What is peptic ulcers?

Peptic Ulcers

Peptic ulcers: Overview

Peptic ulcers are sores on the inside of the stomach. Or they may be on the inside of the small intestine (such as a duodenal ulcer). They are most often caused by an infection with Helicobacter pylori (H. pylori) bacteria or use of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include aspirin, ibuprofen (Advil or Motrin), and naproxen (Aleve).

Your doctor may have prescribed medicine to reduce stomach acid. You also may need to take antibiotics if your peptic ulcers are caused by an infection. You can help yourself heal and help keep ulcers from coming back. You can do this by making some changes in your lifestyle. Avoid smoking and alcohol. Ask your doctor if you need help quitting or cutting back.

Peptic ulcer (stomach ulcer)

A peptic ulcer is a sore in the lining of your stomach or upper small intestine. Ulcers form when the protective layer in the lining has broken down, often because of an infection with Helicobacter pylori (H. pylori) bacteria or use of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include aspirin, ibuprofen (Advil or Motrin), and naproxen (Aleve).

Peptic ulcers can cause pain in the belly, above the belly button. Ulcers can also bleed.

What happens when you have peptic ulcers?

The symptoms of peptic ulcers, such as belly pain, may come and go. Some ulcers will heal by themselves. But even with treatment, ulcers sometimes come back. They may cause problems like bleeding or perforation. That's why it's important to treat an ulcer, even if you don't have any symptoms.

What are the symptoms of a peptic ulcer?

Symptoms of a peptic ulcer can include a burning, aching, or gnawing pain between the belly button and the breastbone, and belly pain that is temporarily relieved by taking an antacid. Symptoms can also include back pain, loss of appetite, bloating, nausea, and vomiting. Some people have no symptoms.

How are peptic ulcers treated?

To treat peptic ulcers, most people take medicines that reduce acid in the stomach. If you have an H. pylori infection, you'll also take antibiotics. You can help your ulcer heal by quitting smoking and avoiding alcohol. Using medicines such as aspirin, ibuprofen, or naproxen may increase the chance of your ulcer returning.

How are peptic ulcers diagnosed?

Your doctor will ask you questions about your symptoms and your general health. The doctor will do a physical exam.

Your doctor may test you for an H. pylori infection. This is done using your breath, blood, or stool.

The only way for you and your doctor to know for sure if you have an ulcer is to do an endoscopy. An endoscopy allows the doctor to look inside your esophagus, stomach, and small intestine. It's done to look for an ulcer and to test for an H. pylori infection.

You may get other tests to find problems that are caused by peptic ulcers. Tests may include blood tests or X-rays.

How are medicines used to treat peptic ulcers?

Peptic ulcers are treated with medicines. You can get some of these medicines over the counter. Medicines can do different things. They can:

Reduce stomach acid.
Medicines that reduce the amount of stomach acid include:
  • Antacids, such as Tums.
  • Acid reducers, such as:
    • H2 blockers like famotidine (Pepcid).
    • Proton pump inhibitors (PPI) like omeprazole (Prilosec).
Treat an H. pylori infection.
If you have an H. pylori infection, you usually get antibiotics and a PPI. Sometimes you will also get a bismuth medicine.
Protect the stomach lining.
If your ulcer is from use of aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs), you usually get medicines that protect the stomach lining from damage. These include:
  • Acid reducers, such as H2 blockers like cimetidine (Tagamet).
  • PPIs like omeprazole (Prilosec).

How can you care for yourself when you have a peptic ulcer?

Take your medicines as directed. Don't take aspirin or other NSAIDs such as ibuprofen or naproxen. If you smoke, try to quit. Smoking can make ulcers worse. To help improve symptoms, eat smaller, more frequent meals. Avoid alcohol. Alcohol may make an ulcer heal more slowly and make your symptoms worse.

What increases your risk for peptic ulcers?

Doing the following things can increase your chance of getting a peptic ulcer. They may also slow the healing of an ulcer you already have.

  • Taking nonsteroidal anti-inflammatory drugs (NSAIDs). These include aspirin, ibuprofen (Advil or Motrin), and naproxen (Aleve).
  • Smoking.
  • Drinking too much alcohol.

Some things that you can't control may increase your risk of getting an ulcer.

  • A Helicobacter pylori (H. pylori) bacterial infection. This is the most common cause of ulcers.
  • Physical stress caused by a serious illness or injury. Examples are a major trauma, surgery, or the need to be on a ventilator to assist breathing.
  • Hypersecretory condition. With this, your stomach produces too much acid.
  • A personal or family history of ulcers.

What problems can be caused by peptic ulcers?

A peptic ulcer may cause problems such as:


Peptic ulcers sometimes bleed.

  • Sometimes an ulcer may involve just the surface lining of the digestive tract. The person may then have a slow but constant loss of blood into the digestive tract. Over time, this may cause anemia.
  • If ulcers become larger and go deeper into the digestive tract lining, they may damage large blood vessels. This can result in sudden, serious bleeding into the intestinal tract.

Perforation occurs when an ulcer eats through the wall of the stomach or intestine into the belly cavity.

  • When perforation happens, partly digested food, bacteria, and enzymes from the digestive tract may spill into the belly cavity. This causes inflammation and infection (peritonitis).
  • Peritonitis usually causes sudden and severe pain. In most cases, treatment requires an urgent stay in the hospital and surgery.

What causes peptic ulcers?

The most common causes of peptic ulcers are infection with Helicobacter pylori (H. pylori) bacteria and use of nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs include aspirin, ibuprofen (Advil or Motrin), and naproxen (Aleve). H. pylori and NSAIDs break down the protective mucus layer in the stomach or intestine.

What is a peptic ulcer?

A peptic ulcer is a sore in the inner lining of the stomach or upper small intestine. Ulcers form when the protective layer of the intestine or stomach is broken down. When this happens, digestive juices—which contain hydrochloric acid and an enzyme called pepsin—can damage the intestine or stomach tissue.

Peptic ulcer disease: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have symptoms of a heart attack. These may include:
    • Chest pain or pressure, or a strange feeling in the chest.
    • Sweating.
    • Shortness of breath.
    • Nausea or vomiting.
    • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly or in one or both shoulders or arms.
    • Lightheadedness or sudden weakness.
    • A fast or irregular heartbeat.
  • You have sudden, severe, continuous belly pain or vomiting.
  • You vomit bright red blood or what looks like coffee grounds.
  • You pass maroon or very bloody stools.

Call your doctor now or seek immediate medical care if:

  • You have new or worse belly pain.
  • Your stools are black and look like tar, or they have streaks of blood.
  • You vomit.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

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