Things to know about peptic ulcer disease:

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

The most common causes of peptic ulcer disease are infection with Helicobacter pylori and prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs). Other contributing factors include excessive acid production, smoking, alcohol consumption, severe stress, and certain medical conditions. These factors weaken the stomach’s protective lining and promote ulcer formation.

🔹 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

The typical symptom of PUD is a burning or gnawing pain in the upper abdomen, often related to meals. The pain may improve or worsen after eating, depending on the ulcer location. Other symptoms include bloating, nausea, vomiting, loss of appetite, and weight loss. In some cases, ulcers may remain asymptomatic until complications occur.

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

-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 of peptic ulcer disease is confirmed by upper gastrointestinal endoscopy, which allows direct visualization of ulcers and biopsy if needed. Testing for H. pylori infection is essential and may be done using breath tests, stool antigen tests, or biopsy during endoscopy. Blood tests may help assess complications such as anemia.

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

Treatment involves eliminating the underlying cause and promoting ulcer healing. Proton pump inhibitors (PPIs) are used to reduce acid secretion, while antibiotics are prescribed to eradicate H. pylori infection. Avoidance of NSAIDs, alcohol, and smoking is crucial. Most ulcers heal with appropriate medical therapy.

1️⃣ Medical Treatment

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 left untreated, peptic ulcers can lead to serious complications such as gastrointestinal bleeding, perforation of the stomach or intestine, and gastric outlet obstruction. These conditions may present with severe pain, vomiting blood, or black stools and require urgent medical care.

• Bleeding

• Perforation

• Gastric outlet obstruction

• Anemia

• Increased risk of gastric cancer (especially gastric ulcers)

 Prevention

Preventive measures include avoiding unnecessary NSAID use, limiting alcohol intake, quitting smoking, maintaining good hygiene to reduce H. pylori infection, and managing stress. Early treatment of symptoms helps prevent progression and complications.

• 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.