I'm Dr John Bennett,
and I'm the chairman of the charity CORE,
which raises money for research into the whole of gastroenterology,
that's the whole of the gut and the stomach,
and the liver and the pancreas, and all the bits attached to it.
A stomach ulcer, or a peptic ulcer,
in either the stomach or the duodenum
is a breach in the normal lining
of the stomach or duodenum like a hole.
They're not dissimilar from the ulcers you get in your mouth.
When should you see a doctor with indigestion?
Well, we all get indigestion occasionally
if we eat too much or drink too much.
Then once in a while we'll get some heartburn or soreness
and it serves us right.
But if you get symptoms recurrently
and similar symptoms over and over again,
especially the more severe pains in the top of the stomach,
then people should certainly see their doctor and ask for advice.
The main symptom of a peptic ulcer is pain,
and it's usually very localised where the V of the ribs is.
It may go through into the back or a little bit up into the chest.
Now, sometimes, ulcers don't have any symptoms in the form of pain
and they may first be noticed
if the patient, for example, bleeds from them,
either vomits blood or passes changed blood through their back passage.
But one thing that people with any indigestion need to be careful about
is if they choose to take drugs such as aspirin
or more powerful pain relievers,
those have a damaging effect on the stomach and duodenum,
and if these people are inclined to have an ulcer,
or do have an ulcer already, these will only make it worse.
If they have pain of that variety
and it comes back more than once or a few times,
then, of course, they'll need to see their doctor about it.
And then if it sounds to the doctor
that they are the symptoms of an ulcer,
he will have the choice of investigating it,
or to test the patient for the presence
of a microbe or germ
or a bacterium called Helicobacter pylori,
because they're almost always present in a patient who has an ulcer.
The doctor, believing that this may be due to an ulcer,
then can either arrange for the patient
to have the stomach and duodenum looked at,
or they can simply test for the presence of Helicobacter pylori,
if it's there, then eradicate it
with a combination of antibiotics and an acid-reducing drug,
and then if the symptoms go, you presume it's been an ulcer.
Occasionally, similar symptoms are due to more serious conditions,
such as, for example, a cancerous ulcer in the stomach,
and that can easily be differentiated
by one of these tests with an endoscope,
when the abnormality can be looked at
and specimens taken from it using a pair of tiny forceps.
When a course of treatment is given,
it's essential to follow it accurately and carefully and fully,
and that's especially true when you're treating Helicobacter pylori,
because if the doses are cut short or reduced or missed out,
then it's quite likely that this very difficult bacterium
will be resistant to the treatment and the treatment will fail.
If a patient is told that he or she has an ulcer,
there's no reason for great anxiety about this
because they are very treatable these days,
and especially they're treatable by relatively simple means,
with tablets, and the likelihood of needing an operation is very remote.
30 or 40 years ago that wasn't the case,
and it was a much more serious matter,
but today, while it can't be regarded trivially,
it's certainly not a matter for great concern.