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What is a peptic ulcer?

Most often caused by bacteria, these sores in the digestive tract can be the source of pain and bleeding.

A peptic ulcer is a sore that develops when stomach acid penetrates the lining of the stomach or upper part of the small intestine. The ulcer may cause pain and bleeding.

A peptic ulcer can be treated with medication and lifestyle changes. Untreated, the ulcer can eat a hole in the stomach lining, requiring surgery.

If you think you have an ulcer, call your doctor as soon as possible.

Causes

According to the American Gastroenterological Association (AGA), most peptic ulcers are caused by:

  • Infection from Helicobacter pylori bacteria. It's not known exactly how the bacteria are transmitted, but scientists suspect H. pylori spreads from person to person.
  • Pain medications called nonsteroidal anti-inflammatory drugs (NSAIDs). These include aspirin and ibuprofen. People take these drugs to reduce pain and inflammation, often for arthritis.

Spicy food and stress are not the cause of most peptic ulcers, says the AGA.

Symptoms

The most common symptom of an ulcer is a burning pain in the stomach, between your breastbone and navel. You'll often feel the pain between meals, when your stomach is empty. The pain can last from a few minutes to several hours.

Other symptoms may include:

  • Feeling sick to your stomach.
  • Vomiting.
  • Bloating.
  • Burping.
  • Blood in the stool.
  • Loss of appetite.

If an ulcer continues to bleed without treatment, a person may become anemic and weak.

Tests for ulcers

Your doctor may order tests to see if you are infected with H. pylori. Tests might be done on a blood sample or you might be given a breath test, which requires you to drink a liquid, wait, and then breathe into a container.

Another test for ulcers is endoscopy. In this test, a doctor puts a small, flexible tube through the mouth and into the stomach. The tube has a camera inside that lets the doctor look for inflammation or ulcers.

The doctor can also take small samples from your stomach lining to be tested for H. pylori. You will usually be sedated for this procedure.

Instead of endoscopy, your doctor might order an upper GI (gastrointestinal) series. You will be given a chalky-tasting liquid to drink, and x-rays will be taken to show the outline of your digestive system.

Treatment

If you have been diagnosed with H. pylori infection, your doctor will provide a treatment plan. The plan will be designed to kill the infection and reduce the acid in your stomach.

If you smoke, you will need to quit smoking. Smoking makes it harder for ulcers to heal. And you should avoid alcoholic beverages.

Your doctor may also recommend that you not take NSAIDs.

You may need surgery if an ulcer fails to heal or you have complications. According to the National Institute of Diabetes and Digestive and Kidney Diseases, you may also need surgery if the ulcer eats through the stomach or intestinal lining, or if it blocks the passage of food.

Prevention

The source of H. pylori infection is not yet known. But it is always wise to:

  • Wash your hands thoroughly.
  • Eat food that has been prepared properly.
  • Drink water from a clean, safe source.

To reduce your risk of ulcers caused by NSAIDs, talk to your doctor about:

  • Trying a different medication.
  • Reducing the amount of medicine you take and how often you take it.

Reviewed 12/7/2020

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