10350 Peptic Ulcer Disease

Overview

A peptic ulcer is a sore that forms on the lining of your stomach or the first part of your small intestine. It happens when the protective layer of mucus in your digestive tract is weakened, allowing stomach acid to irritate the tissue beneath.

Yes, peptic ulcers are fairly common. Around 1 in 10 people in Western countries will have a peptic ulcer at some point in their lives.

Peptic ulcers can affect people of any age, but they are most often diagnosed in adults over 50. Men and women are affected about equally, though some risk factors differ by gender.

Symptoms

Common symptoms

• A dull or burning pain in the middle of the upper belly
• Pain that improves when you eat or take an antacid (for some people it gets worse)
• Feeling full quickly during a meal
• Bloating or burping
• Nausea or vomiting
• Poor appetite or unintended weight loss

Symptoms in children

• Vague belly pain, often around the belly button
• Nausea or upset stomach after meals
• Vomiting
• Poor appetite or slow weight gain

Symptoms in older adults

• May have no pain at all, or only a very mild discomfort
• Loss of appetite or feeling tired
• Anemia (low blood count) due to slow bleeding, which can cause weakness or pale skin
• Confusion or dizziness if bleeding is significant

Causes

Main causes

• Infection with bacteria called Helicobacter pylori (H. pylori)
• Regular use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin
• Excess stomach acid (less common, can be due to tumors or other conditions)

Risk factors

• Being infected with H. pylori
• Taking NSAIDs, especially in high doses or over a long period
• Smoking cigarettes or using tobacco products
• Drinking alcohol heavily
• Having a family history of ulcers
• Being over 50 years old

When to see a doctor

See a doctor urgently if:

• You vomit blood or what looks like coffee grounds
• You pass black or tarry stools, or stools with blood
• You have sudden, severe belly pain that does not settle
• You feel faint, dizzy, or have a racing heartbeat

Book a routine appointment if:

• You have burning pain in your belly that lasts more than a few days
• You get frequent indigestion or heartburn that does not go away with simple measures
• You are taking pain relievers and notice upset stomach or pain
• You have poor appetite or are losing weight without trying

Diagnosis

To diagnose a peptic ulcer, a doctor will talk with you about your symptoms and medical history, and may order tests to look at your stomach lining or check for H. pylori infection.

Tests that may be done

• Breath test for H. pylori
• Stool test for H. pylori
• Endoscopy (a thin, flexible tube with a camera inserted through your mouth to look at your stomach and small intestine)
• Barium swallow X-ray (a contrast drink to outline your digestive tract)
• Blood test for anemia (to check for bleeding)

What to expect at your appointment

Your doctor may prescribe medicine to reduce stomach acid and treat H. pylori if found. You will likely be asked to stop taking NSAIDs if you use them. Most people feel better within a few days, and an ulcer usually heals within 4 to 8 weeks. Your doctor may recommend a follow-up test to make sure the ulcer has healed.

Treatment

Treatment for a peptic ulcer aims to reduce stomach acid, protect the ulcer so it can heal, and treat any underlying infection. Your doctor will create a plan based on the cause of your ulcer. Never treat yourself with medicines without medical advice.

Self-care at home

• Stop or limit smoking and alcohol, as both can irritate the stomach lining.
• If you use NSAIDs (like ibuprofen or aspirin), ask your doctor for a safer alternative.
• Eat smaller, more frequent meals instead of large ones.
• Avoid foods that seem to make your pain worse, such as spicy or acidic foods.
• Manage stress with relaxation techniques like deep breathing or meditation.
• Sleep with your head slightly raised if you have nighttime reflux.

Medical treatments

Common treatments include medicines that reduce stomach acid (called proton pump inhibitors or H2-blockers), medicines that coat and protect the stomach lining, and antibiotics to clear an H. pylori infection if it is present. You may need to take medicines for several weeks. It is important to complete the full course even if you feel better. Your doctor may also recommend stopping NSAIDs or using a different painkiller.

When is surgery considered?

Surgery is rarely needed for peptic ulcers today. It may be considered only if an ulcer causes severe bleeding, a hole in the stomach, or if other treatments have not worked.

Living with this condition

Living with peptic ulcer disease usually means taking your medicines as prescribed and paying attention to what feels comfortable for your stomach. Most people can resume normal activities once pain improves. You can keep a simple diary of foods, medicines, and stress to spot triggers.

Lifestyle tips

• Take medicines exactly as your doctor directs, even if symptoms improve.
• Do not skip meals; regular eating times help buffer stomach acid.
• Avoid alcohol and tobacco, which slow ulcer healing.
• If you need pain relief, talk to your doctor about options that are gentler on the stomach.
• Sleep sufficiently, as poor sleep can worsen stress and stomach symptoms.

Diet and exercise

There is no strict 'ulcer diet,' but eating a balanced diet with plenty of fruits, vegetables, and whole grains supports healing. Regular, moderate exercise like walking can improve circulation and reduce stress. Avoid intense exercise right after eating. If certain foods cause pain, it's okay to avoid them.

Mental health and emotional wellbeing

Living with a chronic condition can sometimes feel stressful, and stress can worsen stomach symptoms. It's normal to feel anxious or worried. Talking about your feelings, practicing relaxation, and staying connected with friends can help. If you feel anxious or depressed, consider speaking to a mental health professional.

Prevention

Many peptic ulcers can be prevented. The most important steps include avoiding unnecessary use of NSAIDs, limiting alcohol, not smoking, and washing hands and preparing food safely to reduce the chance of H. pylori infection. If you have H. pylori, completing treatment helps prevent recurrence.

Vaccines

There is currently no vaccine for H. pylori or for peptic ulcer disease.

Screening programmes

There is no routine screening for peptic ulcer disease in people without symptoms. Your doctor may check for H. pylori if you have a history of ulcers or are starting long-term NSAID therapy.

Complications

If left untreated

• Bleeding ulcer, which can cause vomiting blood or black stools
• Perforation (a hole through the stomach or intestine wall), which is a medical emergency
• Obstruction (blockage in the digestive tract, which can cause repeated vomiting)
• Recurrent ulcers if the cause is not treated

Long-term outlook

With proper treatment, the outlook for peptic ulcer disease is very good. Most ulcers heal completely within weeks, and complications are uncommon. Following your doctor's advice and taking your medicines as directed can help ensure a full recovery and prevent future problems.

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