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Peptic Ulcers Overview
In the digestive system, an ulcer is an area where tissue has been destroyed by gastric juices and stomach acid. Peptic ulcer disease is a general term for ulcers that occur in the stomach or duodenum (upper part of the small intestine).
- A peptic ulcer is an erosion or sore in the wall of the gastrointestinal tract.
- The mucous membrane lining the digestive tract erodes and causes a gradual breakdown of tissue.
- This breakdown causes a gnawing or burning pain in the upper middle part of the belly (abdomen).
- Although most peptic ulcers are small, they can cause a considerable amount of discomfort.
Peptic ulcers are a very common condition in the United States and throughout the world.
- In the United States, about 10% of the population will develop a duodenal ulcer at some point in their lives.
- Peptic ulcer disease affects about 4.6 million people annually.
- The occurrence of peptic ulcer disease is similar in men and women. Approximately 11%-14% of men and 8%-11% of women will develop peptic ulcer disease in their lifetime.
- The mortality rate for peptic ulcer disease is approximately one death per 10,000 cases. The mortality rate due to ulcer hemorrhage is approximately 5%.
Ulcers can occur at any age, although they are rare in children and teenagers.
What Causes Peptic Ulcers?
No single cause has been found for ulcers. However, it is now clear that an ulcer is the end result of an imbalance between digestive fluids in the stomach and duodenum. Most ulcers are caused by an infection with a type of bacteria called Helicobacter pylori (H. pylori).
Factors that can increase your risk for ulcers include:
- Use of painkillers called nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve, Anaprox, Naprosyn, and others), ibuprofen (Motrin, Advil, some types of Midol, and others), and many others available by prescription; even safety-coated aspirin and aspirin in powered form can frequently cause ulcers.
- Excess acid production from gastrinomas, tumors of the acid producing cells of the stomach that increases acid output (seen in Zollinger-Ellison syndrome)
- Excessive drinking of alcohol
- Smoking or chewing tobacco
- Serious illness
- Radiation treatment to the area
Symptoms of Peptic ulcers
Pain is the most common symptom
Burning pain is the most common peptic ulcer symptom. The pain is caused by the ulcer and is aggravated by stomach acid coming in contact with the ulcerated area. The pain typically may:
- Be felt anywhere from your navel up to your breastbone
- Be worse when your stomach is empty
- Flare at night
- Often be temporarily relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication
- Disappear and then return for a few days or weeks
How to Treat a Peptic Ulcers
Treatment will depend on the underlying cause of your ulcer. If tests show that you have an H. pylori infection, your doctor will prescribe a combination of medication, which you will have to take for up to two weeks:
- antibiotics medications that help kill infections
- proton pump inhibitors (PPIs) medications that help reduce stomach acid
You may experience minor side effects like diarrhea or upset stomach from antibiotic regimens. If these side effects cause significant discomfort or do not get better over time, talk to your doctor.
If your doctor determines that you do not have an H. pylori infection, he or she may recommend a prescription or over-the-counter PPI (such as Prilosec or Prevacid) for up to eight weeks to reduce stomach acid and help your ulcer heal.
Acid blockers (like Zantac or Pepcid) can also reduce stomach acid and ulcer pain. These medications are available as a prescription and over the counter (OTC) and, like most OTC drugs, come in lower doses than the prescription drug.