Ulcers

Since the discovery of H. pylori, some researchers have suggested that bacterial ulcers may be prevented with a vaccine given early in childhood. Research has already begun into this kind of vaccine; however, it is unlikely that an H. pylori vaccine will be available within the next few years.

Evidence also suggests that H. pylori infection is highest in areas with poor sanitation facilities, suggesting that the bacteria may be transmitted—like many other human pathogens—by drinking fecally contaminated water. Researchers are currently working on this question, as well as studying transmission routes in the United States. Interestingly, H. pylori has been found in dental plaque, which may explain why the United States, despite its excellent sanitation facilities, has large numbers of people with H. pylori infection: it may be transmitted by kissing or other oral contact.

Despite the revolution brought about by H. pylori, ulcers caused by acid overproduction still represent about 40% of all diagnosed ulcers. But instead of tracing the acid overproduction to nerves, physicians are now digging deeper for the actual cause of the excess acid. Cigarette smoking has long been linked to ulcers. Smoking causes acid to be secreted into the stomach, and if the stomach does not have adequate defenses, the acid secretion, over time, can lead to an ulcer. Aspirin intake is also another culprit. Aspirin irritates the lining of the stomach and may set the stage for an ulcer.

Prevention of both kinds of ulcers is a matter of maintaining a healthy lifestyle. Good hygiene habits and the avoidance of cigarettes and excess aspirin may keep the stomach lining free of ulcers. In the future, a vaccine may entirely eliminate the cause of most ulcers, but until that time, lifestyle still plays the major role in avoiding the pain of ulcers.