Peptic Ulcer- Cause,Symptoms, Investigation and Treatment

What are peptic ulcers?

Peptic ulcers disease (PUD) is a break in the inner lining of the stomach, lower esophagus, or small intestine.  They’re usually formed as a result of inflammation in the mucus layer of intestine caused by the bacteria H. pylori, as well as from erosion from gastric acids. Peptic ulcers are a fairly common health problem in India.

Peptic Ulcer

There are three types of peptic ulcers:

  1. Gastric ulcers: ulcers that develop inside the stomach is known as gastric ulcer.
  2. Esophageal ulcers: ulcers that develop inside the esophagus is knows as esophageal ulcer.
  3. Duodenal ulcers: ulcers that develop in the upper part  of the small intestines, called the duodenum.

Causes of peptic ulcers

There are many  factors which may causes the lining of the esophagus, the stomach and the small intestine to break down. These include:

  • Helicobacter pylori (H. pylori) infection-,It is  a type of bacteria that  causes a stomach infection and inflammation.
  • frequent use of some medication like aspirin , ibuprofen , and other anti-inflammatory drugs (risk associated with this behavior increases in women and people over the age of 60 yrs)
  • smoking
  • drinking too much alcohol
  • radiation therapy
  • stomach cancer

Symptoms of peptic ulcers

Abdominal pain:-The most common symptom of a peptic ulcer is burning abdominal pain that extends from the umbilical region to the chest, which can range from mild to severe. In many cases, the pain may wake you up at night. Small peptic ulcers may be asymptomatic  in the early phases.

Other common signs of a peptic ulcer include:

  • loss of appetite
  • nausea and some time vomiting may occur.
  • bloody or dark stools
  • unexplained weight loss
  • indigestion

Tests and Investigation for peptic ulcers

 There are  two types of tests are available to diagnose a peptic ulcer.

  1. upper endoscopy. 
  2. upper gastrointestinal (GI) series.

1.Upper endoscopy

In this procedure, a long tube with a camera is inserted down in throat and into  stomach and small intestine to examine the area for ulcers. In this investigation a small piece of tissue may be taken  for examination.

upper endoscopy is not require for all cases of peptic ulcer. However, endoscopy  is recommended for people with a higher risk of stomach cancer. This includes people over the age of 45 yrs, as well as people who experience

  • anemia
  • weight loss
  • gastrointestinal bleeding
  • difficulty swallowing

2.Barium swallow-

Barium swallow method is used when there is not  difficulty   in swallowing and patient have a low risk of stomach cancer. For this procedure a thick liquid called barium (barium swallow)is allow to drink and then take an X-ray of  stomach, esophagus, and small intestine. The Barium will make it possible for doctor to view and treat the ulcer.

Investigation for H. pylori bacteria infection because this bacteria  causes of peptic ulcers.

Treatment of a peptic ulcer

Treatment will depend on the underlying cause of peptic ulcer. If on investigation an H. pyloriinfection, was found then  doctor will prescribe a combination of medication. The medications include antibiotics like amoxicillin to  kill the bacterial infections and proton pump inhibitors (PPIs) to help reduce stomach acid.

If your doctor determines that you don’t have an H. pyloriinfection, they may recommend a prescription or over-the-counter PPI  for up to eight weeks to reduce stomach acid and help your ulcer heal.

Acid blockers like ranitidine or famotidine can also reduce stomach acid and ulcer pain.

 sucralfate  is drugs used in ulcer which will coat your stomach and reduce symptoms of peptic ulcers.


Complications of a peptic ulcer

Untreated ulcers can lead to many other more serious health complications such as:

  • Perforation:  development of a hole in the lining of the stomach or small intestine and causes an infection. A sign of a perforated peptic ulcer is sudden, severe abdominal pain.
  • Internal bleeding: Bleeding ulcers causes significant blood loss and thus require hospitalization. Signs of a bleeding ulcer include lightheadedness, dizziness, and black colour of stools.
  • Scar tissue: It is a type thick tissue that develops after an injury. Scar  tissue makes it difficult for food to pass through your digestive tract. Signs of scar tissue include vomiting and weight loss.

All  complications are serious and may require surgery.

urgent medical attention is required if you experience the following symptoms

  • sudden, sharp abdominal pain
  • excessive sweating, fainting,  or confusion, as these are the signs of shock
  • presence of blood in vomit or stool
  • hard  and tender abdomen .
  • abdominal pain that worsens with movement but improves with lying completely still

Outlook for peptic ulcers

With proper treatment, most of the peptic ulcers heal. However, ulcer may not heal if patient  stop taking  medication early or continue to use alcohol, tobacco, and nonsteroidal pain killer during treatment.

Some ulcers, don’t heal with treatment this type of ulcer is knows as refractory ulcers. If  ulcer doesn’t heal with the initial treatment, this can indicate:

  • an excessive production of stomach acid
  • presence of bacteria other than H. pyloriin the stomach
  • another disease, such as  Crohn’s disease or stomach cancer .

Prevention of  peptic ulcers:-

Changing  lifestyle  and habits can reduce  risk of developing peptic ulcers. These include:

  • Avoid the drinking   alcoholic beverages .
  • not mixing alcohol with medication
  • washing your hands frequently to avoid infections
  • limiting your use of ibuprofen, aspirin, and naproxen (Aleve)

Maintaining a healthy lifestyle by quitting smoking cigarettes and other tobacco use and eating a balanced diet rich in fruits, vegetables, and whole grains will help you prevent developing a peptic ulcer.


Author: Dr.Ajay Kumar Singh

Dr. Ajay Kumar Singh was born on 2 Dec,1981 in Allahabad. He is an alumnus of GSVM Medical College Kanpur and MLN Medical College Allahabad. He worked for 8 years in the Uttar Pradesh Provincial services as Medical Officer. He offered his services at various place like Community Health Centre, Police Hospital, and Jail Hospital. He is a social thinker and writer. He is always ready to deliver his services to the needy person and patient. He works with the motto of making the healthy and happy society.

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