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What Are Peptic Ulcers?

Peptic ulcers are small open sores in the stomach or upper intestine. Sores occur when the lining of the stomach or intestine breaks down and exposes tissue underneath. Ulcers may be gastric (stomach) or duodenal (first 12 inches of the small intestine). Duodenal ulcers occur four times more often than gastric ulcers. Peptic ulcer disease (PUD) is common. About 15 million people in the United States have peptic ulcer disease.

What Causes Peptic Ulcers?

Three things cause most peptic ulcers: infection with a bacteria named Helicobacter pylori (H. pylori), taking aspirin or similar medicines (nonsteroidal antiinflammatory drugs, or NSAIDs, such as ibuprofen), and too much acid secretion. Ulcers aren’t contagious but may run in families. Smoking and alcohol increase the risk of stomach ulcers.

What Are the Symptoms of Peptic Ulcers?

The main symptom is stomach pain that may feel like heartburn, indigestion, or hunger. A burning, boring, or gnawing feeling can last from 30 minutes to 3 hours. It’s usually felt in the upper stomach area, but it sometimes occurs below the breastbone. Pain usually happens when the stomach is empty. It can also occur right after eating or hours later, depending on the location of the ulcer.

Complications include bleeding and perforation (hole in the stomach or duodenum). Black, tarry stools and vomiting with blood or with what looks like “coffee grounds” material (blood mixed with stomach acid) indicate bleeding ulcers.

How Are Peptic Ulcers Diagnosed?

The health care provider will suspect PUD from the medical history and physical examination. The health care provider may order blood and stool tests. Endoscopy or barium x-rays may be done. For endoscopy, the better test, the doctor uses a lighted tube to see into the stomach and take a tissue sample for study. Tests will be done to see whether the stomach or duodenum has H. pylori infection.

How Are Peptic Ulcers Treated?

Treatment heals the ulcer, helps symptoms, stops relapses, and avoids complications. With treatment, people usually start to feel better in about 2 weeks. Relapses can occur if the risk factors persist.

Two treatment options are drugs and surgery. Medicines to reduce stomach acid include antacids, histamine-2 blockers such as ranitidine or famotidine, and proton pump inhibitors such as omeprazole. Sucralfate is another medication that can form a protective coating on the ulcer to help it heal. Antibiotics, proton pump inhibitors, and bismuth can be used for H. pylori infection.

Surgery is used when drugs don’t work or serious complications occur. Today, surgery is rarely needed.

DOs and DON’Ts in Managing Peptic Ulcers:

  • DO avoid things that increase the risk of PUD: aspirin, NSAIDs, smoking, and drinking alcohol.
  • DO call your health care provider if your vomit is bloody or looks like coffee grounds.
  • DO call your health care provider if blood is in your stools or stools are dark and tarry.
  • DO call your health care provider if you are unusually weak or pale.
  • DO call your health care provider if pain doesn’t get better with treatment.
  • DON’T change your medicine or dosage because you feel better unless your health care provider tells you to.
  • DON’T smoke. Get help finding a smoking cessation program.
  • DON’T drink caffeine and eat foods that make symptoms worse.
  • DON’T drink alcohol.

Contact the following sources:

  • American College of Gastroenterology
    Tel: (703) 820-7400
  • National Digestive Diseases Information Clearinghouse
    Tel: (800) 891-5389
  • American Gastroenterological Association
    Tel: (301) 654-2055

Copyright © 2016 by Saunders, an imprint of Elsevier, Inc.

Ferri’s Netter Patient Advisor