Peptic Ulcer

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 at night
Nausea
Vomiting
The vomit may look like mucous, blood or coffee grounds (where the blood is mixed with stomach acid and becomes coagulated or clotted).
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.
Endoscopy
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 cancer.
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 syndrome.

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 peptic ulcer.

Forms of Peptic Ulcer

Depending on the location, peptic ulcer is categorized into two forms:

Gastric ulcer or stomach ulcer
Duodenal ulcer or ulcer found in the small intestines
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 forms.

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.
Surgery
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.