An overview of Peptic Ulcer

Peptic ulcers are sores that develop in the lining of the stomach, lower esophagus, or small intestine. They’re usually formed as a result of inflammation caused by the bacteria H. pylori, as well as from erosion from stomach acids. Peptic ulcers are a fairly common health problem.

There are five types of Crohn’s disease. Each affects a different part of the GI tract:

gastric ulcers : ulcers that develop inside the stomach

esophageal ulcers : ulcers that develop inside the esophagus

duodenal ulcers : ulcers that develop in the upper section of the small intestines, called the duodenum

Peptic ulcers occur when acid in the digestive tract eats away at the inner surface of the stomach or small intestine. The acid can create a painful open sore that may bleed.

Your digestive tract is coated with a mucous layer that normally protects against acid. But if the amount of acid is increased or the amount of mucus is decreased, you could develop an ulcer.

Common causes include:

A bacterium : Helicobacter pylori bacteria commonly live in the mucous layer that covers and protects tissues that line the stomach and small intestine. Often, the H. pylori bacterium causes no problems, but it can cause inflammation of the stomach's inner layer, producing an ulcer. It's not clear how H. pylori infection spreads. It may be transmitted from person to person by close contact, such as kissing. People may also contract H. pylori through food and water.

Regular use of certain pain relievers : Taking aspirin, as well as certain over-the-counter and prescription pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs) , can irritate or inflame the lining of your stomach and small intestine. These medications include ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve, Anaprox DS, others), ketoprofen and others. They do not include acetaminophen (Tylenol, others).

Other medications : Taking certain other medications along with NSAIDs, such as steroids, anticoagulants, low-dose aspirin, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax) and risedronate (Actonel), can greatly increase the chance of developing ulcers.

You’ll most likely feel a burning pain or discomfort between your belly button and breastbone. You might especially notice it on an empty stomach -- such as between meals or at night. The pain may stop for a little while if you eat or take an antacid, but then return. The pain can last for a few minutes or a few hours, and may come and go for many days or weeks.

Other symptoms may include:

Bloated feeling

Burping

Lack of appetite or weight loss

Nausea

Bloody or dark poop

Vomiting

You may be able to prevent Peptic Ulcers from forming if you:

Talk to your doctor about alternatives to NSAID medications (like acetaminophen) to relieve pain.

Discuss protective measures with your doctor, if you can’t stop taking an NSAID.

Opt for the lowest effective dose of NSAID and take it with a meal.

Quit smoking.

Drink alcohol in moderation, if at all.

Your doctor will ask about your symptoms, whether you take NSAIDs and other drugs, and medical history. They’ll also check you for bloating in the belly and pain. That may be enough to make a diagnosis.

The only way your doctor can tell for sure if you have an ulcer is to look. They may use a series of X-rays or a test called an endoscopy. This test allows them to pass a thin, bendy tube down your throat and into your stomach and small intestine. The tube has a camera at the end so they can check the lining for ulcers. They may also take a small piece of the lining to test for H. pylori. Blood, breath, and stool sample tests also can screen for the bacteria.

Treatment will depend on the underlying cause of your ulcer. If tests show that you have an H. pylori infection, your doctor will prescribe a combination of medication. You’ll have to take the medications for up to two weeks. The medications include antibiotics to help kill infections and proton pump inhibitors(PPIs) to help reduce stomach acid.

You may experience minor side effects like diarrhea or an upset stomach from antibiotic regimens. If these side effects cause significant discomfort or don’t get better over time, talk to your doctor.

If your doctor determines that you don’t have an H. pylori infection, they may recommend a prescription or over-the-counter PPI (such as Prilosec or Prevacid) for up to eight weeks to reduce stomach acid and help your ulcer heal.

Acid blockers like famotidine (Pepcid) can also reduce stomach acid and ulcer pain. These medications are available as a prescription and also over the counter in lower doses.

Your doctor may also prescribe sucralfate (Carafate) which will coat your stomach and reduce symptoms of peptic ulcers.

If Left untreated, peptic ulcers can result in:

Gastric cancer : Studies have shown that people infected with H. pylori have an increased risk of gastric cancer.

Obstruction : Peptic ulcers can block passage of food through the digestive tract, causing you to become full easily, to vomit and to lose weight either through swelling from inflammation or through scarring.

A hole (perforation) in your stomach wall : Peptic ulcers can eat a hole through (perforate) the wall of your stomach or small intestine, putting you at risk of serious infection of your abdominal cavity (peritonitis).

Internal bleeding : Bleeding can occur as slow blood loss that leads to anemia or as severe blood loss that may require hospitalization or a blood transfusion. Severe blood loss may cause black or bloody vomit or black or bloody stools