Peptic Ulcer Disease

Peptic Ulcer Disease

What is peptic ulcer disease?

Peptic ulcer disease is a common medical problem in the United States. Ulcers form in the lining of the esophagus, stomach and/or the small intestine.

What causes peptic ulcers to form?

The two most common causes of peptic ulcers are arthritis-type medications known as nonsteroidal anti-inflammatory drugs (NSAIDS) and a bacteria that can be present in the lining of the stomach known as Helicobacter pylori (H. pylori). Examples of medications that can cause ulcers include aspirin, ibuprofen, Motrin, Advil and Aleve. Some of these medications are also contained in over-the-counter remedies for colds or combination narcotic prescriptions. Therefore, it is important to review medication labels. Other factors that can contribute to ulcers are smoking, alcohol and spicy food intake.

What are the symptoms and possible complications of peptic ulcer disease?

Ulcers may cause a burning pain in the middle portion of the upper abdomen. This usually occurs about one hour or more after eating and can last from a few minutes to several hours. Less common symptoms of peptic ulcer disease are nausea, vomiting, decreased appetite, or becoming full quickly while eating. A serious complication of peptic ulcer disease is bleeding.  Bleeding can cause vomiting of red blood clots or black material that resembles coffee grounds, or passage of black, tarry stools. Another complication is a perforation or hole in the stomach or small intestine. This would generally cause severe abdominal pain and a potentially life-threatening infection.

How is a peptic ulcer diagnosed?

A peptic ulcer may be suspected based on a patient’s symptoms and physical examination. Blood, breath and stool tests can be done to check for the Helicobacter pylori bacteria. If the test is positive, a patient may be treated with antibiotics to clear the infection. More direct studies to evaluate for a peptic ulcer are an upper GI endoscopy or upper GI x-ray (a patient drinks white, chalky liquid while x-ray pictures are taken). With an upper endoscopy, biopsies of the ulcer can be done. The tissue can be tested for H. pylori.

What is the treatment of peptic ulcer disease?

If Helicobacter pylori infection is diagnosed it can be treated with antibiotics for about 2 weeks. Treatment of ulcers related to arthritis-type medications includes stopping the offending medication if possible and starting medications that significantly decrease the acid levels in the stomach.

How can peptic ulcer disease be prevented?

Reducing or eliminating the use of nonsteroidal anti-inflammatory drugs is one way that peptic ulcers can be prevented. If a patient has to take one of these medications, the physician may advise the patient to stay on an acid-lowering medication to protect the stomach. The source of Helicobacter pylori infection is not certain but it appears to be spread from person to person. Adequate hygiene may be useful in preventing transmission of the bacteria.

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