The Ulcer Bug

It has been nearly 25 years since Drs. Barry Marshall and J. Robin Warren showed that the vast majority of peptic ulcers are caused by a bacterium called Helicobacter pylori, a discovery that was honored last week with a Nobel Prize. Yet I'm always surprised by how many ulcer sufferers don't realize that their stomach pains can be easily and effectively cured with antibiotics.

A peptic ulcer is a sore in the protective lining of the stomach or duodenum (the upper part of the small intestine). The most common symptom is a burning pain between your belly button and your breastbone. It's usually worse at night or when your stomach is empty.

No one knows how H. pylori gets into the stomach--it may be through eating, touching or even kissing--and 80% of people who are infected with the bug never develop ulcers. There may even be some truth to the old ulcer myths: stress and spicy food don't create ulcers, but they can certainly make them worse.

Some ulcers, however, can't be pinned on H. pylori. Instead, they are caused by prescription and over-the-counter anti-inflammatory drugs, such as ibuprofen, aspirin and naproxen, that interfere with the body's mechanism for protecting the stomach lining. The ulcers are particularly common among the elderly, who take a lot of those medicines. Healing begins as soon as you stop taking the drugs.

Ulcers caused by H. pylori can take longer--two to six weeks. The usual treatment is a combination of antibiotics, acid suppressors and something to protect the stomach lining.

Bleeding ulcers that eat all the way through the stomach lining are a serious medical condition that can be life threatening. If you experience sharp, sudden pain in the upper abdomen or have black or bloody stools or vomiting, get emergency care.

Sanjay Gupta is a neurosurgeon and CNN medical correspondent