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What are Peptic Ulcers?


Peptic ulcers are small open sores in the stomach or upper intestine. Sores occur when the lining of the stomach or intestine breaks down and exposes tissue underneath. Ulcers may be gastric (stomach) or duodenal (first 12 inches of the small intestine). Duodenal ulcers occur four times more often than gastric ulcers. Peptic Ulcer Disease (PUD) is common.


What Causes Peptic Ulcers?


Three things cause most peptic ulcers: infection with a bacteria named Helicobacter Pylori (H. Pylori), taking Aspirin (ASA) or Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), and too much acid secretion. Ulcers aren’t contagious but may run in families. Smoking and alcohol increases the risk of ulcers.


What are the Symptoms of Peptic Ulcers?


The main symptom is stomach pain that feels like heartburn, indigestion, or hunger pains. A burning, discomfort, or gnawing feeling can last from several minutes to several hours. It’s usually felt in the upper stomach area, but sometimes occurs below the breastbone. Pain usually happens when the stomach is empty. It can also occur right after eating or hours later, depending on the location of the ulcer. Complications include bleeding and perforation (hole in the stomach or duodenum). Black, tarry stools and vomiting with blood or with what looks like “coffee grounds” material (blood mixed with stomach acid) indicate bleeding ulcers.


How are Peptic Ulcers Diagnosed?


The doctor will suspect PUD from the medical history and physical examination. The doctor may order blood and stool tests. Endoscopy or barium x-rays may be done. For endoscopy, the better test, the doctor uses a lighted tube to see into the stomach and duodenum and take a tissue sample for study (biopsy). Tests will be done to see whether the stomach or duodenum has H. Pylori infection.


How are Peptic Ulcers Treated?


Treatment heals the ulcer, helps symptoms, stops relapses, and avoids complications. With treatment, people usually start to feel better within 2 weeks. Relapses can occur if the risk factors persist. Two treatment options are drugs and surgery. Medicines to reduce stomach acid include antacids, Histamine-2 blockers (such as Ranitidine), and Proton-Pump Inhibitors (such as Omeprazole). Sucralfate is another medication that can form a protective coating on the ulcer to help it heal. Antibiotics, proton-pump inhibitors, and bismuth can be used for H. Pylori infection. Surgery is used when drugs don’t work or serious complications occur (such as severe bleeding or perforation). Today, ulcer medications are extremely effective and surgery is rarely needed.

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