Peptic ulcerDefinition A peptic ulcer is erosion in the lining of the stomach or duodenum (the first part of the small intestine). The word “peptic” refers to pepsin, a stomach enzyme that breaks down proteins. If a peptic ulcer is located in the stomach it is called a gastric ulcer. Small ulcers may not cause any symptoms. Large ulcers can cause serious bleeding. Most ulcers occur in the first layer of the inner lining. A hole that goes all the way through is called a perforation of the intestinal lining. A perforation is a medical emergency. Causes, incidence, and risk factors Normally, the lining of the stomach and small intestines have protection against the irritating acids produced in your stomach. For a variety of reasons, the protective mechanisms may become faulty, leading to a breakdown of the lining. This results in inflammation (gastritis ) or an ulcer. The most common cause of such damage is infection of the stomach with a bacterium called Helicobacter pylori (H.pylori). Most people with peptic ulcers have this organism living in their gastrointestinal (GI) tract. On the other hand, many people have this organism living in their GI tract but they don't get an ulcer. Other factors can make it more likely for you to get an ulcer, including:
In addition, if you have a family history of ulcers or you are blood type O, you are more likely to get a duodenal ulcer. There is also a rare condition called Zolliger-Ellison syndrome in which a tumor in the pancreas secretes a substance that causes ulcers throughout the stomach and duodenum. Many people believe that stress causes ulcers. It is not clear if this is true. While critically ill patients who are on a breathing machine are at risk of so-called “stress ulceration,” everyday stress at work or home doesn't appear to cause peptic ulcers. Symptoms Abdominal pain is a common symptom but it may not always be present. The abdominal pain from peptic ulcers can differ a lot from person to person. For example, the pain may get better or worse after eating a meal. Other possible symptoms include:
It is important to note that you may have no symptoms at all from an ulcer. Signs and tests To diagnose an ulcer, your doctor will order one of the following tests:
During an EGD, the doctor may take a biopsy from the wall of the intestines to test for H. pylori. Your doctor may also order:
Treatment You should see a doctor if you have symptoms of an ulcer. Treatment often involves a combination of medications to kill the Helicobacter pylori bacteria, reduce acid levels, and protect the GI tract. This combination strategy allows your ulcer to heal and reduces the chance it will come back. Take all of your medications exactly as prescribed. The medications may include one or more of the following:
If a peptic ulcer bleeds a lot, an EGD may be needed to stop the bleeding. If bleeding cannot be stopped using an EGD procedure or the ulcer has caused a perforation, then surgery may be required. Expectations (prognosis) Peptic ulcers tend to come back if untreated. If you follow the treatment instructions from your doctor and take all of your medications, the Helicobacter pylori infection will be eliminated and you are much less likely to get another ulcer. Your symptoms will also improve if you follow some preventive lifestyle steps. Complications
Calling your health care provider Call 911 if you:
Call your doctor if:
Prevention
References Spechler, SJ. Peptic Ulcers. In: Feldman, M, Friedman, LS, Sleisenger, MH, eds. Gastrointestinal and Liver Disease, 7th ed. Philadelphia, PA; WB Saunders Company; 2002:747-772. Noble J. Textbook of Primary Care Medicine. 3rd ed. St. Louis, MO: Mosby; 2001:910-918. Mahachai V, Thomson AB, Vilaichone RK. Effect of Helicobacter pylori infection and NSAIDs on the risk of peptic ulcer bleeding. J Med Assoc Thai. 2004 Sep;87 Suppl 2:S295-9. Review. Illustrations
Page Content: Ulcer - peptic; Ulcer - duodenal or gastric; Duodenal ulcer ; gastric and duodenal ulcer; peptic ulcer; disease peptic ulcer; peptic symptom ulcer; diet peptic ulcer; peptic treatment ulcer; peptic picture ulcer; disease pathophysiology peptic ulcer; cause peptic ulcer; peptic sign symptom ulcer; medication peptic ulcer; bleeding peptic ulcer; diet disease peptic ulcer; disease peptic symptom ulcer; cure peptic ulcer; define peptic ulcer; pathophysiology peptic ulcer; condition more peptic symptom ulcer; definition peptic ulcer; duodenal ulcer; duodenal symptom ulcer; duodenal perforated ulcer; diet duodenal ulcer; duodenal treatment ulcer; duodenal gastric ulcer; duodenal gastro ulcer; bleeding duodenal ulcer; cause duodenal ulcer |