Peptic Ulcer

A peptic ulcer is a sore or lesion that develops in the lining of the esophagus, stomach or duodenum.

Types of Peptic Ulcers

Peptic ulcers are classified according to the location they are found within the body. These include the following:

  • Duodenal – located in the duodenum
  • Esophageal – located in the esophagus
  • Gastric – located in the stomach

Causes of a Peptic Ulcer

It is commonly believed that ulcers form as a result of stress or poor eating habits. It has been found, however, that 90 percent of ulcers are caused by Helicobacter pylori, also known as H. pylori, a bacterium that lives on the lining of the stomach. Other causes of an ulcer may include the following:

  • Smoking
  • Caffeine
  • Alcohol
  • Stress
  • Excessive use of nonsteroidal anti-inflammatory agents, or NSAIDs

Symptoms of a Peptic Ulcer

Ulcers commonly cause a gnawing or burning pain in the abdomen. This usually occurs between meals, when the stomach is empty, but can occur at any time. Episodes may last from a few minutes to a few hours, coming and going for a length of time. Other symptoms of ulcers may include the following:

  • Back pain
  • Changes in appetite
  • Bloating
  • Nausea
  • Weakness
  • Vomiting
  • Bloody stools
  • Weight loss

Some people may experience no symptoms at all. Untreated ulcers can lead to more serious symptoms and complications, including bleeding, perforation and obstruction of the intestinal opening.

Diagnosis of a Peptic Ulcer

After a thorough medical and physical examination, the following diagnostic tests may be performed:

  • Blood test
  • Endoscopy with biopsy
  • Upper gastrointestinal series
  • H. pylori breath, blood or stool test

Treatment of a Peptic Ulcer

After a peptic ulcer has been diagnosed, it can usually be treated quickly and effectively. If the ulcer is a result of an H. pylori infection, it can be treated with antibiotic medication. A combination of treatment methods referred to as triple therapy is often used. This treatment combines two antibiotics to kill the bacteria and either an acid suppressor or a stomach protector over the course of a 2 week treatment period.

Ulcers caused by lifestyle factors can be treated simply by behavior modification.. Quitting smoking, eating a healthy diet, reducing stress and alcohol intake can help treat and prevent ulcers. Discontinuation of NSAIDs can also relieve symptoms. Medications that reduce the amount of acid in the stomach, such as H2 blocker and proton pump inhibitors may also be prescribed. Surgery that either removes or opens up part of the stomach may be needed in some rare cases.

Peptic ulcers that do not respond to treatment may be the result of a complication such as stomach cancer. A biopsy is usually performed on these patients to diagnose a more serious complication. If cancer is the cause of the symptoms, more aggressive treatment methods, such as surgery or chemotherapy may be used.

Prevention of a Peptic Ulcer

Ulcers are a common condition that can usually be treated. To reduce the risk of developing an ulcer, avoid the following:

  • Smoking
  • Excessive alcohol use
  • A diet high in fatty foods
  • NSAIDs

Protecting against an infection of H. pylori is not always possible. H. pylori can be spread from one person to another or by food and water. The frequent washing of hands and eating foods that have been properly cooked can help in preventing an infection with the H. pylori bacteria.

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