An open sore, lesion or break in the skin or in a mucous membrane is called an ulcer. The thin protective layer that covers / protects the inner surface of body openings like the lining of the stomach and intestines is a mucous membrane. However when people generally use the term 'ulcers', they usually mean the peptic ulcer (the one that occurs in the upper digestive system). The digestive system is made up of the esophagus, stomach, duodenum and intestines. Ulcers that occur in the stomach are referred to as gastric ulcers, and likewise there are duodenal ulcers and esophageal ulcers. 80% of peptic ulcers are duodenal ulcers.

They are many signs of ulcers. The most common sign is intermittent and irritating pain in the stomach this pain could also transit to other areas such as the back and shoulder blades, indigestion, heartburn, gas, bloating, appetite loss and nausea. Can back pain be caused by ulcers? Yes, a few more common symptoms of ulcers are headache, itching and a choking sensation.

A few years back it was widely considered by physicians that lots of excessive stress was a major cause of ulcers in people. Their theory was that lots of stress increases the production of hydrochloric acid in the body. This acid is strong enough to eat away the proactive mucous lining of the stomach causing an ulcer. Although still widely accepted by many, there is a newer theory that bacterial infection is responsible for ulcers in more that 70 to 80% of the cases.

Gastric ulceration is most commonly caused by bacteria known as 'Helicobacter Pylori'. This bacterium has been known to dig into the mucous layer of the stomach and cause inflammation. Excessive amounts of acidic juices generated by the stomach because of spicy foods is capable of burning the lining of the digestive tract and hence damaging the digestive system. Excessive amounts of physical and emotional stress will probably aggravate an existing ulcer, although it's not considered the root cause of ulcer.

Apart form the infection, use of non steroidal anti-inflammatory drugs or NSAIDs can also trigger ulcers. NSAIDs are commonly used by people as pain killers for headaches, sore muscles, menstrual cramps and other similar situations. Belonging to this family of NSAIDs is aspirin, ibuprofen and acetaminophen, excessive use of such type of drugs may prove to be detrimental to the stomach lining and cause ulcers. Mucosal protection is further damaged by over consumption of Alcoholic beverages and heavy smoking.

The first step towards diagnosing ulcers the doctor would first inquire about the symptoms. Besides the symptoms, the physician would look over the patient's medical history for a family history of ulcers or stomach cancers, frequent alcohol consumption, smoking, patient's age, weight loss, repeated nausea or vomiting incidences, back pain, history of using anti inflammatory drugs or other NSAIDs. Apart from looking into a patient's history and symptoms, Endoscopy is a new approach to minimally invasive diagnostic medical procedure. It is also well accepted as one of the best diagnostic methods for ulcers. An Endoscope is a narrow tube which contains a light and tiny camera at its end to study the patient's digestive system. When inserted down the patient's throat the doctor can examine the walls of the stomach and duodenum. Endoscope has an option that enables it to also carry scissors in order to take small samples of the mucous membrane for further examination of potential stomach cancer.

Imaging techniques are not as reliable as endoscopy but are also used frequently as patients are becoming more comfortable with this technique. Using the imaging technique, the patient is made to drink a fluid containing barium. Barium is a substance which is opaque and transparent to x-rays. An x-ray image of the patient's digestive system can show any abnormalities like ulcers that may be present wherein the opaque substance appears as a white patch on the x-ray image. Most of the symptoms of ulcers can be treated with over the counters medications which can relieve the pain, nausea or other general discomfort created by ulcers.

Do ulcers cause back pain? Yes, ulcers and especially peptic ulcers do cause severe back pain. Such pain is likely to happen immediately after eating when some one is suffering from ulcers.