Bruce Springsteen’s remaining September tour dates will be postponed for medical reasons. The exact health issue: peptic ulcer disease. But what exactly is peptic ulcer disease and why would treatment require the Boss to miss his upcoming shows?
“Peptic ulcer disease is a break in the lining of the stomach or intestine caused by increased acid,” Dr. Judith Kim, a gastroenterologist at NYU Langone Health, told HuffPost via email. “It affects about 5-10% of the population.”
“It almost looks like a little crater in the lining,” said Dr. Aaron Martin, a gastroenterologist at Jefferson Health in Philadelphia. “The most common symptom would be pain in the epigastric area, right at the top of your belly in the center, just below where your sternum is.”
In addition to abdominal pain, common symptoms of peptic ulcer disease include nausea, blood in the stool and poor appetite or feeling full quickly after eating. “The most common cause of peptic ulcer disease worldwide is the bacteria H. pylori,” said Dr. Harmony Allison, a gastroenterologist at Tufts Medical Center in Boston.
When H. pylori infects your stomach, the bacteria can damage the protective lining and weaken it. As a result, your stomach acid can cause ulcers in the lining. Although there’s still some uncertainty around how H. pylori infection is spread, health experts believe the germs can be passed from one person to another through contact with saliva (like kissing), vomit or stool (as with fecal contamination).
“The second most common cause,” Dr. Allison adds, “is nonsteroidal anti-inflammatory medications like ibuprofen, naproxen and aspirin.” Nonsteroidal anti-inflammatory drugs, commonly known as NSAIDs, include Advil, Aleve and Motrin but not, as some mistakenly believe, Tylenol. Another common misconception around the cause of peptic ulcer disease is that it stems from certain foods or stress.
“The incidence of peptic ulcer disease increases with age,” Dr. Kim said. “There is similar prevalence in men and women, though stomach ulcers tend to be more common in women and ulcers in the intestine more common in men. Smoking and alcohol use are risk factors for ulcers. Other medications like steroids or blood thinners have been associated with ulcers as well.”
A breath or stool test can also help identify peptic ulcer disease caused by H. pylori. “But to make an official ulcer diagnosis, we perform an endoscopy ― look in their stomach with a camera while someone is asleep,” Dr. Martin said.
“If the ulcer is actively bleeding at the time of endoscopy, there are techniques and tools we can use to stop the bleeding,” said Dr. Kevin Cronley, a gastroenterologist with Gastro Health in Cincinnati.
“Peptic ulcer left untreated can result is significant complications including GI hemorrhage and perforation of the bowel,” Cronley said. “It is very important to seek urgent evaluation by a gastroenterologist if peptic ulcer disease is suspected. If caught early, it can very easily be treated and prevent significant complications.”