A peptic ulcer is an erosion or sore in the lining of the stomach or intestine that occurs when the protective mucus layer wears away in certain areas, allowing damage to occur from the natural acids of the stomach.
Around 10% of people will have peptic ulcer disease (PUD) at some point in their life. The majority of peptic ulcers are caused by bacteria called Helicobacter pylori (H. pylori) or by taking ASA (acetylsalicylic acid) or nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen*, ketoprofen, naproxen).
The 2 most common types of peptic ulcers:
Although stress and spicy foods might make the symptoms of peptic ulcer worse, they aren’t the cause of the condition as was once thought.
A bacterium called H. pylori causes the majority of ulcers. The bacteria can spread into the mucus lining that usually protects the stomach and small intestine from digestive acids, damaging it in the process. By 60 years of age, up to 50% of people are infected with this bacteria, but only 10% to 20% of these people will actually develop stomach problems.
The other major cause of PUD is the use of ASA (acetylsalicylic acid) and other NSAIDs such as ibuprofen or naproxen. NSAIDs can penetrate the lining of the stomach and release substances that damage cells. NSAIDs also block natural chemicals called prostaglandins that can help to protect and repair those cells. People more at risk of ulcers caused by NSAIDs include those who:
Excessive alcohol can affect the stomach and cause it to produce more stomach acid, but it doesn’t seem to cause ulcers.
Medical treatment focuses on eliminating the H. pylori bacteria in people where it has been detected. The majority of peptic ulcers caused by H. pylori can be cured with a combination of antibiotics, antacids (bismuth subsalicylate), and proton pump inhibitors (PPIs; e.g., omeprazole, lansoprazole, esomeprazole, pantoprazole, rabeprazole).
Other combinations may also be used (e.g., 2 antibiotics and a PPI without bismuth subsalicylate) to treat H. pylori induced ulcers. There are several different combinations, but most of them require taking medications for 14 days. For some people, several courses of treatment may be needed to get rid of H. pylori. In this case, at least one of the antibiotics will be different from the initial combination used.. Follow-up testing to make sure H. pylori is cleared can be done through the breath test or checking the stool.
When an ulcer is not associated with H. pylori or is caused by NSAIDs, treatment with a PPI is prescribed for 4 to 8 weeks. Some people may need to continue treatment for longer periods of time. Another type of acid reducer, H2-antagonists (e.g., ranitidine, nizatidine), may also be used.
If the peptic ulcer was caused by NSAIDs, such as ASA, your doctor will most often recommend that you stop taking them if possible. Some people are more susceptible to peptic ulcers caused by NSAIDs, including those who:
If you’re taking a NSAID and have one of these risk factors, your doctor may prescribe a protective medication to take along with it. Acid-suppressing medications (e.g., PPIs) or misoprostol may be used for this. Misoprostol encourages the stomach to produce its protective mucus coating and improves blood flow.
It’s important for people with PUD to quit smoking. Smoking can delay healing and can cause ulcers to return.
Very rarely, surgical treatment may be needed for PUD and its complications.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2025. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Peptic-Ulcer-Disease
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