A peptic ulcer is a sore or hole that forms in the lining of the stomach, small intestine (duodenum), or esophagus. The term “peptic” refers to the digestive tract, and the ulcers can be classified based on their location: gastric ulcers occur in the stomach, while duodenal ulcers develop in the first part of the small intestine. These ulcers disrupt the protective mucous layer of the digestive tract, allowing stomach acid and digestive enzymes to damage the underlying tissue.
Peptic ulcers are often caused by an infection with the bacterium Helicobacter pylori, which leads to inflammation in the stomach lining, making it more susceptible to acid damage. However, not everyone infected with H. pylori develops ulcers. Another significant cause is the use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen. NSAIDs inhibit the production of prostaglandins, chemicals that normally protect the stomach lining, thus increasing the risk of ulcer formation. Other risk factors include family history, smoking, and excessive alcohol use, although stress and spicy foods do not directly cause ulcers.
Symptoms of peptic ulcers can vary. Many people experience a burning or gnawing pain in the upper abdomen, which often occurs when the stomach is empty and may worsen at night or upon waking. Other symptoms include nausea, vomiting, loss of appetite, bloating, and weight loss. In severe cases, ulcers can lead to serious complications such as bleeding or perforation, which may manifest as blood in vomit or stools, indicating gastrointestinal bleeding.
To diagnose peptic ulcers, healthcare providers may use several tests. A blood test can identify antibodies for H. pylori, but it’s not always accurate. Stool tests are more specific for detecting H. pylori antigens. Endoscopy involves inserting a flexible tube with a camera into the digestive tract to directly observe ulcers and take biopsies if needed. An upper gastrointestinal series, though less common now, involves X-rays taken after ingesting a contrast liquid. Additionally, a urea breath test can detect H. pylori by measuring carbon dioxide levels after ingestion of a labeled substance.
Treatment for peptic ulcers focuses on healing the ulcer, reducing stomach acid, and eliminating H. pylori if present. This typically involves a combination of antibiotics and acid-suppressing medications such as proton pump inhibitors (PPIs) or H2 blockers. If NSAID use caused the ulcer, discontinuing the drug is essential. In severe cases, surgery may be required to address complications like perforation or significant bleeding, though modern treatments have reduced the need for surgery.
Preventing peptic ulcers involves avoiding smoking, excessive alcohol consumption, and unnecessary NSAID use. Good hygiene practices can also help reduce the spread of H. pylori. Although preventing the initial occurrence of ulcers is challenging, appropriate treatment for H. pylori and lifestyle adjustments can help prevent recurrence. With proper management, the prognosis for peptic ulcers is generally excellent, and most individuals recover well with the right medical care and lifestyle changes.
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