What you have read is true. Most, if not all, ulcers are caused by infection. For decades, physicians thought that ulcers are caused by stress and food that we eat. More recent research suggests that these are likely less important as the cause of ulcer. Certain medications, however, have been shown to cause irritation of the stomach and ulcer. These include aspirin and other non-steroidal anti-inflammatory medications (also called NSAID) that are used for arthritis type of problems. Oral steroids, when used in high doses for a long time, can also cause ulcer.

The suggestion that infection is the cause of ulcer actually started in the early part of this century. When examining stomach tissues under the microscope, several doctors had noticed bacteria inside the ulcer craters and wondered whether these bacteria caused the ulcer. However, it wasn’t until 1982 when doctors from Australia actually discovered these bacteria, and called them Helicobacter pylori. Before this discovery, doctors believed that most bacteria cannot survive the stomach acid to cause infection. It turned out that Helicobacter produces a substance called urease, which can reduce the acid in the stomach and produce a nice environment for itself to survive and grow.

Ongoing research in the past decade has shown that Helicobacter can cause stomach and duodenal ulcers, as well as a condition called gastritis. Patients with gastritis also have pain in the stomach area. However, examination of the stomach and duodenum (this is the first part of the intestines) by X-ray and endoscopy (see below) is often completely normal. When biopsies are taken from the stomach and examined under the microscope, there would be inflammation of the stomach wall, and Helicobacter can be easily found in the mucus inside the stomach.

In North America, it has been shown that Helicobacter infection of the stomach is uncommon in children. As a person gets older, the chance of infection increases. By 60 years of age, almost half of them have been infected with Helicobacter. Acute infection can occur when a person ingests large number of Helicobacter bacteria into the stomach. The symptoms include pain in the stomach area, nausea, vomiting of food, and sometimes even blood. Most people would assume that they have flu-like illness, not realizing that these can be symptoms of Helicobacter infection.

These symptoms usually disappear after a few days. However, in some people, the infection will progress to ulcer with recurrent or constant pain in the stomach. Other patients can have intermittent pain, and further tests will show the presence of gastritis. The great majority of people have no symptom at all, although infection of the stomach will continue. It is suspected that certain stomach cancers may be related to long-standing Helicobacter infection.

In the beginning, Helicobacter infection can only be diagnosed with endoscopy. In this procedure, doctors pass an instrument called endoscope through the mouth to look inside the stomach and take biopsies. This is a rather invasive test, especially for children. More recently, a blood test was developed which can detect special antibodies caused by Helicobacter. Some laboratories can even do this test on saliva. A breath test can also be done, although it requires the use of radioactive material, which carries a small risk of radiation.

Once a person is infected with Helicobacter, the body cannot get rid of it. This is because the bacteria grow in the mucus inside the stomach. Earlier efforts to treat this infection were not very successful, and patients had to take several medications for two to four weeks. Some of these medications also have rather unpleasant side effects.

More recently, scientists have found several combinations of medicine which are more effective in treating this infection. Most of them involve the use of 3 medications taken twice a day for seven days. The side effects are much milder, although these medications are rather expensive. In my opinion, it is far better than weeks and months of antacids or other ulcer medications.

I would recommend that you see your family doctor and explore the possibility of testing for Helicobacter in your child. If a blood test is available in your area, this may be the simplest way. One word of caution: just like any test, there are false positive and false negative results. Once the diagnosis is made, then you can discuss with your doctor about the best choice of treatment.