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A peptic ulcer is a sore or raw area in the lining of the stomach or the upper part of the small intestine (called the duodenum). It’s most often caused by an infection with the bacteria Helicobacter pylori (H. pylori). Another common cause is long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. In rare cases, it can be caused by cancerous and noncancerous tumors.
Symptoms of peptic ulcer disease
Small ulcers may cause no symptoms. A burning pain in the stomach is the most common sign. The pain usually lasts for a few minutes to a few hours and comes and goes for several days or weeks. It usually begins between meals or during the night, and subsides after eating or taking antacids. Other symptoms include:
- a feeling of fullness
- difficulty drinking as much liquid as usual
- hunger and an empty feeling in the stomach soon after eating
- mild nausea
- stomach pain that wakes you up at night
Less common symptoms include:
- poor appetite
- bloody or dark stools
- chest pain
- weight loss
What causes peptic ulcer disease?
Peptic ulcers are most often caused by an infection with the bacteria Helicobacter pylori (H. pylori). Another common cause is long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, and naproxen. In rare cases, it can be caused by cancerous and noncancerous tumors.
How is peptic ulcer disease diagnosed?
Your doctor will discuss your symptoms. Be sure to mention any medicines you take, particularly ones such as aspirin, ibuprofen, and naproxen. He’ll also give you a physical examination. He’ll look for stomach bloating, listen to the sounds within your abdomen with a stethoscope, and tap your stomach to check for pain or tenderness.
He may prescribe medicine right away. Ulcers often feel better within a few weeks of treatment, so tests may be unnecessary.
If medicine doesn’t help, your doctor may do a test called an upper endoscopy. For this procedure, you’ll be put under sedation. The doctor will insert a thin, flexible tube down your throat. A tiny camera on the end of the tube lets the doctor examine the lining of the esophagus, stomach, and duodenum. The doctor may also take a sample of the stomach lining (a biopsy) to test for H. pylori. Blood, breath, and stool sample testing can also be used to check for H. pylori.
Can peptic ulcer disease be prevented or avoided?
Experts used to think that stress and eating too many spicy foods led to ulcers. We now know that’s not the case. (Although if you have an ulcer already, stress and certain foods can aggravate it.) We do know that smoking raises your risk of getting a peptic ulcer. If you smoke, speak to your doctor about how to quit. Alcohol also contributes to ulcers. Men should limit alcohol to 2 drinks a day, and women should drink no more than 1 drink a day.
Long-term use of NSAIDs may damage the lining of the stomach and raise the risk of developing a peptic ulcer. Speak to your doctor about how often you should be taking NSAIDs.
Peptic ulcer disease treatment
Several different types of medicines can help a peptic ulcer. Once your doctor determines what’s causing the ulcer, he can make a decision on the best course of action.
If H. pylori bacteria are causing the ulcer, your doctor will probably try to fight it by what’s called “triple therapy.” This is a combination of 2 antibiotics plus bismuth subsalicylate (such as Pepto-Bismol). H pylori can be stubborn, so be sure to take the entire course of medicine you’ve been prescribed.
Your doctor may also recommend other medicines to neutralize the acid and protect the lining in your stomach. These include:
- Protein pump inhibitors, like esomeprazole (Nexium) or lansoprazole (Prevacid).
- Histamine receptor blockers, like famotidine (Pepcid) or ranitidine (Zantac).
- Protectants, like sucralfate (Carafate).
If using NSAIDs caused your peptic ulcer and there’s no H. pylori infection, you may need to stop or reduce the amount of NSAIDs you take and switch to another type of medicine for pain.
Living with peptic ulcer disease
Most ulcers heal within about 8 weeks. Peptic ulcers can come back, so you have to be careful to reduce your risk of the disease. If you smoke or chew tobacco, ask your doctor about how to quit. Eat a well-balanced diet, avoiding foods that cause discomfort. These can include alcohol, coffee, caffeinated soda, fatty foods, chocolate, and spicy foods. Avoid eating late at night.
Speak to your doctor about alternatives to NSAIDs. And take all medicines with plenty of water.
Questions to ask your doctor
- What caused my ulcer?
- What are the side effects to the medicines I’m taking?
- How long will it take to treat my ulcer?
- How did I get pylori?
- Am I at risk for getting another ulcer?
- What medicines can I take for pain?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.