Health & Fitness

Peptic Ulcer: Symptoms, Causes, and Diagnosis


Peptic ulcers are the painful sores in the stomach lining or the first part of the small intestine (the duodenum). Many cases of peptic ulcer disease occur when a bacterial infection eats away the protective lining of the thick layer of mucus of the digestive system. It damages the tissues that line the stomach by the action of digestive acids resulting in an ulcer. The most common sign of a peptic ulcer is stomach pain.

Peptic ulcers often include gastric ulcers occurring on the inside of the stomach and duodenal ulcers occurring on the inside of the upper portion of your small intestine (duodenum). If you frequently use pain relievers, you are more likely to develop ulcers. They can be easily treated, but they may become severe without proper cure.

What are the Symptoms of peptic ulcers?

When stomach ulcers occur, you can experience a large number of symptoms. The severity of these symptoms may base on the severity of the ulcer. Symptoms also vary from person to person. In some cases of ulcers, it is possible that the disease may not cause any symptoms.

The most common symptom of ulcer is a dull or burning sensation in your belly between your chest and your belly button (navel). Normally, the burning pain occurs around meal times when your stomach is empty or may occur when you wake up at night. The pain can last from a few minutes to a several hours.

A few other signs and symptoms of ulcers may include:

  • Nausea or vomiting
  • Vomiting with blood
  • Burping
  • Cannot eat properly because of pain
  • Weight loss even without trying
  • Bloating
  • Feeling full easily even after eating a lower amount of food
  • Burping or acid reflux
  • Pain that may get better when you eat, drink, or take antacids
  • Severe pain in the stomach
  • Bloody or black stool
  • Dark and tarry stools
  • Heartburn (a burning sensation in the chest)
  • Vomit that is more bloody and looks like coffee grounds
  • Anemia in which you may observe tiredness, shortness of breath, or paler skin

When to see a doctor

See your healthcare provider immediately when you observe any symptoms of a peptic ulcer. Symptoms of this disease may look like other health problems, it’s better to consult doctor. Even though your discomfort is mild or severe, ulcers can be worst if they aren’t treated. Bleeding ulcers, especially, that may become life-threatening.

What Causes Peptic Ulcers?

Peptic ulcers occur when acid in the digestive system eats away the tissues present at the inner surface of your stomach or small intestine. When the mucus layer becomes too thin or your stomach starts making too much acid, your gut will feel it. As the amount of these acids is increased or the amount of mucus is decreased, you may develop an ulcer. This can result in a painful open sore that may bleed.

The major causes of peptic ulcer are:

  • Bacteria: A bacteria called Helicobacter pylori (H. pylori) commonly lives in the mucous layer that covers and protects tissues lining the stomach or small intestine. Normally the H. pylori bacterium does not cause any problem. But it might cause inflammation of the stomach’s inner layer, resulting in an ulcer. It causes ulcer by raising the amount of acid and breaking down the protective mucus layer, thus irritating the digestive tract. It’s not sure yet how H. pylori infection spreads. It may be passed from person to person through close contact, such as kissing. You may also contract H. pylori through contaminated food and water.
  • Regular use of certain pain relievers: In case you are taking aspirin often or for a quite long time, you’re more likely to develop a peptic ulcer. The same is the condition for other nonsteroidal anti-inflammatory drugs (NSAIDs). These medicines block your body from forming a chemical that assists protecting the inner walls of your stomach or small intestine from stomach acid. 
  • Other medications. If you are taking certain other medications along with NSAIDs, like anticoagulants, steroids, selective serotonin reuptake inhibitors (SSRIs), alendronate (Fosamax) and risedronate (Actonel), it can increase the chance of developing ulcers. These medications contain naproxen sodium (Aleve, Anaprox DS, others), ibuprofen (Advil, Motrin IB, others), ketoprofen and others. But they do not contain acetaminophen (Tylenol, others). These medications can irritate and inflame the lining of your stomach or small intestine.
  • Smoking: Taking cigarettes, drinking alcohol, and smoking are also the leading causes of ulcer. Stress and eating a lot of junk foods may not cause ulcers, according to experts. But you must remember that they can make your ulcers worse and harder to treat.

What are the Risk factors of ulcer?

After knowing the major causes of peptic ulcer, it is important to know what triggers ulcer. Other than the risks of taking NSAIDs, you are more likely to develop peptic ulcers if you:

  • Smoke
  • Drink alcohol
  • Have untreated stress
  • Eat spicy foods

These factors alone do not cause ulcers. But these can make your ulcers worse and more difficult to cure.

How are peptic ulcers diagnosed?

Diagnosis of the disease mainly depends on your symptoms and the severity of your ulcer. For the diagnosis a peptic ulcer, your healthcare provider will check your medical history along with your symptoms. If you’re taking any prescription or over-the-counter medications, your doctor may review this as well for further treatment. You may also have some physical exams and tests.

The tests and procedures used to diagnose peptic ulcers include:

  • Upper endoscopy or EGD (esophagogastroduodenoscopy): This test reviews the lining of your esophagus, stomach, and duodenum. It involves using a thin lighted tube, having a camera at one end, known as endoscope. You have to put this tube into your mouth and throat. Then it follows the way into your esophagus, stomach, and duodenum. Your doctor will see the inside of these major parts. For the purpose of checking for H. pylori, your health care provider may use a small tissue sample (biopsy).
  • Upper GI (gastrointestinal) series or barium swallow: This test reviews the major organs of the upper part of your digestive system. It involves checking your food pipe (esophagus), stomach, and the first portion of the small intestine (the duodenum). You have to swallow a metallic fluid known as barium. This fluid will coat the organs so that your doctor can observe it on X-ray.

A number of lab tests are performed as well to see if you whether have an H. pylori infection or not. These tests may include:

  • Urea breath test: This is used to check how much carbon dioxide is present in your breath when you exhale. You will take the sample of your breath by breathing into a bag. It will be then sent to a lab. Doctor may allow you to swallow a urea pill that contains carbon molecules. The urea will break down and become carbon dioxide if you have H. pylori. Your breathing will sample shows higher than normal amounts of carbon dioxide when you have H. pylori.
  • Blood test: It is a test for checking the infection-fighting cells (antibodies) which indicate that you may have H. pylori.
  • Stool culture: For this test, you need to collect a small sample of your stool and then sent it to a lab. In 2 or 3 working days, the test will tell if you have H. pylori or not.

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