Peptic ulcer is a painful ulcer (lesion or crater)
in the lining of the stomach or small intestines.
Symptoms of Peptic Ulcer
The symptoms of peptic ulcer are:
- Pain or burning sensation in the stomach, especially at night
or between meals
This pain may go away (or in some people, worsen) when eating.
- Heartburn or pain in the chest or upper abdomen, especially
The vomit may look like mucous, blood or coffee grounds (where
the blood is mixed with stomach acid and becomes coagulated
- Blood in the stool
- Black-colored, tar-like or dark-reddish stool
Peptic Ulcer Diagnosis
Your doctor would do the following tests to diagnose peptic ulcer:
- Physical exam
Tenderness as the doctor pushes into the stomach with his fingers,
or immediately after he lifts his fingers.
A flexible tube with camera attached to it is inserted into
the stomach to visualize the whitish lesions of peptic ulcer.
Usually a biopsy (or tissue sampling) is performed
during an endoscopic procedure, especially if the ulcer is located
in the stomach as lesions may also be indicative of stomach
- Barium X-Ray
A solution of barium is given to the patient to swallow before
an X-ray is taken. This allows the doctor to see shadows of
the peptic ulcer lesion.
- Stool examination
Blood in the stool may indicate a bleeding ulcer.
- Blood tests
Your doctor may look for the presence of:
- Heliobacter pylori (h. pylori), a bacteria
that commonly cause peptic ulcer
- Elevated level of gastrin, which may
indicate gastrinoma or Zollinger-Ellison
Causes of Peptic Ulcer?
In normal stomach, a thick layer of mucus that
coats the lining of the stomach prevents the gastric juices from
damaging the stomach. In peptic ulcer, this mucus layer is compromised
and a lesion or crater is formed.
There are two main causes of peptic ulcer:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)
These are the active ingredients of the common painkillers aspirin,
ibuprofen, and naproxen.
- H. pylori bacteria
Despite common belief, stress and eating spicy foods do not cause
Forms of Peptic Ulcer
Depending on the location, peptic ulcer is categorized into two
- Gastric ulcer or stomach ulcer
- Duodenal ulcer or ulcer found in the small
Accounting for almost 80% of the cases, it is the most common
form of peptic ulcer.
Who Gets It?
Peptic ulcer is a very common condition – it is estimated
that approximately 4 million people in the United States have
it. This condition is usually found in people above the age of
50 years old. Approximately 350,000 new cases of peptic ulcer
are diagnosed every year.
Prevention of Peptic Ulcer
Prevention of peptic ulcer includes:
- Avoid taking NSAIDs for painkillers.
Instead, use alternatives such as acetaminophen,
which does not irritate the stomach lining. If you are taking
aspirin every day, consider instead:
- Taking baby aspirin
- Taking it with meals instead on an empty stomach
- Taking the enteric-coated form, which dissolves in the
small intestine and not the stomach
- Avoid taking alcoholic beverages
- Stop smoking
- If you are taking iron or potassium supplement, take enteric-coated
Be sure to consult your doctor before changing your prescription
or how you take the pills.
Treatment for Peptic Ulcer?
Peptic ulcer treatments include:
- Prescription medicines, including:
- Antibiotics, if you are diagnosed with
H. pylori infection.
- Histamine or H2 blockers
This blocks the histamine receptors that signals the stomach
to produce more acid.
- Proton pump inhibitors
This stops the acid production in the stomach.
- Prescription antacids
Some forms of prescription antacids can also coat the stomach
and promote healing of the peptic ulcer.
In very rare cases, a surgery is required to remove the ulcer
or to tie off an artery that cause bleeding ulcer. If H2 blockers
or proton pump inhibitors do not work, your doctor may order
a surgery to cut or even remove a nerve at the base of the stomach
that stimulates the production of digestive juices.