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Peptic Ulcer- Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Prevention

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Peptic Ulcer- Causes, Symptoms, Risk Factors, Diagnosis, Treatment and Prevention

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A peptic ulcer is commonly seen on the lining of the stomach, small intestine, and esophagus, which is also called a gastric ulcer. For more details read below.

Medically reviewed by

Dr. Zubin Dev Sharma

Published At January 17, 2019
Reviewed AtOctober 17, 2023


Ulceration in the inner lining of the stomach or upper part of the small intestine is called peptic ulcer. The sore is a result of inflammation caused by the bacteria H.pylori or due to erosion from acids present in the stomach. Stomach pain is the most common symptom experienced by people suffering from peptic ulcer amongst others like bleeding, bloating, and rarely perforation.

What Are the Types of Peptic Ulcers?

Peptic ulcers are generally classified into two types:

  • Gastric ulcers - Ulcers present inside the stomach.
  • Duodenal ulcers - Ulcers that develop in the duodenum, that is the upper part of the small intestine.


What Are the Causes of Peptic Ulcers?

Normally, the digestive tract is covered with a protective mucous layer, that prevents the stomach acid from destroying the inner stomach lining. Conditions that cause an increase in the stomach acids and decreases the amount of mucus results in inflammation in the stomach. The excess acid destroys the mucus layer and eats away the stomach lining.

The common causes are as follows:

  • Helicobacter pylori (H.pylori) infection - More than half of the population has H.pylori living in the mucous layer of the stomach. It is harmless in most people, but in a few individuals, it increases the stomach acids causing inflammation and ulcer formation. The exact mode of transmission is still not known, but it is believed to spread through direct contact and contaminated food and water.
  • Indiscriminate use of painkillers - Frequent use of analgesics of the nonsteroidal anti-inflammatory drug (NSAIDs) group like Aspirin, Ibuprofen, Naproxen, and Ketoprofen can irritate or inflame the lining of the stomach.
  • Other Causes: Smoking, consuming too much alcohol, radiation therapy, too much stress, eating spicy food, family history of peptic ulcer, and stomach cancer can increase the risk of developing a peptic ulcer.

Some rare causes of peptic ulcers are:

  • Ulcer may develop after being very ill due to any infection or disease.
  • Due to medications such as steroids.
  • Ulcer may develop after surgery.
  • Ulcers can also develop due to Zollinger-Ellison syndrome which causes the formation of acid-producing cell tumors in the digestive tract. They cause severe damage to the stomach tissues, and these tumors can be cancerous or non-cancerous.

What Are the Symptoms of Peptic Ulcer?

Burning type of abdominal pain is the most common symptom of peptic ulcers. This pain radiates from the navel to the chest and varies from being mild to severe. Small ulcers do not produce any pain in the initial stages. The symptoms include:

  • Feeling bloated.
  • Belchings.
  • Nausea.
  • Vomiting.
  • Stools become black and tarry because of the presence of blood in them.
  • Loss of appetite.
  • Unexplained weight loss.
  • Chest pain.
  • Indigestion.

What Are the Risk Factors of Peptic Ulcers?

People with the following adverse habits are at risk of developing peptic ulcers.

  • Indiscriminate use of NSAIDs (painkillers).
  • Smoking.
  • Alcoholism.
  • Untreated stress.
  • Eating a lot of spicy food.

How Is Peptic Ulcer Diagnosed?

If the person experiences any of the above symptoms, they should consult a doctor. The doctor will ask about the symptoms and history, and if the doctor suspects a peptic ulcer, the person will have to undergo the following tests:

  • Upper GI (Gastrointestinal) Endoscopy - This test is not done for all suspected cases of ulcers but is done for people with a higher risk of stomach cancer, bleeding or symptoms not responding to usual medications. Here, the doctor inserts a long tube with a camera attached on one side (endoscope) through your mouth and throat, into the stomach. This will help the doctor to see the stomach and small intestine lining, and to visualize the ulcer. They can also collect tissue samples for testing.

  • Upper GI Series - Upper GI radiography is a real-time fluoroscopy technique that involves taking series of X-rays of the esophagus, stomach, and small intestine after the patient drinks a thick liquid called barium (barium swallow). This liquid coats the digestive tract, making the ulcer more visible.
  • Tests for Helicobacter pylori - The presence of H.pylori bacteria is tested in the biopsies from stomach (taken during endoscopy), blood, stool, or breath. Endoscopic biopsies are the gold standard for detection of H.pylori in stomach tissue. The breath test is the most accurate of them all. In the breath test, the patient is asked to drink or eat something that contains radioactive carbon. H.pylori breaks down the radioactive carbon that is released as carbon dioxide, the presence of which is tested in the breath.

How Is Peptic Ulcer Treated?

The treatment depends on the cause. The following treatments are used:

1) Medications:

  • Antibiotics are given to kill H.pyori in the stomach. The combination of antibiotics includes Amoxicillin, Clarithromycin, Metronidazole, Tinidazole, Tetracycline, and Levofloxacin.
  • Proton pump inhibitors (PPIs) are used to reduce the acid production in the stomach. Examples of PPIs are Omeprazole, Rabeprazole, Pantoprazole, Lansoprazole, and Esomeprazole.
  • Histamine (H2) blockers are used to block the cells that produce acids in the stomach. These medicines include Ranitidine, Famotidine, Cimetidine, and Nizatidine.
  • Antacids help in neutralizing the stomach acid and help in relieving the pain.
  • In a few cases, cytoprotective agents are given to protect the tissues in the lining of the stomach. Sucralfate and Misoprostol are the examples.

2) Home Remedies:

  • Consume a diet rich in vitamins, minerals, and proteins. Eat fruits, vegetables, and whole grains.
  • Avoid taking painkillers frequently. Talk to your doctor about taking Paracetamol instead.
  • Reduce stress by doing things you like, go out, talk to your friends, and exercise.
  • Avoid smoking and drinking alcohol.
  • Get enough sleep.

What Are the Complications of Peptic Ulcer?

It is essential to detect and treat ulcers as soon as possible because untreated ulcers can cause serious health complications like:

  • Bleeding from the ulcers can cause anemia and other emergency conditions. Blood transfusion might be required if there is a severe loss of blood. Signs of bleeding include blood in vomit, black stools, lightheadedness, and dizziness.
  • Sometimes, peptic ulcer can perforate the wall of the stomach. This puts you at risk of serious infections.
  • The scar tissue formation over an ulcer can obstruct the passage of food through the digestive tract.

All the above conditions are serious, so seek medical attention if you experience any of the following symptoms:

  • Sharp and sudden abdominal pain.
  • Fainting.
  • Profuse sweating.
  • Confusion.
  • Rigid abdomen.

How Can Peptic Ulcer Be Prevented?

A few alterations in your lifestyle and habits can reduce the risk of you developing peptic ulcers. The lifestyle changes and habits include:

  • Reduce the consumption of alcoholic beverages.
  • Do not consume alcohol when on any medication.
  • Limit the use of painkillers.

For many people treatments aim to target the underlying cause which helps in curing the ulcer disease. Ulcers can reoccur if the underlying cause is not completely cured or the person continues to smoke or use NSAIDs (nonsteroidal anti-inflammatory drugs).


Most peptic ulcers heal with proper care, but some ulcers, called refractory ulcers, do not heal with treatment. In such cases, your doctor will run additional tests to rule out stomach cancer and other gastrointestinal diseases. You can recover faster if you follow home remedies and preventive measures along with the prescribed medicines. A lot of medicines used in the treatment of other illnesses can increase the symptoms caused by a peptic ulcer, so always inform your treating doctor about the ulcer.

Frequently Asked Questions


How Do I Know If I Have a Peptic Ulcer?

The usual peptic ulcer sign or symptom is burning stomach pain. Here, the stomach acid makes the pain worse, as much as having an empty stomach. This pain can often be eliminated by consuming certain foods that buffer stomach acid or taking an acid-reducing medication. But, in the later period, this may come back.


What Is the Most Common Treatment for Peptic Ulcer?

The recommended remedy of peptic ulcers is a combination of medications to remove acid in your stomach and antibiotic drugs to kill the H. pylori bacteria. These typically include antibiotics like Amoxicillin and proton pump inhibitors like Omeprazole. You will take proton pump inhibitors for several weeks.


How Painful Is a Peptic Ulcer?

The usual peptic ulcer sign or symptom is burning stomach pain. Here, the stomach acid makes the pain worse, as much as having an empty stomach. In rare scenarios, these ulcers may lead to severe symptoms by causing vomiting or vomiting blood, which may appear black or red.


What Should I Not Eat With Stomach Ulcers?

Foods that must be limited or avoided during peptic ulcer are:
- Chocolate.
- Coffee.
- Alcohol.
- Spicy food.
- Caffeine.
- Acidic foods, such as tomatoes and citrus.


How Are Peptic Ulcers Treated?

Treatment for peptic ulcers purely depends on the cause. Usually, the treatment involves killing the H. pylori bacterium, if present, reducing or eliminating the use of NSAIDs, and helping the ulcer heal with medication. However, the patients must consult with their doctor or healthcare advisor for proper treatment.


Is Garlic Good for a Peptic Ulcer?

Having two cloves of raw garlic per day for three consecutive days will help to decrease bacterial action in the stomach lining of patients who are suffering from H. pylori infection. Garlic has antibacterial and antimicrobial properties that will help prevent ulcers and heal them quickly.


What Are Ulcer Healing Drugs?

Below are certain medications that are used to heal ulcers; they are:
- Proton pump inhibitors (PPIs).
- Antibiotics.
- Histamine-2 receptor antagonists.
- Cytoprotective agents.


How Does Peptic Ulcer Affect the Digestive System?

Ulcers sometimes cause swelling and scarring of the tissues in the small intestine. It can also cause edema. It may prevent food from easily passing out of the stomach. This blockage may cause nausea, bloating, or vomiting after eating.


Is Peptic Ulcer Curable?

Stomach ulcers might be easily cured with adequate treatment, but they are capable of becoming severe without proper treatment. Uncomplicated gastric ulcers can take a period of two to three months to heal. Duodenal ulcers usually take a period of about six weeks to heal. However, an ulcer is capable of temporarily healing without the use of any antibiotics.


Who Is Most Likely to Get Peptic Ulcers?

Peptic ulcer disease is more common with the following people.
- Those who are infected with the Helicobacter pylori bacterium.
- Those who intake NSAIDs like Aspirin, Ibuprofen, Naproxen ,etc.
- Those who have a strong family history of ulcers.
- Those who smoke.
- Those who have comorbidities, such as liver, kidney, or lung disease.
- Chronic alcoholics.


How Long Do Peptic Ulcers Take to Heal?

Uncomplicated gastric ulcers usually take a period of two or three months to heal adequately. Duodenal ulcers will take a period of six weeks to heal. An ulcer is also capable of temporarily healing without antibiotics. However, it is common for any ulcer to recur again, or also another ulcer can form nearby to the previous ulcer if the bacteria are not eradicated.


What Is the Difference Between a Gastric Ulcer and a Peptic Ulcer?

A peptic ulcer is defined as a sore that is seen on the lining of the stomach or at the first portion of the person's small intestine, which is known as the duodenum. If the ulcer is at the stomach, it is then called a gastric ulcer. If the ulcer is at the duodenum, then it is known as a duodenal ulcer.


Is Ginger Good for Peptic Ulcers?

A study has proven that ginger can help in treating gastric ulcers, which are caused by Helicobacter pylori bacteria. Intake of ginger is also capable of preventing ulcers caused by NSAIDs. Along with ginger intake of raw garlic can also help in reducing the bacteria at the stomach and duodenum.


How to Treat a Peptic Ulcer at Home?

Peptic ulcers can be treated and prevented at home by choosing a healthy diet, Consuming foods that contain probiotics. Avoid the intake of milk. During severe flare-ups of the ulcer, do switch pain relievers apart from the NSAIDs group of drugs. Control and mindfully manage stress. Do not smoke also limit or completely avoid alcohol consumption. Always get an adequate amount of sleep.


Which Medication for Peptic Ulcer Disease Causes Hallucinations?

The following are the medications prescribed for peptic ulcer disease that are known to cause hallucinations
1. Nizatidine.
2. Sucralfate.
3. Omeprazole.
4. Metoclopramide.


What Is the Management of Peptic Ulcer?

Treatment for peptic ulcer disease solely depends on the cause of the disease. Normally treatment will focus on eradicating the H. pylori bacterium. If it is the cause present, the next best step in management is by eliminating or reducing the use of NSAIDs. Both these steps in management help the ulcer to heal with appropriate medication.


How Long Does It Take for a Stomach Ulcer to Go Away?

Non-complicated gastric ulcers can take up to two to three months to heal. Duodenal ulcers, however, take a shorter period of about six weeks to heal. An ulcer is able to temporarily suppress even without antibiotics. However, it is usual for an ulcer to occur again at a site near to the old ulcer, especially if the bacteria are not killed.


What Is the Fastest Way to Cure a Peptic Ulcer?

The fastest way to cure a peptic ulcer is by following measures in addition to proper medical treatment
- Choosing a healthy diet profile.
- Intake of foods that contain probiotics.
- Eliminating the intake of milk.
- Switching pain relievers and eliminating the intake of NSAIDs.
- Control stressful conditions.
- Quit smoking.
- Limiting or avoiding alcohol intake.
- Get enough quality of sleep.


What Is the Most Common Type of Peptic Ulcer?

There are two common types of peptic ulcers, and those are gastric ulcers and duodenal ulcers. If the peptic ulcer develops in the small intestine, then it is called in medical terms as a duodenal ulcer. If the peptic ulcer occurs in the stomach, it is called a gastric ulcer.


What Are the Complications of Peptic Ulcer?

Complications of peptic ulcers may include the following.
- Profuse bleeding.
- Perforation of the mucosal layer.
- Penetration that needs surgical correction.
- Obstruction of the gastric or duodenal lumen.


What Is the Prognosis of Peptic Ulcer?

When the underlying cause of peptic ulcer disease is treated properly with medicines, the prognosis of the disease is usually excellent. Most of the patients are treated completely with the eradication of the Helicobacter pylori infection, elimination of nonsteroidal anti-inflammatory agents like Aspirin and Naproxen that are used to treat any other conditions must be done if possible, and the appropriate use of antisecretory therapy increases the prognosis of peptic ulcer disease.


What Drink Is Good for Ulcers?

Any form of cranberry juice or raw fruit is known to fight the Helicobacter pylori infection. It is always good to avoid alcohol, tea, and caffeine-containing beverages.
Dr. Zubin Dev Sharma
Dr. Zubin Dev Sharma

Medical Gastroenterology


helicobacter pyloriacid refluxheartburnpeptic ulcer
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