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Peptic ulcers are sores that develop in the lining of the stomach, esophagus, and small intestine as a result of erosion from stomach acids. Peptic ulcers are a fairly common health problem, and it is estimated that more than 20 million Americans will experience a peptic ulcer in their lifetime (Cleveland Clinic).
There are three types of peptic ulcers:
Different factors can cause the lining of the stomach, the esophagus, and the small intestine to break down. These include:
The most common symptom of a peptic ulcer is burning abdominal pain that extends from the navel to the chest, which can range from mild to severe. In some cases, the pain may wake you up at night. Small peptic ulcers may not produce any symptoms.
Other common signs of a peptic ulcer include:
Two types of tests are available to diagnose a peptic ulcer. They are called upper endoscopy and upper gastrointestinal (GI), an X-ray examination
In this procedure, your doctor inserts a long tube with a camera down your throat and into your stomach and small intestine in order to examine the area for ulcers. This instrument also allows your doctor to remove a tissue sample for examination.
An upper endoscopy is not performed in all cases. However, this procedure is recommended in people with a higher risk of stomach cancer. This includes people over the age of 45, as well as those who experience:
If you do not have difficulty swallowing and have a low risk of stomach cancer, your doctor may recommend an upper GI test. For this procedure, your doctor will have you drink a thick liquid called barium, and then take an X-ray of your stomach, esophagus, and small intestine. The liquid will make it possible for your doctor to view and treat the ulcer.
Because H. pylori is a cause of peptic ulcers, your doctor will also run a test to check for this infection in your stomach.
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, which you will have to take for up to two weeks:
You may experience minor side effects like diarrhea or upset stomach from antibiotic regimens. If these side effects cause significant discomfort or do not get better over time, talk to your doctor.
If your doctor determines that you do not have an H. pylori infection, he or she 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 Zantac or Pepcid) can also reduce stomach acid and ulcer pain. These medications are available as a prescription and over the counter (OTC) and, like most OTC drugs, come in lower doses than the prescription drug.
Untreated ulcers can become worse over time and lead to other, more serious health complications, such as:
All three complications are medical emergencies that require surgery. Call your doctor if you feel dizzy or if symptoms return. Seek urgent medical attention if you experience the following symptoms:
With proper treatment, most peptic ulcers heal. However, you may not heal if you stop taking your medication early or continue to use tobacco and pain relievers during treatment. Your doctor will schedule a follow-up appointment after your initial treatment to evaluate your recovery.
Some ulcers, called refractory ulcers, do not always heal with treatment. If your ulcer does not heal with the initial treatment, this can indicate:
Your doctor may offer a different method of treatment or run additional tests to rule out stomach cancer and other gastrointestinal diseases.
Certain lifestyle choices and habits can reduce your risk of developing peptic ulcers. These include:
Written by: Valencia Higuera
Published on Aug 15, 2012
Updated on Feb 15, 2013
Medically reviewed by Brenda B. Spriggs, MD, MPH, FACP
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