Peptic Ulcer Disease
Peptic ulcers are sores that develop in the lining of the stomach or the duodenum (the first part of the small bowel).
- Upper abdominal pain
- Nausea and vomiting
- Bleeding (vomiting blood or having black stools).
Ulcers develop when the acid erodes the lining of the upper digestive tract. This occurs if there is excess acid or if there is a breakdown in the mucus protective barrier.
The most common causes include:
- Helicobacter pylori infection. H pylori is a common type of bacteria that can infect the stomach and cause inflammation (gastritis) or ulcers.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). These commonly used pain medications can cause damage to the protective lining of the bowel.
- Smoking. People who smoke are more likely to develop peptic ulcers than non-smokers.
Your doctor will review your medical history and perform a physical examination and may recommend an upper endoscopy.
Upper endoscopy: While you are sedated the doctor inserts a thin tube with a camera and a light at its tip from your mouth down to the duodenum. The doctor may take small pieces of tissue from the stomach lining (biopsies). The tissue will be examined under the microscope to look for inflammation, abnormal cells or H pylori infection.
H pylori testing: Blood, breath or stool tests may be performed to look for evidence of H pylori infection.
Peptic ulcers follow a benign course but untreated ulcers can cause serious life-threatening complications.
- Bleeding. Symptoms may include vomiting blood or having blood in the stools (red blood or back tarry stools).
- Perforation. This occurs when the ulcer causes a hole in the wall of the stomach or the bowel. It presents with severe abdominal pain and usually requires surgery.
- Obstruction. Rarely severe swelling can occur around the ulcer and cause an obstruction of the outlet of the stomach resulting in recurrent vomiting.
The treatment depends on the specific cause of the ulcers.
- Acid suppression using proton pump inhibitor medications or H-2 blockers is the mainstay of treatment.
- Antibiotics maybe used to eradicate H pylori infection.
- Stopping any offending medications such as Nonsteroidal anti-inflammatory drugs (NSAIDs) or Aspirin.