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What Is Peptic Ulcer Disease

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What Are The Symptoms Of Peptic Ulcer Disease

Peptic ulcer disease – causes, symptoms, diagnosis, treatment, pathology

The most common symptom of an ulcer is abdominal discomfort. Dr. Popli says, Sometimes its very sharp but it can also be burning and cramping as well. In addition to this people will also get associated nausea, bloating, and even atypical symptoms such as even chest pain that is reflux related as well.

Typically, the early symptoms of peptic ulcer disease can include:

  • A dull, kind of gnawing stomach ache
  • An aching in the middle of the night when the stomach is empty
  • Discomfort that comes and goes for a few days or weeks
  • Pain two to three hours after mealtime

These symptoms may be alleviated by eating or with over-the-counter antacids. Over time you may experience additional symptoms such as:

  • Bloating

A peptic ulcer can also cause serious symptoms that require emergency treatment. This could include:

  • Bloody or black stools
  • Bloody vomit or vomit that resembles coffee grounds
  • Severe, sharp, sudden, and persistent stomach pain

Any of these symptoms could signal that the ulcer has broken a blood vessel in the stomach or that it has perforated or burrowed deeply into the lining of the stomach or intestines. It could also signal that the ulcer has blocked the path of food that is trying to pass through the stomach. If you experience any of these symptoms seek treatment immediately.

Anorexia Vs Anorexic Vs Anorexia Nervosa

Anorexic is a description of somebody with the stereotypical thin, frail, malnourished appearance. The appearance is classically associated with anorexia, although in rare cases do patients end up becoming anorexic. An anorexic or is also a description given to substances that cause anorexia for weight loss purposes.

is an characterized by food restriction due to the strong desire to remain thin. It is considered a mental health diagnosis where people see themselves as regardless of their weight or appearance. The person does not necessarily exhibit anorexia as a symptom in their quest to restrict food intake.

What Causes A Peptic Ulcer

Causes of peptic ulcers include

Sometimes peptic ulcers are caused by both NSAIDs and H. pylori.

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Types Of Peptic Ulcers

Generally, peptic ulcers can be classified into two categories. While one is gastric ulcers, another is referred to as duodenal ulcers. In gastric ulcers, stomach ulcers develop on the stomach’s interior. However, in case of duodenal ulcers, they form on the interior of the first segment of the small intestine referred to as duodenum.

Pathology Of Peptic Ulcer Disease

Peptic Ulcer Disease PUD

The discontinuation of the gastric epithelium, the prime defensive mucosal layer that protects the inner tissues, causes perforations. These perforations also happen due to erosion of this layer from the increased population of Helicobacter pylori signifying the occurrence of an infection. The increased growth of this bacterium that generally resides inside the GI tract can cause ulcers. In fact, research suggests that the consumption of non-steroidal anti-inflammatory drugs for a prolonged period can also cause the formation of peptic ulcers.

Whenever a patient suffers from recurrent stomach pain within 15-30 minutes of consuming food, he is recommended to take an H. pylori test to check the increase in the population of this bacterium. In chronic cases, an endoscopy is done to detect the condition and location of the ulcers in the GI tract. If you follow the peptic ulcer pathophysiology flow chart below, you will understand how this disease develops.

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Enhancing Healthcare Team Outcomes

An evidence-based approach to peptic ulcer disease is recommended. PUD is a very common disorder that affects millions of people. When left untreated, it has significant morbidity. The majority of patients with PUD present to their primary caregiver, but others may present to the emergency department, urgent care clinic, or an outpatient clinic. Because the presentation of PUD is often vague, healthcare workers, including nurses, need to be aware of this diagnosis. The abdominal pain can mimic a number of other pathologies and consequently lead to a delay in treatment.

Once the diagnosis is made, the key is to educate the patient on lifestyle changes, which include discontinuation of smoking, abstaining from alcohol and caffeinated beverages, and avoid consumption of too many NSAIDs. Gastroenterology nurses monitor patients, provide education, and keep the team updated on the patient’s condition. The pharmacist should educate the patient on medication compliance to obtain symptom relief and a cure. A dietary consult should be sought as there is evidence that obesity may be a trigger factor for peptic ulcer disease. Only through a team approach can the morbidity of peptic ulcer disease be decreased. For most patients with PUD who are treated with the triple regimen or PPI, the outcomes are excellent, but recurrence of symptoms is not uncommon.

How Do Doctors Treat An Nsaid

If NSAIDs are causing your peptic ulcer and you dont have an H. pylori infection, your doctor may tell you to

  • stop taking the NSAID
  • reduce how much of the NSAID you take
  • switch to another medicine that wont cause a peptic ulcer

Your doctor may also prescribe medicines to reduce stomach acid and coat and protect your peptic ulcer. Proton pump inhibitors , histamine receptor blockers, and protectants can help relieve pain and help your ulcer heal.

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What If A Peptic Ulcer Doesn’t Heal

Most often, medicines heal a peptic ulcer. If an H. pylori infection caused your peptic ulcer, you should finish all of your antibiotics and take any other medicines your doctor prescribes. The infection and peptic ulcer will heal only if you take all medicines as your doctor prescribes.

When you have finished your medicines, your doctor may do another breath or stool test in 4 weeks or more to be sure the H. pylori infection is gone. Sometimes, H. pylori bacteria are still present, even after you have taken all the medicines correctly. If the infection is still present, your peptic ulcer could return or, rarely, stomach cancer could develop. Your doctor will prescribe different antibiotics to get rid of the infection and cure your peptic ulcer.

Deterrence And Patient Education

Peptic Ulcer Disease Nursing, Pathophysiology, Treatment | Gastric Ulcer vs Duodenal Ulcer Part 1

Patients with peptic ulcer disease should be counseled about potentially injurious agents like nonsteroidal anti-inflammatory drugs , aspirin, alcohol, tobacco, and caffeine. If it is necessary to use NSAIDs use the lowest possible dose and also consider prophylaxis for patients who use NSAIDs. Obesity has a strong association with peptic ulcer disease, and patients should be asked to lose weight. Stress reduction counseling can be helpful in some cases.

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Why Is My Stomach Bloated

The most common cause of stomach pain and bloating is excess intestinal gas. If you get a bloated stomach after eating, it may be a digestive issue. It might be as simple as eating too much too fast, or you could have a food intolerance or other condition that causes gas and digestive contents to build up. Your menstrual cycle is another common cause of temporary bloating. Sometimes a bloated stomach can indicate a more serious medical condition.

What Questions Should I Ask My Doctor About Zollinger

If you have Zollinger-Ellison syndrome, you may want to ask your doctor:

  • Do I have symptoms that suggest Zollinger-Ellison syndrome?
  • What are my diagnostic options?
  • What are my treatment options?
  • What signs of complications should I look out for?
  • How will Zollinger-Ellison syndrome affect my job or lifestyle?
  • Should my family consider genetic testing?
  • Are there focus groups or support groups in our area for people with this syndrome?
  • When can I go back to my regular activities?
  • What kind of follow up/surveillance should I have?

Last reviewed by a Cleveland Clinic medical professional on 11/01/2018.


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How Can I Prevent Ulcers

You may be able to prevent ulcers from forming if you:

  • Talk to your doctor about alternatives to NSAID medications to relieve pain.
  • Discuss protective measures with your doctor, if you cant stop taking an NSAID.
  • Opt for the lowest effective dose of NSAID and take it with a meal.
  • Quit smoking.
  • Drink alcohol in moderation, if at all.

Possible Erectile Dysfunction Risk

Heres everything that you must know about peptic ulcer ...

A 2005 Finnish survey study found an association between long term use of NSAIDs and .

A 2011 publication in received widespread publicity. According to the study, men who used NSAIDs regularly were at significantly increased risk of erectile dysfunction. A link between NSAID use and erectile dysfunction still existed after controlling for several conditions. However, the study was observational and not controlled, with low original participation rate, potential participation bias, and other uncontrolled factors. The authors warned against drawing any conclusion regarding cause.

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Risk Factors You Cannot Control

Some things that you cannot control may increase your risk of getting an ulcer. These include:

  • A Helicobacter pylori infection, the most common cause of ulcers.
  • Physical stress caused by a serious illness or injury .
  • Hypersecretory condition, in which your stomach produces too much acid.
  • A personal or family history of ulcers.

How Can I Prevent Stomach Bloating

If your stomach bloating is caused by diet or alcohol, you can help prevent it by making some lifestyle changes. Some good general guidelines include:

If the cause of your bloated stomach is something more specific, such as specific food intolerance, perimenopause or a medical condition, you might need a little help with diagnosis, treatment and prevention. Some options include:

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H Pylori Infection Treatment

Patients infected with H. pylori will usually need PPIs and antibiotics. This treatment is effective in most patients, and the ulcer will start to disappear within days. When treatment is over, the individual will have to be tested again to make sure the H. pylori have gone. If necessary, they will undergo another course of different antibiotics.

What Are Some Ulcer Symptoms


Some people with ulcers dont experience any symptoms. But signs of an ulcer can include:

  • Gnawing or burning pain in your middle or upper stomach between meals or at night.
  • Pain that temporarily disappears if you eat something or take an antacid.
  • Bloating.

In severe cases, symptoms can include:

  • Dark or black stool .
  • Vomiting.
  • Severe pain in your mid- to upper abdomen.

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What Are The Symptoms And Signs Of An Ulcer

Peptic ulcers are usually chronic and may come and go over a period of many years, even without treatment. The most common symptoms are:

  • abdominal pain, usually located in the upper central abdomen
  • pain which may also be felt in the back
  • pain which may be worse when the stomach is empty although not always the case, this pain can sometimes be relieved by eating
  • pain which wakes a patient from sleep
  • indigestion or heartburn
  • vomiting and anemia.

In a few patients, an ulcer may be silent until it erodes completely through the gut wall causing perforation, or erodes into a blood vessel causing bleeding. These complications are serious and usually present as an emergency.

How Stomach Ulcers Are Treated

With treatment, most stomach ulcers will heal within a month or two. The treatment recommended for you will depend on what caused the ulcer.

Most people will be prescribed a medication called a proton pump inhibitor to reduce the amount of acid their stomach produces and allow the ulcer to heal naturally.

If an H. pylori infection is responsible for the ulcers, antibiotics will also be used to kill the bacteria, which should prevent the ulcer coming back.

If the ulcers are caused by the use of NSAIDs, PPIs are usually prescribed and your doctor will discuss whether you should keep using NSAIDs.

Alternative medication to NSAIDs, such as paracetamol, may be recommended.

Stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed.

Read more about treating stomach ulcers.

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When Should I Call The Doctor

  • sudden, sharp, lasting belly pain
  • bloody or black bowel movements
  • bloody vomit or vomit that looks like coffee grounds

These could be signs of a serious problem for a child whos had a peptic ulcer, such as:

  • perforation
  • bleeding
  • obstruction

If your child takes NSAIDs and shows signs of a peptic ulcer, get medical help right away. Delaying diagnosis and treatment can lead to more problems and, possibly, the need for surgery. But with quick treatment, almost all peptic ulcers can be cured.

How Do Nsaids Cause A Peptic Ulcer

Peptic Ulcer Disease Nursing Care and Management: Study ...

To understand how NSAIDs cause peptic ulcer disease, it is important to understand how NSAIDs work. Nonsteroidal anti-inflammatory drugs reduce pain, fever, and inflammation, or swelling.

Everyone has two enzymes that produce chemicals in your bodys cells that promote pain, inflammation, and fever. NSAIDs work by blocking or reducing the amount of these enzymes that your body makes. However, one of the enzymes also produces another type of chemical that protects the stomach lining from stomach acid and helps control bleeding. When NSAIDs block or reduce the amount of this enzyme in your body, they also increase your chance of developing a peptic ulcer.

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How Do Tumors From Zes Cause Peptic Ulcers

Zollinger-Ellison syndrome is a rare disorder that happens when one or more tumors form in your pancreas and duodenum. The tumors release large amounts of gastrin, a hormone that causes your stomach to produce large amounts of acid. The extra acid causes peptic ulcers to form in your duodenum and in the upper intestine.

How Can Doctors Tell If I Have A Peptic Ulcer

Your doctor may suspect an ulcer based on your symptoms and just start you on ulcer treatment. If you get better, they often don’t do any tests.

However, doctors may do tests if:

  • You’ve had symptoms for a long time

  • Your symptoms are severe or aren’t typical for ulcers

  • Your symptoms didn’t start until you were past age 45

  • You don’t get better after taking medicine

The main test doctors do is:

During endoscopy, doctors usually take a biopsy to look for Helicobacter pylori bacteria or cancer.

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How To Treat A Peptic Ulcer

Treatment will depend on the underlying cause of your ulcer. If tests show that you have an H. pylori infection, your doctor will prescribe a combination of medication. Youll have to take the medications for up to two weeks. The medications include antibiotics to help kill infections and proton pump inhibitors to help reduce stomach acid.

You may experience minor side effects like diarrhea or an upset stomach from antibiotic regimens. If these side effects cause significant discomfort or dont get better over time, talk to your doctor.

If your doctor determines that you dont have an H. pylori infection, they may recommend a prescription or over-the-counter PPI for up to eight weeks to reduce stomach acid and help your ulcer heal.

Acid blockers like famotidine can also reduce stomach acid and ulcer pain. These medications are available as a prescription and also over the counter in lower doses.

Your doctor may also prescribe sucralfate which will coat your stomach and reduce symptoms of peptic ulcers.

Peptic Ulcer Disease: Symptoms Causes Treatment

Peptic Ulcer Disease

Peptic ulcer disease is when ulcers develop in the stomach or small intestine. Know the symptoms, causes and treatment.

Peptic ulcer disease develops when open sores, or ulcers, form in the stomach or initial section of the small intestine. A bacterial infection eats away the protective lining of the digestive tract, which causes many cases of peptic ulcer disease. People who often use pain killers are more prone to develop ulcers. Onlymyhealth editorial team spoke to Dr. Jagan Mohan Reddy Bathalapalli, M.B.B.S M.S., MCH, General Surgery, Laparoscopy and Minimal Access Surgery, Apollo Spectra Hospitals, Kondapur-Hyderabad, to know about the symptoms, causes and treatment of peptic ulcer disease.

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Are Peptic Ulcers Painful

The pain of ulcer disease correlates poorly with the presence or severity of active ulceration. Some individuals have persistent pain even after an ulcer is almost completely healed by medication. Others experience no pain at all. Ulcers often come and go spontaneously without the individual ever knowing that they are present unless a serious complication occurs.

Symptoms and signs of peptic ulcers disease vary. Some people with stomach ulcers do not have any symptoms or signs while others may have a few or several.

The most common symptom of a peptic ulcer is a dull or burning pain in the stomach. The pain may be felt anywhere between your belly button and breastbone. Pain from a peptic or stomach ulcer

  • usually happens when your stomach is empty, for example, such as between meals or during the night
  • may stop briefly if you eat or take antacids
  • may last for minutes to hours
  • may come and go for several days, weeks, or months
  • Peptic ulcer other symptoms and signs that are less common include

  • bloating,

    Cigarette smoking not only causes ulcers, but it also increases the risk of complications from ulcers such as bleeding, obstruction, and perforation. Cigarette smoking also is a leading cause of failure of treatment for ulcers.

    Contrary to popular belief, alcohol, coffee, colas, spicy foods, and caffeine have no proven role in ulcer formation. Similarly, there is no conclusive evidence to suggest that life stresses or personality types contribute to ulcer disease.

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