When To Seek Medical Attention
Most peptic ulcers are not a medical emergency and can be treated on an outpatient basis. But if there has been a perforation, severe internal bleeding, or obstruction, you’ll need to seek immediate medical care.
If left untreated, intestinal perforation and internal bleeding can lead to shock, coma, multiple organ failure, and death.
Symptoms And Signs Of Peptic Ulcer Disease
Symptoms of peptic ulcer disease depend on ulcer location and patient age many patients, particularly older patients, have few or no symptoms. Pain is most common, often localized to the epigastrium and relieved by food or antacids. The pain is described as burning or gnawing, or sometimes as a sensation of hunger. The course is usually chronic and recurrent. Only about half of patients present with the characteristic pattern of symptoms.
Gastric ulcer symptoms often do not follow a consistent pattern . This is especially true for pyloric channel ulcers, which are often associated with symptoms of obstruction caused by edema and scarring.
Duodenal ulcers tend to cause more consistent pain. Pain is absent when the patient awakens but appears mid-morning and is relieved by food but recurs 2 to 3 hours after a meal. Pain that awakens a patient at night is common and is highly suggestive of duodenal ulcer. In neonates, perforation and hemorrhage may be the first manifestation of duodenal ulcer. Hemorrhage may also be the first recognized sign in later infancy and early childhood, although repeated vomiting or evidence of abdominal pain may be a clue.
Signs Of Peptic Ulcer And Diagnosis
The majority of people affected with ulcers present a dyspepsia symptomatology. The pattern of dyspepsia symptoms already guides the diagnosis of ulcer. Symptoms include epigastric pain on an empty stomach that subsides with food or antacids.
For the diagnosis, it is important to have information about the lifestyle, pharmacological treatments and personal history of ulcer or infection by Helicobacter pylori.
In some people, the ulcer can coexist with gastroesophageal reflux disease. This can make diagnosis difficult. However, the most sensitive and specific test to confirm the existence of ulcer is upper digestive endoscopy .
The objective of the treatment is the relief of the signs of peptic ulcer, the healing of the ulcer and the prevention of complications. In addition, you should follow hygienic-dietetic measures, such as:
- Avoid the use of NSAIDs.
- Do without food and drinks that cause the symptoms.
- Stop smoking, as tobacco delays the healing of the ulcer and increases recurrences.
- Antisecretory treatment
Currently proton pump inhibitors are the drugs that achieve higher rates of mucosal healing.
You should take them before meals. In addition, there are studies that show greater effectiveness if you take them in the morning than at the end of the day.
Proton pump inhibitor drugs require 3 to 5 days to reach the maximum effect. However, there is a variability in the clinical response due to the hepatic metabolism of the drug.
Eradication of Helicobacter pylori
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You Have Heartburn At Most Meals
If you find yourself experiencing frequent heartburn, regardless of what you eat, an ulcer may be responsible. Many patients with ulcers describe feeling very intense chest pain, which often causes them to burp or hiccup more than usual after eating. In many cases, a simple over-the-counter antacid can be taken to temporarily alleviate some of the pain and gassiness, but if it persists day after day, its likely something more than a regular case of heartburn.
Peptic Ulcer Disease Symptoms
Symptoms of peptic ulcer disease may be similar to other upper gastrointestinal conditions. Symptoms include:
- Abdominal discomfort or pain
- Pain radiating to the back
- Burning or gnawing feeling similar to hunger pains
- Pain aggravated by meals
- Pain relieved by meals
Because the symptoms of peptic ulcer disease are often nonspecific, it is important that you see a gastroenterologist for diagnosis.
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What Are Stomach Ulcers
Stomach ulcers, also called peptic ulcers, are open sores that can develop in the inside lining of your stomach. They can also form on the upper section of your small intestine.
Peptic ulcers have different names depending on where theyre located in the body: gastric ulcersif they are in the stomach, and duodenal ulcers when they are in the small intestine.
Stomach ulcers happen when the acid in your digestive track eats at the inner surface of the organ, causing a sore to form. Just like a sore on the outside of the body, this can be painful and difficult to heal. Normally, the digestive tract of the body is coated with a thick mucus layer that prevents this from occurring. When the acid level increases or this mucus thins, you could develop an ulcer.
The acidity and weakening of the stomach lining that leads to ulcers can be caused by several things:
- A bacterium called Helicobacter pylori
- Factors like genetics, smoking, certain diets, or habitual stress. Certain seasons, such as the winter holidays, can also increase your chances due to heightened stress and richer food intake
- Long-term use of nonsteroidal anti-inflammatory drugs like Advil or Motrin, which can negatively impact your stomach lining
- As a side-effect of other medications
- A rare disease called Zollinger-Ellison syndrome that leads to hyperacidity
Today, H. pylori causes about 95% of all duodenal ulcers and about 70% of all gastric ulcers.
What Are The Symptoms Of A Duodenal Ulcer
If you have a duodenal ulcer, you might:
- have pain in your stomach or abdomen
- have indigestion
- feel very full and bloated after eating
- feel like you might vomit
Your stomach pain may come and go. It can often be relieved by eating or taking an antacid.
Very occasionally, an ulcer can cause serious complications. Go to the emergency department if:
- you have a sharp pain in your stomach that doesn’t go away
- your vomit or stools look bloody or a black colour
If you have these symptoms, call triple zero and ask for an ambulance.
If you are concerned about symptoms, you can use healthdirect’s online Symptom Checker. This can give you advice on the next appropriate healthcare steps and when to seek medical attention.
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What Causes Peptic Ulcers
Ulcers form when digestive juices damage the walls of the stomach or small intestine. If the mucus layer gets too thin or your stomach makes too much acid, your gut will feel it. The two major causes are:
- Bacteria. Itâs called Helicobacter pylori , and as many as half of us carry it. Most people infected with H. pylori do not get ulcers. But in others, it can raise the amount of acid, break down the protective mucus layer, and irritate the digestive tract. Experts arenât sure how H. pylori infection spreads. They think it may pass from person to person through close contact, like kissing. You may also get it from unclean food and water.
- Certain pain relievers. If youâve been taking aspirin often and for a long time, youâre more likely to get a peptic ulcer. The same is true for other nonsteroidal anti-inflammatory drugs . They include ibuprofen and naproxen. NSAIDs block your body from making a chemical that helps protect the inner walls of your stomach and small intestine from stomach acid. Other types of pain meds, such as acetaminophen, wonât lead to peptic ulcers.
- Smoking cigarettes and drinking alcohol also can make you more likely to get ulcers. Stress and eating a lot of spicy food donât cause ulcers, as experts once thought. But they can make ulcers worse and harder to treat.
Can You Prevent A Peptic Ulcer
While stress and spicy foods can make symptoms of a peptic ulcer worse, they donât seem to make you more likely to have one. But a few other things can raise your chances.
Be careful when you take pain relievers. Some people who have arthritis or other conditions that cause chronic pain take nonsteroidal anti-inflammatory drugs for weeks or months at a time to ease pain and swelling. These medicines can affect the mucus that protects your stomach against acid and make you more likely to have peptic ulcers.
These pain relievers include:
You’re more likely to get an ulcer while taking one of these if you:
- Are over age 65
- Are infected with H. pylori bacteria
- Take more than one NSAID at a time
- Have had a peptic ulcer in the past
- Also take a steroid drug or selective serotonin reuptake inhibitor
To lower your chances for peptic ulcers while you take NSAIDs:
- Use the lowest possible dose to control your symptoms, and stop taking them as soon as you no longer need them.
- Take your medicine with food.
- Don’t drink alcohol while youâre taking these medicines.
While you’re on NSAIDs, you can take medicine to lower the amount of acid your stomach makes. Drugs that can do that include:
- Dairy products that have live cultures, like yogurt, kefir, and aged cheeses
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What Are The Symptoms Of A Bleeding Ulcer
Bleeding ulcers dont always cause pain. Sometimes the first signs of a bleeding ulcer are signs of anemia. These include:
- Dizziness or lightheadedness.
You might have a heavier bleed if you notice:
- Blood in your poop, or black poop that resembles tar.
These symptoms require urgent medical attention.
How Are Stomach Ulcers Diagnosed
Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications youre taking.
To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, youll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.
Other tests and procedures used to diagnose stomach ulcers include:
- Barium swallow: You drink a thick white liquid that coats your upper gastrointestinal tract and helps your doctor see your stomach and small intestine on X-rays.
- Endoscopy : A thin, lighted tube is inserted through your mouth and into the stomach and the first part of the small intestine. This test is used to look for ulcers, bleeding, and any tissue that looks abnormal.
- Endoscopic biopsy: A piece of stomach tissue is removed so it can be analyzed in a lab.
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Signs Of Abdomen Perforation
One other uncommon and probably life-threatening complication of an ulcer is the perforation of the wall of the abdomen or duodenum. This creates a gap between the abdomen and the stomach cavity and carries with it a excessive danger of an infection. A perforation presents in sudden and intense stomach ache and tenderness. The most typical symptom of an infection is a fever. ake1150sb / Getty Photographs
How Are Duodenal Ulcers Treated
If your ulcer is caused by H pylori, the usual treatment is ‘triple therapy’. This involves taking 2 antibiotics and a medicine. The antibiotics kill the bacteria, while the medicine reduces the acid made by your stomach.
If you don’t have an H. pylori infection, and you have been using anti-inflammatory drugs, you will need to stop taking them . You will also need to start taking a drug to reduce the acid production in your stomach.
You can make some other changes to improve your symptoms, such as:
- taking antacids
What Is The Difference Between Peptic Ulcers Gerd And Gastritis
Peptic ulcers are holes or lesions that form due to too much acid. GERD, which stands for gastroesophageal reflux disease, occurs when a persons stomach acid repeatedly backs up into the esophagus. Gastritis is a group of conditions that cause inflammation in the stomach. While all of these conditions affect the stomach, they are not the same and require different treatments.
What Is A Stomach Or Duodenal Ulcer
An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body.
- An ulcer in the lining of the stomach or duodenum, where hydrochloric acid and pepsin are present, is referred to as a peptic ulcer.
- When the ulcer is in the stomach, it is called a gastric ulcer.
- When the ulcer is in the duodenum, it is called a duodenal ulcer.
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Who Is More Likely To Get Ulcers
One in 10 people develops an ulcer. Risk factors that make ulcers more likely include:
- Frequent use of nonsteroidal anti-inflammatory drugs , a group of common pain relievers that includes ibuprofen .
- A family history of ulcers.
- Illness such as liver, kidney or lung disease.
- Regularly drinking alcohol.
What Causes Duodenal Ulcers
Your stomach makes a strong acid that helps you digest food and kills germs. The cells of the stomach and duodenum make a barrier from mucus, to protect themselves against this acid. If the mucus barrier is damaged, an ulcer can form.
The main cause of this damage is infection with bacteria called Helicobacter pylori, or H. pylori. The bacteria can cause the lining of your duodenum to become inflamed and an ulcer can form.
Some medications can also cause duodenal ulcers, particularly anti-inflammatory medicines such as ibuprofen and aspirin. It is rare that other medicines or medical conditions cause an ulcer.
There are some lifestyle factors that may make you more likely to get a duodenal ulcer, such as:
However, these things are less important than infection with H. pylori.
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How Are Stomach Ulcers Treated
Ulcers can heal if they are given a rest from the factors that created them. Healthcare providers treat uncomplicated ulcers with a combination of medicines to reduce stomach acid, coat and protect the ulcer during healing and kill any bacterial infection that may be involved. Medicines may include:
- Antibiotics. If H. pylori was found in your digestive tract, your healthcare provider will prescribe some combination of antibiotics to kill the bacteria, based on your medical history and condition. Commonly prescribed antibiotics include tetracycline, metronidazole, clarithromycin and amoxicillin.
- Proton pump inhibitors . These drugs help reduce stomach acid and protect your stomach lining. PPIs include esomeprazole,dexlansoprazole,lansoprazole, omeprazole,pantoprazole and rabeprazole.
- Histamine receptor blockers . These reduce stomach acid by blocking the chemical that tells your body to produce it . H2 blockers include famotidine, cimetidine and nizatidine.
- Antacids. These common over-the-counter medicines help to neutralize stomach acid. They may bring some symptom relief, but they arent enough to heal your ulcer. They also might interfere with some antibiotics.
- Cytoprotective agents. These medicines help to coat and protect your stomach lining. They include sucralfate and misoprostol.
- Bismuth Subsalicylate. This over-the-counter medicine, commonly found as Pepto-Bismol, can help coat and protect your ulcer from stomach acid.
When Should I Go To Er
Seek emergency care if you have:
- Severe pain that doesnt go away.
- Signs of blood in your poop or bloody vomit.
- Signs of severe blood loss, such as paleness and faintness.
A note from Cleveland Clinic
Stomach ulcers are common and treatable, but they should be taken seriously. Even when they dont cause symptoms, they arent a good sign. A stomach ulcer means that your natural stomach acid is overwhelming your protective stomach lining. Thats a situation that can only get worse if it isnt managed. Lifestyle changes may help, but youll still need to treat the underlying cause. Its probably either NSAID use or a common bacterial infection. Your healthcare provider can help prescribe the right medicines for your condition.
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Symptoms And Signs Of Peptic Ulcer Causes And Treatment Options
The signs of peptic ulcer must be recognized in time, so that you get an adequate treatment. Learn them and report them to your doctor immediately!
The bacterium Helicobacter pylori is found in more than 90% of cases of peptic ulcer. Learn why and how, and make sure you prevent this from happening to you.
Peptic ulcer is a lesion with loss of substance from the gastroduodenal mucosa. Although the incidence of peptic ulcer disease is decreasing, it still affects a large part of the population.
Helicobacter pylori is found in more than 90% of cases of peptic ulcer. It is a type of bacteria that causes infections in the stomach.
The ulcer is found in approximately two thirds of the worlds population. It is possible that it is transmitted through contaminated water and food.
Causes of peptic ulcer
Most ulcers are produced by an imbalance between the aggressive and defensive agents of the gastroduodenal mucosa. This imbalance is secondary to infection by Helicobacter pylori or the consumption of non-steroidal anti-inflammatory drugs .
In cases of peptic ulcer that present Helicobacter, eradication of the bacteria will reduce recurrence. However, only between 10 and 20% of people infected by Helicobacter pylori will develop at some point a peptic ulcer.
When there is a chronic use of NSAIDs, 50% of these people will present superficial gastric lesions. In addition, ulcers in these cases are usually asymptomatic.
The risk factors for peptic ulcer in people who consume NSAIDs are: