Things to know about peptic ulcer disease:
reviewed by-medskology medical team
Peptic Ulcer Disease: overview
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
According to WHO 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
-medskology medical team
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.