Peptic Ulcer Disease

Also called: Duodenal ulcer, Gastric ulcer, Ulcer (1)

Illustration of an ulcer in the duodenum.

Peptic ulcer, a common digestive problem, is a sore in the lining of your stomach or duodenum. The duodenum is the first part of your small intestine. If peptic ulcers are found in the stomach, they're called gastric ulcers. If they're found in the duodenum, they're called duodenal ulcers. You can have more than one ulcer.

Symptoms

An abdominal pain or discomfort is the most common symptom of peptic ulcer. The pain
  • feels like a dull ache
  • comes and goes for a few days or weeks
  • starts 2 to 3 hours after a meal
  • comes in the middle of the night when your stomach is empty
  • usually goes away after you eat

Other symptoms are
  • losing weight
  • not feeling like eating
  • having pain while eating
  • feeling sick to your stomach
  • vomiting
Some people with peptic ulcers have mild symptoms. If you have any of these symptoms, you may have a peptic ulcer and should see your doctor(2).

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Causes

Peptic ulcers can be caused by the bacteria called Helicobacter Pylori, or H. pylori, nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen, and other diseases.

Your body makes strong acids that digest food. A lining protects the inside of your stomach and duodenum from these acids. If the lining breaks down, the acids can damage the walls. Both H. pylori and NSAIDs weaken the lining so acid can reach the stomach or duodenal wall.H. pylori causes almost two-thirds of all ulcers. Many people have H. pylori infections. But not everyone who has an infection will develop a peptic ulcer.Most other ulcers are caused by NSAIDs. Only rarely do other diseases cause ulcers(3).

Stress or eating spicy foods do not cause peptic ulcers but they can make ulcers worse. Drinking alcohol or smoking can also make ulcers worse.

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Can the condition get worse?

Peptic ulcers will get worse if they aren't treated. Call your doctor right away if you have any of these symptoms:
  • sudden sharp pain that doesn't go away
  • black or bloody stools
  • bloody vomit or vomit that looks like coffee grounds

    These could be signs that
  • the ulcer has gone through, or perforated, the stomach or duodenal wall
  • the ulcer has broken a blood vessel
  • the ulcer has stopped food from moving from the stomach into the duodenum
These symptoms must be treated quickly. You may need surgery.

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Diagnosis

If you have symptoms, see your doctor. Your doctor may
  • take x rays of your stomach and duodenum, called an upper GI series. You'll drink a liquid called barium to make your stomach and duodenum show up clearly on the x rays.
  • use a thin lighted tube with a tiny camera on the end to look at the inside of your stomach and duodenum. This procedure is called an endoscopy. You'll take some medicine to relax you so your doctor can pass the thin tube through your mouth to your stomach and duodenum. Your doctor may also remove a tiny piece of your stomach to view under a microscope. This procedure is called a biopsy.

If you do have a peptic ulcer, your docor may test your breath, blood, or tissue to see whether bacteria caused the ulcer(4).

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Treatment

Peptic ulcers can be cured. Medicines for peptic ulcers are
  • proton pump inhibitors or histamine receptor blockers to stop your stomach from making acids
  • antibiotics to kill the bacteria

Depending on your symptoms, you may take one or more of these medicines for a few weeks. They'll stop the pain and help heal your stomach or duodenum.

Ulcers take time to heal. Take your medicines even if the pain goes away. If these medicines make you feel sick or dizzy, or cause diarrhea or headaches, your doctor can change your medicines.

If NSAIDs caused your peptic ulcer, you'll need to stop taking them. If you smoke, quit. Smoking slows healing of ulcers.

If you have a peptic ulcer, taking antacids will stop the acids from working and reduce the pain and help ulcers heal

You can buy antacids at any grocery store or drugstore. But you must take them several times a day. Also, antacids don't kill the bacteria, so your ulcer could come back even if the pain goes away(5).

Peptic ulcers will recur if you stop taking your antibiotic too soon as not all the bacteria will be gone and not all the sores will be healed. If you still smoke or take NSAIDs, your ulcers may come back.

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Surgical Procedure

In many cases, medicine heals ulcers. You may need surgery if your ulcers
  • don't heal
  • keep coming back
  • perforate, bleed, or obstruct the stomach orduodenum

Surgery can
  • remove the ulcers
  • reduce the amount of acid your stomach makes(6)

Sources:

1. Peptic Ulcer. MedlinePlus. National Institutes of Health

2. What I need to know about peptic ulcers. National Digestive Diseases Information Clearinghouse (NDDIC). National Institutes of Health. NIH Publication No. 05–5042 October 2004

3. Ibid.

4. Ibid.

5. Ibid.

6. Ibid.

7. Image Credit: National Institute of Diabetes and Digestive and Kidney Diseases. National Institutes of Health


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Page Last Revised: May 2012