Peptic ulcer disease is a condition in which there are painful sores or ulcers in the lining of the stomach or the first part of the small intestine (the duodenum). Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing for ulcers to occur.
You may be more likely to develop an ulcer if you:
No single cause has been found for ulcers. However, it is now clear that an ulcer is created by an imbalance, or unevenness, between the digestive fluids hydrochloric acid and pepsin (a digestive enzyme) in the stomach and duodenum.
Ulcers can be caused by:
Though spicy foods can make ulcers more painful, they are not known to cause ulcers.
An ulcer may or may not have symptoms. When symptoms occur, they include:
In severe cases, symptoms can include:
Your doctor may be able to make the diagnosis just by talking with you about your symptoms. However, to confirm the diagnosis, one of several tests should be taken. First, your doctor may ask you to take an acid-blocking medication for a short period of time to see if your symptoms improve.
If needed, your doctor may recommend a procedure called an upper endoscopy. In this procedure, the doctor inserts a small, lighted tube (endoscope) through the throat and into the stomach to look for abnormalities. This procedure is usually done if you are having severe ulcer symptoms.
Often, doctors will treat without confirming the diagnosis with endoscopy. If the cause is not likely to be from taking NSAIDs, then it is very likely to be from H. pylori. Most doctors will now test for H. pylori and will treat specifically for that, in addition to giving medications to reduce the symptoms.
H. pylori can be discovered either directly by taking a sample during an upper endoscopy, or indirectly, with a blood test or a breath test.
There are several ways in which ulcers can be treated, including making changes to one's lifestyle, taking medication, and/or having surgery.
If you have an ulcer, you should first eliminate substances that can be causing it. If you smoke or drink alcohol, stop. If the ulcer is believed to be caused by the use of NSAIDs, they need to be stopped.
Some bleeding ulcers can be treated through the endoscope.
An operation may be needed if the ulcer has created a hole in the stomach wall or if there is serious bleeding.
No. Milk can make your ulcer worse. Milk provides brief relief of ulcer pain because it coats the stomach lining. But milk also causes your stomach to produce more acid and digestive juices, which can make ulcers worse.
The risk of an ulcer is related to the dose of the NSAID (meaning the more you take, the greater the risk). The risk increases with:
Though ulcers often heal on their own, you shouldn't ignore their warning signs. If they are not properly treated, ulcers can lead to serious health problems, including:
Taking NSAIDs can cause any of the above, without warning. The risk is especially worrying for those over age 75 and for those who have a history of peptic ulcer disease.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 01/13/2016