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Peptic Ulcers

Peptic Ulcers

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
Gastric Ulcer
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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 use disorder
  • Tumors
  • Other medications, such as steroids or those to treat osteoporosis
  • Severe stress such as surgery, trauma , head injury, shock , or burns

Risk Factors

Factors that may increase your chance of peptic ulcer include:

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

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.

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
  • Upper GI endoscopy
  • X-rays using contrast material—upper GI series
  • Biopsy

Treatment

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

Prevention

To help reduce your chance of H. pylori infection:

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

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

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