What is Peptic Ulcer Disease?

Peptic ulcer disease refers to painful sores in the stomach lining or the duodenum, which is the first portion of the small intestine. A dense layer of mucus typically covers the stomach lining. Ulcers occur when this mucosal layer is impaired and degraded.

What Causes Peptic Ulcer Disease?

Peptic ulcers are typically caused by a fluid imbalance in the stomach and small intestine. The bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) and naproxen sodium (Aleve) are the most common causes of peptic ulcers. Some risk factors include excessive alcohol consumption and smoking. Contrary to popular belief, stress and spicy foods do not cause ulcers, but they can exacerbate symptoms.

What are the Symptoms of Peptic Ulcer Disease?

It is important to note that many people with peptic ulcers may not experience symptoms. For those that do, burning stomach pain is the most common peptic ulcer symptom. The discomfort is made worse by stomach acid, especially on an empty stomach. Some other common peptic ulcer symptoms include:

  • Feeling of fullness, bloating, or belching

  • Intolerance to fatty foods

  • Heartburn

  • Nausea

Less common signs or symptoms that may indicate severe ulcer damage include:

  • Reddish or black vomit indicating the presence of blood

  • Black or tarry stools indicating the presence of blood

  • Trouble breathing

  • Feeling faint

  • Unexplained, rapid weight loss

  • Drastic appetite changes

If you are experiencing common symptoms, schedule an appointment with your primary care physician. If you are experiencing severe symptoms, seek immediate medical attention. 

How is Peptic Ulcer Disease Diagnosed?

After a typical physical exam and a thorough discussion about your medical history, your physician may recommend several diagnostic tests such as: 

  • Helicobacter pylori (or H. pylori) test. Determining the presence of H. pylori is often done via the breath test; the patient consumes a special liquid that, when broken down in the stomach, may produce excess carbon dioxide if H. pylori bacteria are present. The patient will blow into a bag both before and after consuming the liquid, and then carbon levels are compared to determine the presence of H. pylori. Other exams include examining blood or stool samples; however, the breath test yields the most accurate results. 

  • Endoscopy. Using the endoscope, your doctor will look for the presence of ulcers. If an ulcer is detected, a small tissue sample may be taken for analysis.

  • Upper gastrointestinal series. This diagnostic method involves swallowing a liquid that will coat your digestive tract and appear white on X-ray scans. A series of X-rays are then taken, and the presence of an ulcer should be visible. 

How is Peptic Ulcer Disease Treated?

Treatment for peptic ulcers varies depending on the cause. If H. pylori bacteria are present, eliminating the bacteria through an antibiotic regimen is the primary treatment course. If consumption of certain medications is the cause, then reducing or stopping the use of said medications is the main course of treatment, given that doing so can be done safely. Once the underlying cause is treated, attention will turn toward healing the ulcer, which involves lifestyle and diet changes as well as an antacid regimen to reduce stomach acid production.

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