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Peptic Ulcer

A peptic ulcer is an open sore in the lining of the stomach. It may also occur in the duodenum (first part of the small intestine). 

Causes

The most common causes of ulcers are:

  • H. pylori bacteria infection

  • Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin or ibuprofen

Other factors that can increase the risk for ulcers include older age and family history of peptic ulcers. Tobacco and alcohol use are also risk factors.

Symptoms

A peptic ulcer may or may not cause symptoms. If symptoms do occur, they can include:

  • Dull or burning pain in the stomach region (anywhere between your belly button and breastbone)

  • Loss of appetite

  • Heartburn or upset stomach

  • Frequent burping

  • Bloated feeling

  • Nausea or vomiting (vomit may be bloody or look like coffee grounds)

  • Black, tarry, or bloody stools (this means the ulcer is bleeding)

If an ulcer is suspected, tests may be done to check for H. pylori infection. These can include blood, stool, or breath tests. In some cases, other tests such as an upper endoscopy is done. You’ll be told more about this, if needed.

Without treatment, a peptic ulcer may worsen. This can lead to serious problems such as bleeding or perforation (a hole) in the stomach or duodenum. Treatment is needed to prevent these problems.

Medicines are the most common treatment for peptic ulcers. In severe cases, surgery may be needed.

Home Care

  •  If you’re prescribed medicines, be sure to take them as directed. Common medicines prescribed include:

    • Antibiotics. These kill H. pylori bacteria. In many cases, you’ll need to take at least two types of antibiotics.

    • Proton pump inhibitors. These block your stomach from making any acid.

    • H2 blockers. These reduce the amount of acid your stomach makes.

    • Bismuth subsalicylate. This helps protect the lining of your stomach and duodenum from acid.

  • Don’t take any NSAIDS without talking to your provider first. These may delay healing. Also check with your provider before taking any antacids.

  • Avoid alcohol and tobacco use. These may delay healing. They may also worsen symptoms.

Follow-up care

Follow up with your healthcare provider as directed. If testing was done, you’ll be told the results when they are ready.

When to seek medical advice

Call your healthcare provider right away if any of these occur:

  • Fever of 100.4°F (38°C) or higher or as directed by your provider

  • Stomach pain that worsens or moves to the lower right part of abdomen

  • Continued weight loss

  • Pale skin

  • Fast heartbeat

  • Weakness or dizziness

  • Extreme fatigue

  • Frequent vomiting, blood in your vomit, or coffee ground-like substance in your vomit

  • Black, tarry, or bloody stools

Call 911

Call 911 right away if any of these occur:

  • Sudden or severe pain in the stomach region

  • Stomach becomes rigid

  • Low body temperature

  • Unusually fast heart rate

  • Chest pain appears or worsens, or spreads to the back, neck, shoulder, or arm

  • Trouble breathing or swallowing

  • Confusion

  • Extreme drowsiness or trouble waking up

  • Fainting

  • Large amounts of blood present in vomit or stool

 

 
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