Peptic Ulcers
Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is burning stomach pain.
Types of Peptic Ulcers
- Gastric ulcers – Occur on the inside of the stomach.
- Duodenal ulcers – Occur on the inside of the upper portion of your small intestine (duodenum).
Causes
Peptic ulcers occur when acid in the digestive tract damages the inner surface of the stomach or small intestine. This happens if the protective mucus layer becomes weak or the acid level increases. Common causes include:
- Helicobacter pylori infection: A bacterium that lives in the stomach lining and may cause inflammation and ulcers.
- Long-term use of NSAIDs: Such as ibuprofen, naproxen, and aspirin, which can irritate the stomach lining.
- Other medications: Steroids, anticoagulants, SSRIs, and osteoporosis medicines may increase the risk when combined with NSAIDs.
Note: Stress and spicy foods do not directly cause ulcers, but they can worsen the symptoms.
Symptoms
Many people with ulcers have no symptoms, but common signs include:
- Burning stomach pain (worse on an empty stomach or at night).
- Feeling of fullness, bloating, or belching.
- Heartburn and nausea.
- Intolerance to fatty foods.
Severe symptoms (seek medical help immediately):
- Vomiting blood (red or black).
- Dark, tarry stools.
- Unexplained weight loss.
- Trouble breathing or fainting.
- Persistent nausea and appetite changes.
Risk Factors
- Smoking, especially if infected with H. pylori.
- Excessive alcohol use, which erodes stomach lining.
- Untreated stress and frequent spicy food intake (aggravates symptoms).
- Frequent NSAID use without protective measures.
Complications
If untreated, peptic ulcers can cause serious problems:
- Internal bleeding: May lead to anemia or require urgent treatment.
- Perforation: A hole in the stomach or intestine causing infection (peritonitis).
- Obstruction: Swelling or scarring may block food passage.
- Gastric cancer: Chronic H. pylori infection increases the risk.
Prevention
You may lower your risk of ulcers by:
- Practicing good hygiene (wash hands regularly, eat well-cooked food).
- Using pain relievers cautiously – take the lowest dose, with meals.
- Avoiding alcohol while taking medications.
- Discussing with your doctor about acid-protective medicines if NSAIDs are required.
Diagnosis
Doctors may recommend one or more of the following tests:
- Tests for H. pylori: Blood, stool, or breath test to confirm infection.
- Endoscopy: A scope is used to examine the stomach and intestine. Biopsy may be taken.
- Upper GI series: X-ray with barium swallow to highlight ulcers.
Treatment
Treatment depends on the cause of the ulcer. Common options include:
- Antibiotics: To kill H. pylori infection.
- Proton pump inhibitors (PPIs): Reduce stomach acid and promote healing.
- H-2 blockers: Reduce acid production.
- Antacids: Neutralize existing stomach acid and provide quick relief.
- Cytoprotective agents: Protect the stomach lining (e.g., sucralfate, misoprostol).
Follow-up & Refractory Ulcers
Most ulcers heal with treatment, but some may persist due to:
- Antibiotic resistance of H. pylori.
- Continued NSAID use.
- Smoking or other underlying conditions.
In rare cases, surgery may be needed if complications such as severe bleeding or perforation occur.