At first you may have thought it was a bad case of heartburn or indigestion. But when the burning pain failed to subside, you suspected much worse: an ulcer.

At least five million Americans suffer from ulcers, or open sores or lesions in the lining of the gastrointestinal tract. Ulcers form when there is too much stomach acid or when the mucous lining fails to protect the digestive tract. People who take large doses of stomach-irritating antiinflammatory drugs to manage pain are at increased risk of developing ulcers.

There are two kinds of ulcers: gastric, which appear in the stomach, and duodenal, which form in the duodenum (the first part of the small intestine). Duodenal ulcers are about five times more common than gastric ulcers and about four times more common in men than in women.

UlcersResearchers have found that many ulcers are caused or exacerbated by a bacterium known as Helicobacter pylori. A two-week regimen of antibiotics can wipe out this bacterium, vastly diminishing the odds of a recurrence. Research shows that the bacterium is present in up to 100 percent of patients with duodenal ulcer and in up to 70 percent of those with gastric ulcer. Factors that predisposed to infection by H. pylori include low levels of antioxidants in the stomach and intestinal linings and low gastric acid production.

Left untreated or undetected, ulcers can lead to peritonitis, an inflammation of the lining of the abdominal cavity. In severe cases, an ulcer can burn a hole right through the stomach or intestine; this is a medical emergency. Fortunately, a number of natural remedies can be used to prevent and treat ulcers before they reach this stage.

Symptoms of ulcer include abdominal discomfort (usually described as burning, gnawing, or cramplike) forty-five to sixty minutes after eating or during the night. This distress is relieved by food, antacids, or vomiting. The abdomen may be tender, and some patients have blood in their stools.

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