Peptic ulcers are the open sores on the wall of stomach, esophagus or upper small intestine. They are esophageal ulcers, gastric ulcers or duodenal ulcers depending on their location.
Peptic ulcers are caused due to stress, smoking, excessive alcohol intake, Helicobacter pylori infection or long term use of non-steroidal anti-inflammatory drugs and the same act as risk factors for the development of peptic ulcers.
The most generalized symptom of peptic ulcer is abdominal pain. Pain may be anywhere from breast bone to navel, burning type of pain, heartburn, severe when stomach is empty, severe at night, lasts for few minutes or few hours and subsides on taking antacids or certain foods are the most common symptoms of peptic ulcer.
The pain may be on and off at the interval of few days. Less common symptoms are abdominal fullness, bloating, nausea, vomiting, blood in vomit, blood in stool, dark color stool, appetite changes and unexplained weight loss.
Tests are done to detect the presence of bacteria Helicobacter pylori by culture of biopsies taken during endoscopy, rapid urease test, detection of anti-H. pylori antibodies, urea breath test and detection of H. pylori antigen in stool (stool antigen test). Other tests are upper gastrointestinal endoscopy and barium X-ray. Upper gastrointestinal endoscopy is more sensitive test for the diagnosis of peptic ulcers. Blood test may be done to check for anemia and guaiac stool test to check for presence of blood in stool.
The treatment for peptic ulcers is aimed to kill the bacteria (if the ulcers are due to them) and to reduce the stomach acid secretion. Generally combination of antibiotics is used for killing the bacteria. Antibiotics used are amoxicillin, clarithromycin, tetracycline, and metronidazole. The combination therapy includes two antibiotics and a gastric acid suppressor or a cytoprotective agent. Acid suppressing drugs are antacids, histamine H2 blockers (ranitidine, famotidine, roxatidine) and proton pump inhibitors (omeprezole, lansoprazole, rabiprazole, esomeprazole and pentaprazole). Cytoprotective agents are bismuth subsalicylate, mesoprostol and sucralfate. If medicines cannot cure peptic ulcers then surgery is an option.
Peptic ulcers can cause internal bleeding, infection, perforation (hole in the wall of the intestine), peritonitis (infection and inflammation of the lining of the abdominal cavity) due to leakage of intestinal contents in the abdominal cavity or production of scar tissues. Scar tissues can cause intestinal obstruction resulting in easy fullness and vomit and thereby weight loss.
Avoiding alcohol, smoking, tobacco and non steroidal anti inflammatory drugs and reducing stress or learning stress management can prevent peptic ulcers.
