Topic updated: September 2012

Peptic Ulcers

What is a peptic ulcer?

A peptic ulcer is a sore in the lining of your stomach or duodenum. The duodenum is the first part of your small intestine. A peptic ulcer in the stomach is called a gastric ulcer. One that is in the duodenum is called a duodenal ulcer. A peptic ulcer also may develop just above your stomach in the esophagus, the tube that connects the mouth to the stomach. But most peptic ulcers develop in the stomach or duodenum.

Many people have peptic ulcers. You can have both gastric and duodenal ulcers at the same time and you also can have more than one ulcer in your lifetime.

Peptic ulcers can be treated successfully. Seeing your doctor is the first step.

What causes peptic ulcers

Most peptic ulcers are caused by

  • Helicobacter pylori (H. pylori), a germ that causes infection
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen

H. pylori is the most common cause of peptic ulcers. Doctors think H. pylori may be spread through unclean food or water or by mouth-to-mouth contact, such as kissing. Even though many people have an H. pylori infection, most of them never develop an ulcer.

Use of NSAIDs is the second most common cause of peptic ulcers. But not everyone who takes NSAIDs gets a peptic ulcer. Ulcers caused by NSAIDs are more often found in people who

  • are age 60 or older
  • are female
  • have taken NSAIDs for a long time
  • have had an ulcer before

Other causes of peptic ulcers are rare. One rare cause is Zollinger-Ellison syndrome - a disease that makes the body produce too much stomach acid, which harms the lining of the stomach or duodenum.

Stress or spicy food does not cause peptic ulcers, but either can make ulcers worse and keep them from healing.

What are the symptoms of peptic ulcers?

A dull or burning pain in your stomach is the most common symptom of peptic ulcers. You may feel the pain anywhere between your belly button and breastbone. The pain often

  • starts between meals or during the night
  • briefly stops if you eat or take antacids
  • lasts for minutes to hours
  • comes and goes for several days or weeks

Other symptoms of peptic ulcers may include

  • weight loss
  • poor appetite
  • bloating
  • burping
  • vomiting
  • feeling sick to your stomach

Even if your symptoms are mild, you may have peptic ulcers. You should see your doctor to talk about your symptoms. Peptic ulcers can get worse if they aren't treated.

Call your doctor right away if you have

  • sudden sharp stomach pain that doesn't go away
  • black or bloody stools
  • bloody vomit or vomit that looks like coffee grounds

These symptoms could be signs an ulcer has

  • broken a blood vessel
  • gone through, or perforated, your stomach or duodenal wall
  • stopped food from moving from your stomach into the duodenum

These symptoms must be treated quickly. You may need surgery.

How are peptic ulcers diagnosed?

Tell your doctor about your symptoms and which medicines you take. Be sure to mention those you get without a prescription, such as Bayer, Motrin, Advil, or Aleve. These medicines are all NSAIDs.

To see if you have an H. pylori infection, your doctor will test your blood, breath, or stool. About half of all people who develop an ulcer from NSAIDs also have an H. pylori infection.

Your doctor also may want to look inside your stomach and duodenum by doing an endoscopy or an upper gastrointestinal (GI) series - a type of x ray. Both procedures are painless.

For an endoscopy, you will be given medicine to relax you. Then the doctor will pass an endoscope - a thin, lighted tube with a tiny camera - through your mouth to your stomach and duodenum. Your doctor also may take a small piece of tissue - no bigger than a match head - to look at through a microscope. This process is called a biopsy.

For an upper GI series, you will drink a liquid called barium. The barium will make your stomach and duodenum show up clearly on the x rays.

Read the rest of this excellent article on peptic ulcers, including information on treatment, produced by the National Digestive Diseases Information Clearinghouse

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