ULCER, PEPTIC

(Duodenal Ulcer; Gastric Ulcer)

 Basic information

description

A peptic ulcer is an erosion (sore area) in the lining of the gastrointestinal tract. Ulcers that form in the upper part of the small intestine are duodenal ulcers. They are the most common type. Ulcers that form in the stomach are called gastric ulcers. They are less common. Ulcers can affect all ages.

FREQUENT SIGNS & SYMPTOMS

• Pain in the upper abdomen or, sometimes, the lower chest. It may be a burning, boring, or gnawing feeling that lasts 30 minutes to 3 hours. It may be worse before or after eating. It often awakens a person during the night. The pain may come and go. Weeks of off-and-on pain may alternate with short, pain-free periods.
• Pain is temporarily relieved with use of antacids.
• Appetite loss and weight loss. With duodenal, it may be weight gain, as person eats more to ease discomfort.
• Vomiting (may contain bright red blood or digested blood, which looks like coffee grounds).
• Blood in the stool.

causes

• Almost all ulcers are caused by either an infection with Helicobacter pylori bacteria or the use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs). Helicobacter pylori bacteria is present in many healthy people. Why it causes ulcers in some is unknown.
• Ulcers are not caused by stress, or anxiety, or eating spicy foods, but they may aggravate existing ulcers.

risk increases with

• Use of nonsteroidal anti-inflammatory drugs (e.g., aspirin).
• Helicobacter pylori infection.
• Family history of ulcers.
• Elderly.
• Smoking.
• Excess alcohol use (possibly).
• Type-O blood (for duodenal ulcers).

PREVENTIVE MEASURES

Avoid as many risk factors as possible.

expected outcomes

With treatment, gastric ulcers heal in about 8 weeks and duodenal ulcers in about 4 weeks. Ulcers can recur.

possible complications

• Perforation. This is an erosion of the ulcer through the stomach or intestinal wall. It can cause infection or bleeding into the abdomen. Surgery may be required.
• Internal bleeding (which can cause anemia).
• Duodenal ulcers are almost always benign, while gastric ulcers may rarely become malignant.
• Intestinal obstruction.

 diagnosis & treatment

general measures

• Your health care provider will do a physical exam and ask about your symptoms and activities. Medical tests may include blood and stool studies, gastrointestinal tract studies, and tests for Helicobacter pylori.
• Treatment is with drugs and, sometimes, lifestyle changes.
• Discontinue the use of NSAIDs. If unable to do so, other drugs may be prescribed to prevent side effects.
• Quit smoking. Find a way to stop that works for you.
• If you drink alcohol heavily, stop or cut down.
• If stress is a problem, learn ways to help you cope.
• Hospital care may be needed for complications such as bleeding ulcer or severe perforation or obstruction.
• Surgery for some patients for complications or if drug treatment is not effective.
• To learn more: National Digestive Diseases Information Clearinghouse, 2 Information Way, Bethesda, MD 20892; (800) 891-5389; website: www.digestive.niddk.nih.gov.

medications

• Your health care provider may prescribe:
  • Antibiotics to treat the Helicobacter pylori infection.
  • Antacids to help neutralize excess stomach acid.
  • Proton pump inhibitors or H-2 blockers to reduce stomach acid. Long-term therapy may be required for some patients.
  • Drugs to coat and protect the lining of the stomach and the small intestine.

activity

No limits.

diet

Eat several small, healthy meals at regular times each day. Avoid foods that bring on pain.

 notify our office if

• You or a family member has symptoms of an ulcer.
• Vomiting occurs that is bloody or looks like coffee grounds, or stool is bloody, black, or tarry-looking.
• You feel weak, tired or have pale skin or back pain.

Special Notes: