Peptic ulcer disease

What is peptic ulcer disease?

Peptic ulcer disease is a condition where open sores form on the lining of the stomach or the small intestine. Gastric ulcers occur in the stomach and duodenal ulcers occur in the upper part of the small intestine. Often times these ulcers are present but not symptomatic.

What causes peptic ulcer disease?

The most common cause of peptic ulcer disease is infection from Helicobactor pylori (H. pylori) bacteria. H. pylori commonly lives in the mucous layer that protects the lining of the stomach and small intestine. It can cause the lining to become inflamed and this inflammation can lead to ulcers. 

Often times H. pylori is present and causes no issues. It is unclear how exactly this bacteria spreads. It could be contracted through food or water or transmitted person to person by close contact.

Another cause of peptic ulcer disease is long-term use of aspirin and nonsteroidal anti-inflammatory (NSAIDs) medications such as Advil and Aleve. Taking these pain medications regularly may inflame and irritate the lining of the stomach eventually causing ulcers. 

Who’s at risk?

Peptic ulcers are most common in older adults who take NSAIDs frequently.

Taking certain medications along with NSAIDs can also greatly increase your risk of developing peptic ulcer disease. These medications include steroids, selective serotonin reuptake inhibitors, alendronate, and risedronate. 

Other factors that increase your risk of developing symptomatic peptic ulcers

• Drinking alcohol
• Being stressed
• Smoking
• Eating spicy foods

Symptoms

The most common symptom of peptic ulcer disease is a burning stomach pain, although nearly three quarters of those with the condition experience no symptoms. The pain can vary from person to person. It is often felt on an empty stomach, one to three hours after a meal, and at night. Pain may wake you from your sleep.

Additional symptoms include

• A full, bloated sensation
• Belching/burping
• Heartburn
• Nausea

Serious side effects of peptic ulcer disease may include

• Vomiting
• Dark blood in the stools or stools that appear black
• Feeling faint/fatigue
• Trouble breathing
• Appetite changes
• Weight loss

You should see a doctor if you are experiencing symptoms of peptic ulcer disease. If left untreated, peptic ulcers tend to return. Complications from severe peptic ulcers can be serious.

Diagnosis

If you are experiencing symptoms of peptic ulcer disease your doctor may perform one or more of the following tests.

• Tests for H. pylori- By either a breath, stool, or blood test your doctor can determine if the H. pylori bacteria is present in your digestive tract. A breath test is the most accurate method, and blood tests tend to be the least accurate. 
• Endoscopy- A small flexible tube with a camera can be inserted into your stomach and small intestine. A biopsy can also be done during this exam—where a cell sample is taken for testing. Your doctor may take a biopsy if they detect an ulcer. A biopsy can test for many things including H. pylori. An endoscopy will typically be recommended if you have signs/symptoms of bleeding in the GI tract.
• X-ray- Your doctor may recommend a series of x-rays. Before the x-rays you will be asked to swallow a liquid containing barium in order to make ulcers more visible. 

Treatment

Medications

A number of medications can treat the causes of peptic ulcers and promote healing. What your doctor prescribes will depend on the cause of your ulcers. 

If H. pylori is found in your digestive tract, your doctor will most likely prescribe an antibiotic to kill the bacteria. An antibiotic will often be prescribed in combination with a medication that reduces stomach acid. 

Many over-the-counter medications either block the production of stomach acid or reduce the amount of stomach acid released into your digestive tract. These medications promote the healing of stomach ulcers, some include Prilosec, Nexium, and Zantac. Antacids, such as Tums, can provide immediate pain relief but aren’t typically used to heal your ulcer. 

If your ulcer is due to frequent use of NSAIDs you should work with your doctor in order to reduce or eliminate your use of them. Medication that helps protect your stomach and small intestine lining may also be prescribed to promote healing.

Lifestyle

Avoid the risk factors for developing peptic ulcers. Limit alcohol, refrain from smoking, and control stress. Avoiding spicy foods may also help prevent symptoms. Eating a healthy diet full of fruits, vegetables, and whole grains will make it easier for your body to heal an ulcer.