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.