This is my first year in college and I am pursuing pre-pharmacy, which is a competitive field right now. I am trying really hard to get A's in all of my classes to get accepted into a School of Pharmacy. I'm pretty stressed out. I was wondering what the likelihood would be of me to develop an ulcer? One of my sister's friends had a mild one, and my friend's dad had to drop out of med school cause he got one. I don't want the same fate. What are warning signs? I work out. Should I do aerobics to reduce stress? What can I do to minimize the chances of an ulcer?

Starting at a new school, getting good grades, thinking about graduate school — you've got plenty on your mind; however, giving yourself an ulcer or worrying about giving yourself an ulcer does not have to be one of them. Contrary to popular belief, neither stress, nor spicy foods, another commonly blamed culprit, cause ulcers. These can, however, exacerbate ulcers.

Peptic ulcers — sores in the lining of the stomach or intestines — largely can be blamed on a bacterium called Helicobacter pylori (H. pylori), a spiral-shaped microorganism that can live in the human digestive system. According to the Centers for Disease Control and Prevention (CDC), about two-thirds of the world's population is infected with H. pylori, although most people don't have any symptoms. Researchers aren't completely certain how the bacteria are spread, but several likely routes have been discovered:

• contact with human feces
• kissing or sharing saliva with someone who's infected
• ingesting contaminated food or drinking water

The following are common symptoms of an ulcer:

• dull, aching, abdominal pain that comes and goes over an extended period of time
• weight loss
• nausea and vomiting
• loss of appetite
• burping and bloating

Ulcers can cause serious problems including internal bleeding, blockage of food as it leaves the stomach, and/or holes in the intestines. Symptoms needing immediate medical attention include:

• sudden, sharp, and persistent abdominal pain
• black or bloody stools
• vomit that contains blood or looks similar to coffee grounds

A good way to prevent an ulcer is to guard against infection by H. pylori and to avoid activities that weaken the protective lining of the stomach. You can do this in the following ways:

Avoid using nonsteroidal anti-inflammatory drugs (NSAIDS) regularly.
These medications can damage the lining of the stomach or small intestine. Long-term and/or regular use of NSAIDS, such as aspirin and ibuprofen, can cause ulcers.

Stay away from cigarettes and do not smoke.
Some research has shown that smoking can increase the risk of getting an ulcer and slow the healing of ulcers.

Don't drink large amounts of acidic, caffeinated, and/or alcoholic beverages.
These drinks can cause increased stomach acid and irritate the stomach, possibly making the stomach more susceptible to ulceration.

Wash your hands.
Be sure to wash your hands completely, tops and palms, using soap and water after using the bathroom, and dry them well. H. pylori can be transmitted through human stools.

Drink water from clean sources.
Contaminated water can contain H. pylori.

Health care providers usually treat ulcers caused by H. pylori with antibiotics and other drugs. If you're having some of these or other symptoms, and you're worried you might have an ulcer, make an appointment with your health care provider. S/he will give you an examination, if necessary, and a diagnosis so that a course of treatment can be determined for you.

As far as dealing with the stresses of being a student, you've got the right idea — regular exercise is great! Whether it's aerobics or biking, playing squash, or dancing salsa, regular physical activity helps people relax, feel great, and maintain good health. If you look at the Related Q&As listed below, you'll get all sorts of tips, including other ways to reduce and manage stress, get more sleep, and eat better.

Good luck making those A's!

Alice

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