Bruce Springsteen announced Wednesday that his remaining September tour dates will be postponed for medical reasons. The exact health problem: stomach ulcers.
But what exactly is peptic ulcer disease and why would the boss have to miss his upcoming shows because of the treatment? We asked gastroenterologists to explain what the condition entails, as well as its possible causes, treatments, and other important things you should know.
What is Peptic Ulcer Disease?
“Peptic ulcer disease is a rupture in the lining of the stomach or intestines caused by increased acidity.” Judith Kim, a gastroenterologist at NYU Langone Health, told HuffPost via email. “It affects about 5-10% of the population.”
Basically, peptic ulcer disease is a fancy medical term for someone having stomach ulcers or duodenal ulcers, which are defects in the first part of the small intestine (known as the duodenum).
“It almost looks like a little crater in the lining,” he said Aaron Martin, a gastroenterologist at Jefferson Health in Philadelphia. “Symptoms can vary and sometimes people can be asymptomatic. However, pain most commonly occurs in the upper abdominal area, right at the top of the middle of the abdomen, just below the breastbone.”
In addition to abdominal pain, the common symptoms of stomach ulcer disease include nausea, blood in the stool and loss of appetite or a quick feeling of fullness after eating.
What causes it?
“The most common cause of stomach ulcers worldwide is the bacterium H. pylori,” he said Dr. Harmony Allison, a gastroenterologist at Tufts Medical Center in Boston. “The second most common cause is nonsteroidal anti-inflammatory drugs such as ibuprofen, naproxen and aspirin.”
If H. pylori infects your stomach, the bacteria can damage the protective lining and weaken it. As a result, your stomach acid can cause ulcers in the lining of your stomach. Although there is still uncertainty about how an H. pylori infection spreads, health experts believe that the germs can be acquired through contact with saliva (e.g. kissing), vomit or stool (e.g. fecal contamination). can be transferred from one person to another.
Nonsteroidal anti-inflammatory drugs, commonly known as NSAIDs, include Advil, Aleve, and Motrin, but not, as some mistakenly believe, Tylenol. Another common misconception about the cause of stomach ulcers is that they are due to certain foods or stress.
“I still often hear people say things like, ‘My job is so stressful, I’m going to get a stomach ulcer,'” Martin said. “Although we assume that stress contributes to the development of ulcers, this does not usually relate to the stress of daily life. It’s more like the stress of someone who is very sick and has been in the hospital for a long time in the intensive care unit.”
There are other risk factors and less common causes.
“The incidence of stomach ulcers increases with age,” Kim said. “The prevalence is similar in men and women, with stomach ulcers tending to be more common in women and intestinal ulcers more common in men.” Smoking and alcohol consumption are risk factors for ulcers. Other medications such as steroids and blood thinners have also been linked to ulcers.”
How is it diagnosed and treated?
“We can make a presumptive diagnosis based on a person’s symptoms and history. “So if someone says they have pain in that area and they’ve taken a lot of ibuprofen, sometimes we can make a presumptive diagnosis that it’s pain,” Martin said.
A breath or stool test can also help detect stomach ulcers caused by H. pylori.
“But to make an official diagnosis of an ulcer, we do an endoscopy — we look into the stomach with a camera while someone is sleeping,” Martin said.
An upper endoscopy allows doctors to directly visualize the patient’s digestive tract.
“If the ulcer is actively bleeding at the time of the endoscopy, there are techniques and tools we can use to stop the bleeding,” said Dr. Kevin Cronley, a gastroenterologist at Gastro-health in Cincinnati.
In rare cases, surgical treatment of peptic ulcer disease may be necessary, but in most cases there are less invasive options.
“Ulcers are typically treated with proton pump inhibitors, which reduce the acid produced by the stomach,” Kim said. “We typically expect healing within 4 to 8 weeks after treatment. If there is an H. pylori infection, patients are also treated with antibiotics. Additionally, avoiding NSAIDs or other irritants such as tobacco and alcohol will aid recovery.”
Most people with stomach ulcers can be treated on an outpatient basis and recover by taking medications such as Prilosec and Nexium to suppress acid production. However, if complications occur, hospitalization may be required.
How can you prevent ulcers? What should you do if you think you might develop one?
“Some ulcers can be prevented by avoiding NSAIDs or treating H. pylori infection early before ulcers develop,” Kim said. “Avoiding smoking and alcohol can also help prevent stomach ulcers.”
It is important to take action if you suspect you may be developing an ulcer. Your GP can help you with the initial assessment and steps and refer you to a gastroenterologist.
“If you have persistent pain – most days of the week for more than a week – or nausea, bloating or other discomfort, it’s worth discussing this with your GP,” said Allison. “If you notice black stools or blood in your stool, you should seek medical attention immediately.” People with known risk factors or the symptoms listed above should not delay assessment.
“If left untreated, a peptic ulcer can lead to significant complications such as gastrointestinal bleeding and intestinal perforation,” Cronley said. “It is very important to urgently consult a gastroenterologist if you suspect peptic ulcer disease. If caught early, it can be treated very easily and prevent significant complications.”