Peptic Ulcers Symptoms & Treatments
A peptic ulcer is a sore in the lining of the stomach or the duodenum (upper part of the small intestine). The stomach secretes mucus to protect the lining of the stomach from the acids and digestive enzymes it produces to break down food for digestion. An imbalance of these digestive fluids causes inflammation and weakening of the protective mucus lining, which leads to the formation of ulcers.
A gastric ulcer refers to an ulcer that is located in the stomach. A duodenal ulcer is located in the first section of the small intestine. Peptic ulcer gets its name from the pepsin enzyme produced by the stomach and duodenum.
Two common causes of peptic ulcers include long-term use of nonsteroidal anti-inflammatory agents (NSAIDs), like aspirin and ibuprofen, and Helicobacter pylori, or H. pylori, a bacterial infection in the stomach.
Most ulcers occur in the first layer of the stomach or intestinal lining. Some ulcers can penetrate through the intestine, creating a hole. This condition is called a perforated ulcer or perforation of the intestinal lining.
Some ulcers may not cause symptoms. Others may cause pain and bleeding. Ulcers are rarely life threatening. Treatments for ulcers include lifestyle changes, medications, and surgery.
Peptic ulcers are caused by an imbalance between acid and pepsin enzyme in the stomach and duodenum. The imbalance of digestive fluids causes the protective mucus lining of the stomach and duodenum to become inflamed and weak, which leads to the formation of ulcers.
You are more likely to get peptic ulcers if you use nonsteroidal anti-inflammatory medications (NSAIDS) such as aspirin, ibuprofen, and naproxen for long periods of time.
Another common cause of peptic ulcers is Helicobacter pylori (H. pylori), a type of bacterial infection in the stomach. In the US, approximately 30 to 40 percent of people have an H. pylori infection, although most never develop a peptic ulcer.
In addition, tumors produced by a rare disorder known as Zollinger-Ellison syndrome can increase acid output and cause ulcers.
Many people with ulcers do not experience any symptoms. If symptoms do occur, they can include:
- A burning pain in your stomach or upper abdomen
- Nausea or vomiting
Stomach or abdominal pain may occur more frequently between meals or at night. The pain may even wake you at night. Your pain may get better or worse after eating a meal.
In severe cases, ulcers can bleed, which is a serious complication. Bleeding from an ulcer can be slow and go unnoticed or can cause life-threatening hemorrhage that requires immediate medical attention. Slowly bleeding ulcers might not produce any symptoms until anemia occurs. Symptoms of a rapidly bleeding ulcer include vomiting blood or blood in your stools. Your stools may appear very dark or black if they contain blood.
To diagnose peptic ulcer disease, your doctor will first review your medical history and conduct a physical exam. Be sure to tell your doctor about your symptoms and risk factors.
Your doctor may order blood tests, stool tests, and a urea breath test to check for the presence of H. pylori bacteria. Other tests your doctor may order to confirm the diagnosis include:
- Upper gastrointestinal (GI) endoscopy
- Upper GI series with barium swallow
- CT scan
Treatment will depend on the cause of your peptic ulcer. Sometimes ulcers can resolve with lifestyle changes such as eliminating the use of NSAIDs. Your doctor may prescribe medication to treat your ulcer. If your ulcer is caused by an H. pylori infection, you will need an antibiotic. Other ulcers can be treated with:
- An over-the-counter H2 blocker such as Zantac®, Tagamet®, or Pepcid AC®
- A prescription proton pump inhibitor (PPI) such as Prilosec®, Prevacid® or Nexium®
- A tissue lining protector called Carafate®
H2 blockers and PPIs reduce stomach acid and protect the lining of your stomach and duodenum. The protectant coats ulcers and protects them against acid and enzymes to allow healing. Most ulcers heal with medication in about 8 weeks.
An upper GI endoscopy may be used to stop ulcers from bleeding while perforated ulcers or severe bleeding may require surgery.
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