Last Updated: October 19, 2017

Peptic Ulcers

Overview

A peptic ulcer is an open sore that results when sensitive tissue in the digestive tract is exposed to acid. Peptic ulcers are typically found in the stomach (where they are called gastric ulcers) and duodenum (the beginning of the small intestine, where they are called duodenal ulcers), but can also less commonly occur in the esophagus.

The two most common causes of peptic ulcers in the United States are bacterial infection and a specific class of anti-inflammatory drugs, both of which compromise the protective lining of the gastrointestinal tract. In severe cases, peptic ulcers can obstruct the passage of food into the duodenum, or lead to cancer. Half a million Americans develop peptic ulcer disease each year.

Causes and Risk Factors

Cross-section of stomach and duodenum

The main causes of peptic ulcers are the bacterium Helicobacter pylori (H. pylori), and a class of drugs referred to as nonsteroidal anti-inflammatory drugs (NSAIDs). Smoking and alcohol use increase the chances of developing ulcers, especially when combined with the above risk factors. Despite common belief, spicy foods do not cause ulcers; they only worsen the symptoms of existing ulcers.

Symptoms

Abdominal pain is the most common symptom of peptic ulcer disease. The pain may follow meals, last for varying lengths of time, and be reoccurring. Patients also experience nighttime pain that can be managed by eating, or taking antacids. Other symptoms include:

Symptoms that require immediate medical attention are associated with bleeding and they include:

Diagnosis and Treatment

Peptic ulcers are diagnosed based on the symptoms, and in some cases, using invasive techniques that survey the upper gastrointestinal (GI) tract. If the patient is not taking NSAIDs, various techniques are used to test for the presence of H. pylori.

Peptic ulcers are fully treatable by removing their main cause (H. pylori or NSAIDs) and controlling their acidic environment.

Prevention

Peptic ulcers are best prevented by reducing the risk of infection with H. pylori. Frequent handwashing and proper food handling help prevent the spread of harmful bacterial, including H. pylori. If NSAIDs cannot be avoided, then the lowest effective dosage is recommended. Smoking and excessive alcohol consumption are not advisable.

Sources

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Authored by: Tina Shahian, PhD