Peptic Ulcer

A peptic ulcer is a sore in the lining of the stomach or the first part of the small intestine. This area of the small intestine is called the duodenum. Peptic ulcers may be named by their location: Treatment may include antibiotics, medications that heal the ulcer and protect the stomach, and lifestyle changes. Surgery may be needed for ulcers that bleed, obstruct, perforate, or don't heal with other treatments.

  • Causes

    Upsets in the balance of stomach acid and digestive juices can lead to an ulcer. This can be caused by:

    • Helicobacter pylori
      (
      H. pylori
      ) infection
    • Use of nonsteroidal anti-inflammatory drugs (NSAIDs)

    Less common causes include:

    • Zollinger-Ellison syndrome
    • Radiation therapy
    • Bacterial or viral infections
    • Alcohol abuse
    • Tumors
    • Other medicines such as steroids or medicines to treat osteoporosis

    • Severe stress such as surgery,
      trauma
      , head injury,
      shock
      , or
      burns

  • Definition

    A peptic ulcer is a sore in the lining of the stomach or the first part of the small intestine. This area of the small intestine is called the duodenum. Peptic ulcers may be named by their location:

    • Gastric ulcers
      are in the stomach
    • Duodenal ulcers
      are in the duodenum

    Treatment may include antibiotics, medications that heal the ulcer and protect the stomach, and lifestyle changes. Surgery may be needed for ulcers that bleed, obstruct, perforate, or don't heal with other treatments.

    Gastric Ulcer
    IMAGE
    Copyright © Nucleus Medical Media, Inc.

  • Diagnosis

    The doctor will ask about your symptoms and medical history. A physical exam will be done.

    Tests may include:


    • Rectal exam and
      stool guaiac test
    • Blood test, stool test, or breath test
    • Endoscopy
    • Upper GI series
    • Biopsy

  • Prevention


    To reduce your chance of getting
    H. pylori
    infection:

    • Wash your hands after using the bathroom and before eating or preparing food.
    • Drink water from a safe source.
    • Don't smoke
      . Cigarette smoking increases the chances of getting an ulcer.

    To reduce your chance of getting a peptic ulcer from NSAIDs:

    • Use other drugs when possible for managing pain.
    • Take the lowest possible dose.
    • Don't take drugs longer than needed.
    • Don't drink alcohol while taking the drugs.
    • Ask your doctor about switching to medicines less likely to cause ulcers. Talk to your doctor about taking other drugs to protect your stomach and intestine lining.
    • Don't smoke.
      Cigarette smoking increases the chances of getting an ulcer.

  • Risk Factors

    Factors that increase your chances of peptic ulcer include:

    • H. pylori
      infection
    • Taking NSAIDs for a long time and at higher doses
    • Prior peptic ulcer disease
    • Cigarette smoking
    • Alcohol abuse

  • Symptoms

    Peptic ulcers do not always cause symptoms. Symptoms may come and go. Food or fluids sometimes make symptoms better. Having an empty stomach may make symptoms worse. However, symptoms can occur at any time.

    Symptoms may include:


    • Gnawing pain:

      • May awaken you from sleep
      • May change when you eat
      • May last for a few minutes or several hours
      • Feels like unusually strong hunger pangs
      • May be relieved by taking antacids
    • Nausea
    • Vomiting
    • Loss of appetite
    • Bloating
    • Burping
    • Weight loss

    Ulcers can cause serious problems and severe abdominal pain. One problem is bleeding. Bleeding symptoms may include:

    • Bloody or black, tarry stools
    • Vomiting what looks like coffee grounds or blood
    • Weakness
    • Lightheadedness

    A perforated ulcer is a break through the wall of the stomach or duodenum. It causes sudden and severe pain.

  • Treatment

    Talk to your doctor about the best treatment plan for you. Treatment options may include one or more of the following: