What Is Peptic Ulcer Disease?
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Medically reviewed by Kumkum Sarkar Patel, MD
Peptic ulcer disease occurs when stomach acid erodes (or destroys) the inner lining of the stomach, causing sores and ulcers inside your stomach. As a result, symptoms like abdominal pain and nausea can develop. If you develop symptoms, it's important to seek care from a healthcare provider soon—as complications like internal bleeding can happen without proper treatment.
Types
There are two main types of peptic ulcer disease—each of which is based on the location of the ulcers. These include:
Stomach ulcer: Occurs when the mucous lining in the stomach wall wears away. How deep the erosion of the mucous lining is will often determine the severity of your symptoms. Generally, the deeper the erosion, the more severe the symptoms.
Duodenal ulcer: Causes erosion in the duodenum, which is the first and upper portion of your small intestine.
Peptic Ulcer Disease Symptoms
Symptoms of a peptic ulcer can vary from person to person. In the early stages, you might not experience any symptoms at all. When symptoms do start, you'll likely experience them during or after eating meals. Common symptoms include:
Feeling full before finishing a meal
Trouble swallowing
Nausea and vomiting
Excessive burping
Without proper treatment, peptic ulcer disease can progress and cause bleeding in the stomach wall. If you develop bleeding, the following symptoms may occur:
Anemia (low red blood cell levels)
Dark stools (poop)
Bright red or dark-colored vomit
Causes
Peptic ulcer disease occurs when the inner lining of the stomach wall erodes. The erosion causes acid to damage the underlying stomach muscles. There are two primary causes of this condition, which include the Helicobacter Pylori (H. Pylori) infection and taking certain medications.
H. Pylori is a type of bacteria that triggers an immune system response that inflames and damages the inner lining of the stomach. Because this condition is a bacterial infection, you can develop symptoms by consuming contaminated food and water. Making contact with someone's saliva or other body fluids while they have the infection can also cause you to contract the infection.
However, taking certain medications like non-steroidal anti-inflammatory drugs (NSAIDs) can also interfere with the mucous lining of your stomach wall. Many people take NSAIDs to relieve pain symptoms. But long-term use of these medications increases your risk of developing a peptic ulcer. If you are at risk of peptic ulcer disease (such as by having a family history of stomach-related conditions), it's best to ask your healthcare provider about taking NSAIDs before using them.
Diagnosis
If you experience symptoms of a peptic ulcer, it's important to seek treatment from a healthcare provider as soon as possible to avoid complications from occurring. At your appointment, your healthcare provider will ask about your personal and medical family history—such as which conditions you have, what medications you're taking, and which symptoms you're currently experiencing. They may also ask about your lifestyle habits and dietary choices.
Once your provider learns more about your symptoms, they will perform a physical exam to check for signs of a peptic ulcer. To confirm a diagnosis for peptic ulcer disease, your provider will also likely order one or more of the following exams:
Upper endoscopy: Uses a special tube that's attached to a small camera that passes through the mouth to look for signs of damage to the mucous lining in the stomach and duodenum. This test is the gold standard way to diagnose peptic ulcer disease.
Barium swallow: Involves the use of a special contrast dye while taking an X-ray of the stomach to outline the stomach wall and reveal the presence of any ulcers in the imaging scan.
Blood tests: Takes a sample of your blood to check for signs of anemia.
H. Pylori tests: Includes breath tests, stool antigen tests, or antibody tests to detect the presence of bacteria.
Peptic Ulcer Disease Treatments
If you receive a diagnosis for peptic ulcer disease, your healthcare provider will recommend medications to improve your symptoms. The goals of treatment are to reduce the production of stomach acid and promote healing of the ulcers. Your healthcare provider will likely prescribe you one of two types of medications: stomach acid inhibitors or H. pylori medications.
Stomach acid inhibitors help stop the production of stomach acid and improve the lining of the stomach wall. For best results, your provider will likely recommend taking these medications about 30 minutes before eating a meal. There are two types of stomach acid inhibitors that your provider may prescribe, which include:
Proton pump inhibitors: Prilosec OTC (omeprazole), AcipHex (rabeprazole), or Protonix (pantoprazole)
H2-receptor blockers: Zantac (ranitidine) and Tagamet (cimetidine)
If the cause of your peptic ulcer is due to an H. Pylori infection, medication will focus on treating the infection. The first-line treatment for H. pylori infection is a regimen combination, which consists of three antibiotics and a proton pump inhibitor. A common example of a triple medication regimen for H. Pylori is Protonix (pantoprazole), Biaxin (clarithromycin), Moxatag (Amoxicillin), and Flagyl (metronidazole). You'll need to take these medications for one to two weeks to see results.
Prevention
Fortunately, there are several things you can do to reduce your risk of developing a peptic ulcer, such as:
Avoid taking NSAIDs without medical supervision
Get screened for H. pylori infections
Engage in stress management activities such as mindfulness, meditation, and exercises.
Complications
Without proper treatment, peptic ulcer disease can progress and cause the following complications:
Upper gastrointestinal bleeding: The most common complication of peptic ulcer diseases and causes internal bleeding in the stomach wall
Perforation: Causes holes to develop in the stomach or duodenum, which can lead to an abdominal infection and worsening symptoms without treatment
Gastric outlet obstruction: Leads to a blockage in the pylorus (the part of the stomach that connects to the duodenum), making it difficult for food to digest into the small intestine
A Quick Review
Peptic ulcer disease is a condition that causes sores or ulcers in the stomach when stomach acid destroys the inner lining of the stomach wall. This can happen due to an H. pylori infection or long-term use of NSAIDs. As a result, symptoms like abdominal pain, bloating, vomiting, and changes in vomit or stool color can occur. It's important to get treatment for peptic ulcers as soon as possible because without treatment, internal bleeding can occur.
Frequently Asked Questions
Do peptic ulcers go away?
Peptic ulcers can heal after taking medications, such as proton pump inhibitors or H. Pylori medicines.
What is the difference between a gastric ulcer and a peptic ulcer?
Peptic ulcer is a broad term for the presence of an ulcer in either the stomach or upper small intestine. A gastric ulcer is the presence of an ulcer in the stomach wall.
What foods should you avoid with a peptic ulcer?
Eating spicy and oily foods can sometimes irritate pre-existing stomach ulcers. For personalized dietary recommendations, talk to your healthcare provider about which foods are safe to eat.
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