. The combination of a weakened defense and increased acid concentration leads to chemical injury of the stomach tissue. This injury can manifest as superficial erosions or, if the damage penetrates deeper, as a peptic ulcer.
Primary Causes of Peptic Ulcers
The vast majority of peptic ulcers are caused by two main factors. The most common cause is infection with the bacterium Helicobacter pylori (H. pylori). This microbe colonizes the stomach, weakens the protective mucus, and causes persistent inflammation that allows stomach acid to damage the tissue beneath.
The second major cause is the chronic use of Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), such as ibuprofen and naproxen sodium. NSAIDs interfere with the production of prostaglandins, which maintain the mucosal barrier and regulate blood flow in the stomach lining. By inhibiting these prostaglandins, NSAIDs reduce the stomach’s natural defense mechanisms, making the tissue vulnerable to acid damage and ulcer formation.
Symptoms and When to Seek Medical Help
The most common symptom of a peptic ulcer or severe gastritis is a burning or gnawing pain in the upper abdomen, often felt between the breastbone and the navel. This pain may worsen when the stomach is empty, such as between meals or during the night. Other frequent symptoms include bloating, feeling full quickly after starting a meal, nausea, and general indigestion.
Signs Requiring Immediate Medical Attention
Certain warning signs indicate a serious complication, such as bleeding or perforation, and require immediate medical attention. You should seek urgent help if you experience sudden, severe, and sharp abdominal pain, which can signal a perforation of the stomach wall. Other symptoms of internal bleeding include vomiting blood or material that looks like dark coffee grounds, or passing black, sticky, tar-like stools.
If an ulcer is diagnosed, treatment typically involves medications to reduce stomach acid, such as proton pump inhibitors or H2 blockers. If H. pylori is the cause, a course of antibiotics is also prescribed to eradicate the bacteria. Moderation or cessation of alcohol use is recommended to allow the stomach lining to heal and prevent future irritation.