Overview
A peptic ulcer is an open sore that develops on the inside lining of the stomach or the upper portion of the small intestine. The most common symptom of a peptic ulcer is stomach pain, and other common symptoms include feeling of fullness, bloating or belching, intolerance to fatty foods, heartburn, and nausea. Peptic ulcers can be caused by infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen sodium. It's important to see a doctor if experiencing severe symptoms or if over-the-counter antacids and acid blockers provide temporary relief but the pain returns.
Understanding the disease
Symptoms
The most common symptom of a peptic ulcer is burning stomach pain. Other symptoms include feeling of fullness, bloating or belching, intolerance to fatty foods, heartburn, and nausea. In some cases, peptic ulcers may cause severe signs or symptoms such as vomiting or vomiting blood, dark blood in stools, trouble breathing, feeling faint, nausea or vomiting, unexplained weight loss, or appetite changes. If you experience any of these severe symptoms or if over-the-counter antacids and acid blockers relieve your pain but the pain returns, you should see a doctor.
Risk Factors
The main risk factors for developing peptic ulcers include infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen sodium. Other risk factors include smoking, drinking alcohol, having untreated stress, and eating spicy foods. These factors do not directly cause ulcers, but they can make ulcers worse and more difficult to heal.
Development
Peptic ulcers can develop in two main locations: the stomach (gastric ulcer) and the upper portion of the small intestine (duodenal ulcer). The most common causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen sodium. These factors cause increased acid in the digestive tract, which can lead to the formation of ulcers. Stress and spicy foods do not directly cause peptic ulcers, but they can exacerbate symptoms.
Assessment and Diagnosis
Triage
You should see a doctor if you have severe signs or symptoms of peptic ulcers, such as vomiting or vomiting blood, dark blood in stools, or stools that are black or tarry. Additionally, you should consult a doctor if over-the-counter antacids and acid blockers relieve your pain but the pain returns.
Diagnosis
To diagnose a peptic ulcer, your doctor may take your medical history and perform a physical exam. Diagnostic tests that may be recommended include laboratory tests for H. pylori infection, such as a blood, stool, or breath test. The breath test is considered the most accurate. If an ulcer is detected, a small tissue sample (biopsy) may be removed for examination in a lab. Depending on the symptoms and severity, your doctor may also perform an endoscopy to examine your upper digestive system. If taking an antacid, make sure to inform your doctor as it may lead to false-negative results.
Management and Treatment
Complications
Potential complications of peptic ulcers include internal bleeding, a hole (perforation) in the stomach wall, obstruction, and gastric cancer. If left untreated, peptic ulcers can cause slow or severe blood loss, leading to anemia or requiring hospitalization and blood transfusion. Severe bleeding may present with black or bloody vomit or stools. Other complications include obstruction of the digestive tract, leading to difficulty in passing food, and an increased risk of gastric cancer in people infected with H. pylori.
Prevention
Peptic ulcers can be prevented by following certain strategies and precautions. Some of these include:
- Protecting yourself from infections: As mentioned, H. pylori infection is a major cause of peptic ulcers. To reduce your risk, frequently wash your hands with soap and water, and consume cooked foods to avoid infections through contaminated food or water.
- Using caution with pain relievers: If you are taking pain relievers that increase your risk of peptic ulcers, talk to your doctor about the safest way to use them. Take your medication with meals and work with your doctor to find the lowest dose possible that still provides pain relief. Avoid drinking alcohol when taking these medications, as it can increase your risk of stomach problems.
- Maintaining a healthy lifestyle: Avoid smoking, drinking alcohol, and consuming spicy foods, as these can aggravate peptic ulcers and make them more difficult to heal. While these measures can help reduce the risk of peptic ulcers, it is essential to consult a healthcare professional if you experience symptoms such as stomach pain, bloating, or difficulty swallowing. Prompt diagnosis and treatment are crucial to prevent complications.
Home Remedies
There are no specific home remedies for peptic ulcers that have been scientifically proven to be effective. However, some general home care tips can help alleviate the discomfort and symptoms associated with peptic ulcers. These include:
- Eating smaller meals: Consuming smaller, more frequent meals throughout the day can help reduce the pressure on your stomach and ease symptoms such as bloating and fullness.
- Avoiding spicy or acidic foods: Limiting your intake of spicy, acidic, or fried foods can help reduce the irritation in your stomach and alleviate heartburn.
- Drinking plenty of water: Staying hydrated can help flush out toxins from your body and reduce symptoms such as bloating and constipation.
- Avoiding caffeine and alcohol: Caffeine and alcohol can aggravate your stomach and make your symptoms worse. Avoid them or consume them in moderation.
- Managing stress: Stress can exacerbate peptic ulcer symptoms. Engage in stress-reducing activities such as meditation, yoga, or deep breathing exercises.
- Getting enough rest: Ensure you are getting adequate sleep and rest to help your body recover and cope with the discomfort of peptic ulcers. It is important to consult a healthcare professional for an accurate diagnosis and appropriate treatment plan for peptic ulcers.
Treatment
Treatment for peptic ulcers depends on the cause. Typically, treatment will involve killing the H. pylori bacterium if present, reducing or eliminating the use of NSAIDs if possible, and helping the ulcer to heal with medication. Medications may include antibiotics to kill H. pylori, proton pump inhibitors to reduce stomach acid, and other medications to promote healing. It is also important to limit or avoid alcohol, control stress, and not smoke. Lifestyle changes, including switching pain relievers and addressing sources of stress, may also provide relief. Consult a healthcare professional for personalized advice and treatment options.
Preparing for medical consultation
To prepare for an appointment for peptic ulcer, you should be aware of any pre-appointment restrictions and ask your doctor if there's anything you need to do in advance, such as restricting your diet. Write down any symptoms you're experiencing, as well as the food you're eating, and include key personal information, such as other medical problems, major stresses, or recent life changes. Make a list of all medications, including over-the-counter medications, vitamins, or supplements that you're taking, especially noting any pain reliever use and the usual dose. Prepare a list of questions to ask your doctor, such as the likely cause of your symptoms, recommended tests, and treatment options. Bring a family member or friend along to help remember the information discussed during the appointment, and prioritize your questions from most to least important.