Peptic Ulcer Disease

August 11, 2024

3 min read

Peptic ulcer disease is a condition that causes open sores or ulcers to develop in the lining of the digestive tract, especially in the stomach lining and the duodenum, the upper part of the small intestine.

Peptic ulcers can worsen if left untreated. Treatments may include medications, antibiotics, or surgery if the ulcer does not heal.

Types of Peptic Ulcers

Peptic ulcers can be of different types.

Duodenal ulcers: They occur in the duodenum in the upper part of the small intestine.
Gastric ulcers: They occur on the inside of the stomach.
Esophageal ulcer: Chronic acid reflux causes stomach acid to rise to the esophagus, eroding the mucus lining to develop an ulcer.
Jejunal ulcer: A jejunum ulcer can occur due to surgery connecting your stomach to the jejunum.

Peptic Ulcer Disease Causes

The gastrointestinal tract has a protective mucus lining that protects the stomach from substances like corrosive digestive acids. Peptic ulcer occurs when the layers of the mucus lining are eroded.

While peptic ulcers commonly occur in the stomach and duodenum, where stomach acids are most active, they can also occur in other parts of the gastrointestinal tract because of stomach acid passing through those parts.

Peptic ulcer disease can occur because of two main reasons.

H.pylori infection

An overgrowth of the H.pylori bacteria can upset the natural microbial balance, causing inflammation in the gastrointestinal lining and leading to peptic ulcers.

Overuse of NSAIDs (non-steroidal anti-inflammatory drugs):

NSAIDS like ibuprofen and aspirin can affect the chemistry inside the duodenum and stomach, inhibiting the prostaglandins from repairing the damaged gastrointestinal lining.

Other causes include:

Ischemia or loss of blood supply
Infections
Crohn’s disease
Severe psychological stress
Radiation or chemotherapy
Zollinger-Ellison syndrome
Stomach cancer

Some other risk factors of peptic ulcer disease include:

Smoking
Drinking alcohol
Eating spicy foods

Peptic Ulcer Complications

Peptic ulcers, when left untreated, may have complications like:

Internal bleeding: Slow bleeding can cause anemia, while severe bleeding can cause blood loss requiring transfusion and hospitalization.
Perforation or hole in the stomach wall: Peptic ulcers can create a hole in the stomach wall, causing severe infections like peritonitis.
Gastrointestinal obstruction: Untreated peptic ulcers can cause gastrointestinal obstruction in the form of scarring and swelling that slows or stops food from passing through.
Gastric cancer: People with H.pylori infection have a higher risk of getting gastric cancer.

Peptic Ulcer Disease Symptoms

The symptoms include:

A burning stomach pain
Bloating. belching and a feeling of fullness
Inability to tolerate fatty foods
Nausea;
Heartburn;
Loss of appetite.

Symptoms of peptic ulcer complications include:

Black, tarry stools
Vomiting blood or coffee ground vomits
Rapid heart rate
Dizziness or faintness

Symptoms of gastrointestinal perforation include:

Abdominal swelling with tenderness to touch
Sudden, sharp abdominal pain
Fever and chills
Constipation or loss of bowel movements

Peptic Ulcer Disease Diagnosis

Your doctor will consider your medical history and perform a physical exam. They may recommend diagnostic tests like:

EGD or upper endoscopy: It is used to examine the upper digestive system for ulcers.
Lab tests for H.pylori: Blood, stool, or breath tests are done to detect H.pylori bacteria.
Upper GI series: After swallowing a barium solution, an x-ray of the upper digestive system is done to visualize the ulcer better.

Peptic Ulcer Treatment

Medications

The medicines that heal the ulcer and prevent a relapse may include:

Proton pump inhibitors (PPIs): They are powerful acid-blocking medicines taken as a pill or IV.
Acid blockers or histamine blockers: They reduce the acid levels in the stomach;
Antacids: They neutralize stomach acids.
Cytoprotective agents: They are medicines that protect the stomach and intestine lining.
Antibiotics: Used to treat an H.pylori infection.

Medical procedures

A bleeding ulcer can be treated by cauterizing or injecting medicine into the wound.
A stomach perforation can be repaired using stitches.
For stomach obstructions, interventions are required to reopen the channel by suctioning or decompressing the stomach or through surgery.