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Q. What's the difference between an ulcer and a lesion in...

June 04, 1999|By Dr. Allen J. Douma.

Q. What's the difference between an ulcer and a lesion in the stomach?

A. The terms "ulcer" and "lesion" are often used interchangeably, but there is a slight difference in definition. Simply put, an ulcer is a form of lesion.

The medical definition of a lesion is a break in, or loss of function of, an area of body tissue, caused by disease or trauma. As you can see, that is a rather broad definition, encompassing any damage done to any tissue.

The definition of an ulcer is more specific: a localized disruption of the surface of an organ or tissue, the result of death of inflamed tissue. Another similar term is erosion, meaning a shallow ulcer.

Although your question relates to a stomach condition, obviously, according to these definitions, lesions and ulcers can be located in or on any part of the body. Nevertheless, many people think of the stomach when they hear the word ulcer.

The inside of the stomach is usually very resistant to damage by the strong acids and digestive enzymes contained there to break down food to be absorbed. This is because the lining of the stomach is protected by a layer of mucus produced in the stomach.

Stomach, or gastric, ulcers are well-defined round sores in the stomach lining caused by the eating away of the protective mucus layer. These ulcers occur when one or both of two conditions are present: when insufficient protective mucus is produced, or when there is an increase in quantity or concentration of stomach acid.

Gastric ulcers are not as common as duodenal, or small intestine, ulcers, and they tend to occur later in life, between the ages of 55 to 70. The incidence of duodenal ulcers is declining, while the number of people with gastric ulcers is increasing.

Certain drugs, especially aspirin, ibuprofen and other non-steroidal anti-inflammatory drugs are associated with the formation of gastric ulcers. Certain diseases can cause an increased secretion of stomach acid, which can contribute to the formation of gastric ulcers.

The presence of Heliobacter pylori bacteria in the stomach is strongly associated with an increased incidence of gastric ulcers. How these bacteria actually cause ulcers is not known, but they are thought to interfere with defenses against the stomach acid.

Complications of gastric ulcers can include hemorrhage and even a hole in the wall of the stomach, both of which can be life-threatening.

As your question implied, ulcers are not the only lesions that can cause problems in the stomach. Various forms of gastritis, which is inflammation of the stomach wall, can result in health complications as serious as those of gastric ulcers.

Gastric adenocarcinoma, malignant tumors of the stomach, the second most common group of tumors worldwide, also produce lesions in the stomach.

Please talk with your health care provider about the diagnosis and get answers to your questions.

