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Peptic Ulcers (H. pylori)

Alternative names: Duodenal Ulcer, Gastric Ulcer

What are peptic ulcers?
What are the signs of peptic ulcers?
What causes peptic ulcers?
How does my doctor tell if I have a peptic ulcer?
How are peptic ulcers treated?

What are peptic ulcers?

A peptic ulcer is a sore on the lining of your stomach or duodenum (the beginning of the small intestine). "Peptic" comes from pepsin, a stomach enzyme that breaks down proteins. Peptic ulcers are common: one in ten Americans will suffer from a peptic ulcer at some time.

What are the signs of peptic ulcers?

The most common symptom of a peptic ulcer is a burning pain in the stomach, felt most often between meals. This pain can last from a few minutes to several hours. The pain is often worse at night, and often can be eased by eating or by taking an antacid. Other symptoms may include:

  • Nausea
  • Vomiting
  • Blood in the stool, or stools that are dark and tarry in appearance
  • Loss of appetite
  • Heartburn, indigestion, and belching

What causes peptic ulcers?

Contrary to popular belief, peptic ulcers are not caused by stress, worry, or from eating spicy food, although these can make an ulcer worse.

Helicobacter pylori (H. pylori), a type of bacteria that lives in the digestive tract, is the most common cause of peptic ulcers. This bacteria weakens the protective mucous coating of the stomach, leaving spots of the tender stomach lining exposed to the acids used in digestion.

Longtime use of pain medications such as aspirin and ibuprofen can also cause peptic ulcers, especially among older people. Over time, these products can harm the stomach's protective coating.

The stomach produces more acid in response to stress, so worry and tension can worsen the symptoms of peptic ulcers. Drinking alcohol to excess and using tobacco products can also aggravate a peptic ulcer.

How does my doctor tell if I have a peptic ulcer?

Your doctor may use one or several of these tests to determine if you have a peptic ulcer:

  • A blood test will tell if you have the H. pylori bacteria. Another test for H. pylori requires you to drink a special liquid, and breathe into a testing container an hour later.
  • In an upper gastrointestinal endoscopy, the doctor uses an endoscope - a tiny video camera mounted on a thin, flexible tube with a light at the end - to look inside your esophagus and stomach. The doctor inserts the endoscope through your mouth. You will be given medication to make you relaxed and drowsy during the procedure, which only takes 15-20 minutes.
  • An upper gastrointestinal X-ray (upper GI series) shows the condition of your esophagus and stomach. Before the test, you will drink a chalky material that helps the esophagus and stomach show up on the X-ray.

How are peptic ulcers treated?

If you have been diagnosed with an H. pylori infection, your doctor will prescribe antibiotics to kill the bacteria, and other drugs to reduce stomach acid and protect the stomach lining. You will take these drugs for two weeks.

Other steps may include:

  • Following a special diet for a short time to avoid foods that cause indigestion, and to reduce stomach acid
  • Quitting smoking, if you smoke. Smoking will keep the ulcer from healing.
  • Avoiding aspirin, ibuprofen, and alcoholic beverages

If an ulcer fails to heal, or if it has perforated the stomach lining, you may need surgery to remove or repair the ulcer.

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