Peptic Ulcer Disease

The most common symptom of a peptic ulcer is burning or dull stomach pain that can last for minutes to hours and comes and goes over days, weeks or months. This pain may be burning, gnawing, or aching and is often worse when the stomach is empty such as between meals or at night. The pain may stop briefly with eating or taking antacids. Other symptoms of a peptic ulcer may include belching, bloating, heartburn, nausea, and vomiting.

The most common cause of a peptic ulcer is an infection with the Helicobacter pylori (H. pylori) bacteria. The bacteria damage the mucosa, the coating that protects the lining of the stomach and small intestines. Once it damages is done stomach acid can get through the lining and cause the ulcer.

Other causes of a peptic ulcer may include long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen. NSAIDS work by blocking enzymes that protect the stomach lining from stomach acid. Stress and spicy foods can make the symptoms worse but don’t cause an ulcer.

Your Gastroenterology clinician will review your medical history, perform a physical exam and or tests such as a breath, blood, or stool test. The presence of an ulcer can only be determined by looking directly into the stomach, so an upper endoscopy or X-ray will be done confirm the diagnosis.

The treatment of a peptic ulcer is based on the underlying cause. If the ulcer is caused by an infection with the H. pylori bacteria, antibiotics will be prescribed to kill the bacteria. If the cause is NSAIDS you will be advised to stop taking these medications, reducing dosages, or switching to a medication that won’t cause a peptic ulcer.

Acid-reducing medications, such as proton pump inhibitors (PPIs) or histamine receptor antagonists (H2 blockers), may also be prescribed. PPIs reduce stomach acid and protect the lining of the digestive tract from stomach acid. Antacids may be used to neutralize stomach acid and provide relief from symptoms. Pepto-Bismol also coats the lining of the digestive tract and can help protect it from stomach acid.

Surgery may be necessary when the ulcer is causing bleeding or severe pain that doesn’t improve with nonsurgical treatments.

Complications of a peptic ulcer may include bleeding, perforation, or obstruction. Bleeding from a peptic ulcer may occur internally, resulting in blood in the stool or vomit. A perforated ulcer is a serious complication that occurs when the ulcer erodes through the wall of the stomach or intestine. This can cause infection or other serious problems. Obstruction occurs when the ulcer blocks the passage of food through the digestive tract.