Search Encyclopedia:    
List of Topics Print This Page
 

Peptic ulcer


Alternative Names:

Ulcer - peptic; Ulcer - duodenal; Ulcer - gastric; Duodenal ulcer; Gastric ulcer; Dyspepsia - ulcers

Symptoms:

Small ulcers may not cause any symptoms. Some ulcers can cause serious bleeding.

Abdominal pain is a common symptom. The pain can differ from person to person, and some people have no pain.

Other symptoms include:

  • Feeling of fullness and problems drinking as much fluid as usual
  • Hunger and an empty feeling in the stomach, often 1 - 3 hours after a meal
  • Mild nausea that may go away with vomiting
  • Pain or discomfort in the upper abdomen
  • Pain in the upper abdomen that wakes you up at night

Other possible symptoms include:

Treatment:

In order for your ulcer to heal and to reduce the chance it will come back, you will be given medicines to:

  • Kill the H. pylori bacteria (if present)
  • Reduce acid levels in the stomach

Take all of your medicines as your doctor recommends. Other changes in your lifestyle can also help.

If you have a peptic ulcer with an H. pylori infection, the standard treatment uses different combinations of the following medications for 7- 14 days:

  • Two different antibiotics to kill H. pylori
  • Proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium)
  • Bismuth (the main ingredient in Pepto-Bismol) may be added to help kill the bacteria

If you have an ulcer without an H. pylori infection, or one that is caused by taking aspirin or NSAIDs, your doctor will likely prescribe a proton pump inhibitor for 8 weeks.

You may also be prescribed this type of medicine if you must continue taking aspirin or NSAIDs for other health conditions.

Other medicines used for ulcers are:

  • Misoprostol, a drug that may help prevent ulcers in people who take NSAIDs on a regular basis
  • Medicines that protect the tissue lining (such as sucralfate)

If a peptic ulcer bleeds a lot, an EGD may be needed to stop the bleeding. Methods used to stop the bleeding include:

  • Injecting medicine in the ulcer
  • Applying metal clips to the ulcer

Surgery may be needed if:

  • Bleeding cannot be stopped with an EGD
  • The ulcer has caused a tear
Outlook (Prognosis):

Peptic ulcers tend to come back if untreated. There is a good chance that the H. pylori infection will be cured if you take your medicines and follow your doctor’s treatment advice. You will be much less likely to get another ulcer.

Possible Complications:
  • Severe blood loss
  • Scarring from an ulcer may make it harder for the stomach to empty
  • Perforation or hole of the stomach and intestines
When to Contact a Medical Professional:

Get medical help right away if you:

  • Develop sudden, sharp abdominal pain
  • Have a rigid, hard abdomen that is tender to touch
  • Have symptoms of shock, such as fainting, excessive sweating, or confusion
  • Vomit blood or have blood in your stool (especially if it's maroon or dark, tarry black)

Call your doctor if:

  • You feel dizzy or light-headed
  • You have ulcer symptoms
Prevention:

Avoid aspirin, ibuprofen, naproxen, and other NSAIDs. Try acetaminophen instead. If you must take such medicines, talk to your doctor first. Your doctor may:

  • Test you for H. pylori before you take these medicines
  • Have you take proton pump inhibitors (PPIs) or an acid blocker
  • Have you take a drug called misoprostol

The following lifestyle changes may help prevent peptic ulcers:

  • Do not smoke or chew tobacco.
  • Limit alcohol to no more than two drinks per day.
References:

Kuipers EJ, Blaser MJ. Acid peptic disease. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 141.

Chan FKL, Lau JYW. Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 53.

Chey WD, Wong BC. American College of Gastroenterology guideline on the management of Helicobacter pylori infection. Am J Gastroenterol. 2007;102:1808-1825.

Lanza FL, Chan FK, Quigley EM; Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol. 2009;104:728-738.

McColl KEL. Helicobacter pylori infection. NEJM. 2010;362:1597-1604.


Review Date: 7/18/2013
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

   View History
  Peptic ulcer

   
   

 

About UPHS   Contact Us   Site Map   Privacy Statement   Legal Disclaimer   Terms of Use

The University of Pennsylvania Health System, Philadelphia, PA 1-800-789-PENN © 2014, The Trustees of the University of Pennsylvania