Peptic Ulcer Disease: Causes, Symptoms, Diagnosis & Treatment

Peptic Ulcer Disease (PUD) is a condition in which open sores (ulcers) develop in the lining of the stomach or the first part of the small intestine (duodenum). These ulcers occur due to an imbalance between aggressive factors like gastric acid and protective mechanisms of the gastrointestinal mucosa.

 What Is a Peptic Ulcer?

A peptic ulcer is a break in the mucosal lining caused by acid and digestive enzymes.
Depending on the location, peptic ulcers are classified into:

• Gastric ulcer – ulcer in the stomach

• Duodenal ulcer – ulcer in the duodenum

 Causes of Peptic Ulcer Disease

🔹 Major Causes

• Helicobacter pylori infection (most common cause)

• Long-term use of painkillers (NSAIDs) such as aspirin, ibuprofen

🔹 Other Contributing Factors

• Excess gastric acid secretion

• Smoking

• Excess alcohol intake

• Severe physiological stress (burns, trauma, ICU illness)

• Zollinger–Ellison syndrome (rare, acid-secreting tumor)

 Symptoms

Symptoms may vary depending on ulcer type and severity.

Common Symptoms

• Burning or gnawing pain in upper abdomen

• Pain related to meals

  • Duodenal ulcer: pain relieved by eating

  • Gastric ulcer: pain worsens after eating

• Nausea or vomiting

• Bloating or fullness

• Loss of appetite

 Alarm Symptoms (Medical Emergency)

• Vomiting blood

• Black, tarry stools (melena)

• Sudden severe abdominal pain

• Dizziness or fainting (bleeding)

• Unexplained weight loss

 Types of Peptic Ulcers

Type

Key Features

-Gastric ulcer

Pain after meals, risk of malignancy

-Duodenal ulcer

Pain at night or when hungry

-Stress ulcer

Seen in critically ill patients

-Drug-induced ulcer

Caused by NSAIDs

 Diagnosis

Diagnosis is based on symptoms and confirmatory tests.

Investigations

• Upper GI endoscopy – gold standard

• H. pylori testing (breath test, stool test, biopsy)

• Blood tests (anemia)

• Stool test for occult blood

• Imaging studies if complications suspected

 Gastric ulcers often require biopsy to rule out cancer.

💊Treatment & Management

1️⃣ Medical Treatment

Medication

Purpose

Proton Pump Inhibitors (PPIs)

Reduce acid production

H2-receptor blockers

Decrease acid secretion

Antibiotics

Eradicate H. pylori infection

Antacids

Symptomatic relief

Mucosal protective agents

Protect ulcer base

 Avoid NSAIDs unless advised by a doctor.

2️⃣ Diet & Lifestyle Changes

Recommended

                                                                                                                                    Avoid

Small frequent meals

                                                                                                                                                                       Spicy & fried foods

Soft, easily digestible food

                                                                                                                                                                         Alcohol

Fruits like banana, papaya

                                                                                                                                                    Coffee & carbonated drinks

Adequate hydration

                                                                                                                                                                        Smoking

Early dinner

                                                                                                                                                               Late-night heavy meals

Additional tips:         

• Eat slowly and chew well

• Avoid lying down immediately after meals

• Manage stress through yoga or meditation

 Complications

If untreated, peptic ulcers can lead to serious complications:

• Bleeding

• Perforation

• Gastric outlet obstruction

• Anemia

• Increased risk of gastric cancer (especially gastric ulcers)

 Prevention

• Treat H. pylori infection completely

• Avoid unnecessary painkillers

• Limit alcohol consumption

• Quit smoking

• Maintain regular meal timing

• Manage stress effectively

 When to Consult a Doctor

• Persistent abdominal pain

• Vomiting blood or black stools

• Symptoms lasting more than 2 weeks

• History of frequent painkiller use

Disclaimer:

The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified physician or other licensed healthcare provider with any questions you may have regarding a medical condition. Do not ignore or delay seeking medical advice because of information you read on this website. The use of any information provided here is solely at your own risk.