HealthInfo Canterbury

Peptic ulcers

Peptic ulcers are open sores that develop in the lining of your stomach or the first part of your small intestine.

When there is an ulcer in the lining of your stomach it is called a stomach or gastric ulcer, and when the ulcer is in the upper part of your small intestine it is called a duodenal ulcer. The term peptic ulcer can apply to either of these.

Peptic ulcers form when digestive juices damage the lining of your stomach or intestine.

The most common causes of peptic ulcers are:

• Infection with a germ (bacterium) called Helicobacter pylori (H. pylori).
• Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, naproxen, diclofenac and aspirin. These medicines are usually used as pain relief, or in the case of aspirin to reduce your chance of a heart attack or stroke.
• Smoking increases your risk of getting an ulcer and makes healing slower. Stress, spicy foods, coffee and alcohol don’t cause ulcers but they can make your symptoms worse and more difficult to heal.

Symptoms of peptic ulcers

The most common symptom of a peptic ulcer is a burning or gnawing pain in the middle of your stomach. The pain can last from a few minutes to a few hours and often starts within a few hours of eating. The pain may be worse between meals and at night.

Other symptoms may include:

• feeling sick (nausea)
• heartburn
• bloating or feeling very full after a meal
• poor appetite
• losing weight.

Occasionally people get very unwell with a peptic ulcer because it bleeds internally, causes a hole in your stomach or small intestine, or causes a blockage in your digestive system. You should see your GP immediately if you:

• have dark, sticky, tar-like bowel motions
• vomit blood
• have a sudden, sharp pain in your stomach that gets steadily worse.

Diagnosing peptic ulcers

To find out if you have a peptic ulcer, your doctor may examine you and ask you about your symptoms and what medicines you take. You may need to have a blood test and provide a poo (stool) sample.

You may need a gastroscopy (also called an endoscopy) to confirm you have a peptic ulcer. This involves passing a long, thin flexible tube with a tiny camera on the end down through your mouth or nose into your stomach.

You have a gastroscopy at hospital. To make it easier, you will usually take a medicine that relaxes you and makes you sleepy.

The camera lets doctors see into your stomach and small intestine. If they see an ulcer, they can take a small sample (biopsy) to check what kind of ulcer it is, so you get the right treatment. They can test you for H. pylori at the same time.

Treating peptic ulcers

The main treatment for peptic ulcers is with a medicine that cuts down the amount of acid your stomach makes, such as omeprazole, and pantoprazole.

If you have an H. pylori infection, you'll also need antibiotics to treat this.

If your ulcer was caused by medicines such as NSAIDs, your GP will probably recommend that you stop taking these.

The following lifestyle measures may help to reduce your symptoms while your ulcer heals:

• eating well and having small regular meals
• identifying and avoiding food and drinks that make your pain worse, this may include alcohol, coffee and spicy foods
• reducing stress
• stopping smoking.

If your ulcer is severe and causes problems such as bleeding, perforation or a blockage, you will need surgery.

On the next page: H. pylori

Written by HealthInfo clinical advisers. Last reviewed July 2021.

Sources

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