Peptic ulcers are sores that develop on the inner lining of the stomach and the small intestine. Stomach pain is the most common symptom of a peptic ulcer.

Based on their site of origin, Peptic ulcers are classified into two types:

  • Gastric ulcers which occur on the inner lining of the stomach
  • Duodenal ulcers which occur on the inner lining of the small intestine (duodenum)

Causes of peptic ulcers are

  • Infection with the bacterium Helicobacter pylori (H. Pylori) 
  • Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen. 
  • Excessive use of corticosteroids or certain antidepressants
  • Diseases or conditions like Crohn’s disease, cirrhosis, COPD, Zollinger -Ellison syndrome

Symptoms

Dull aching abdominal pain and/or burning sensation in the stomach are the primary symptoms of Peptic ulcers. 

Pain may occur during the night or when the stomach is empty, and would go away shortly after eating. On the contrary, for some people, eating may aggravate the pain.

Other symptoms include:

  • Feeling stomach full too soon
  • Getting uncomfortable after eating a meal
  • Belching or bloating
  • Nausea and vomiting

Diagnosis

Doctors can diagnose the condition based on the symptoms and by running some tests like:

  • Blood test: Recommended to check for signs of H. Pylori infection 
  • Urea breath test: Recommended to check for H. Pylori infection. In this test, patients are given a capsule containing urea “labeled” with a special carbon atom. The presence of H. Pylori will convert the urea into carbon dioxide. If the breath detects the labeled carbon atoms, the health care professional will confirm an H. Pylori infection in your digestive tract.
  • Stool test: To check for signs of H. Pylori infection
  • Upper gastrointestinal (GI) endoscopy and biopsy: It is done to confirm the diagnosis of a peptic ulcer using an endoscope, which gives a view of the patient’s esophagus, stomach, and duodenum. This procedure also collects samples for biopsy. 
  • Upper GI series procedure: It uses X-ray and barium swallow test. 

Treatment

The treatment of peptic ulcers typically involves a combination of medication and lifestyle changes. It’s important to work with a healthcare provider to determine the best treatment approach for each one’s individual case of peptic ulcer. While some patient’s condition can be improved with medical management, some patients may need surgical treatment to improve the clinical condition.

Dr. Giridhar Reddy
Consultant Gastroenterologist

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