What causes peptic ulcers? What are the symptoms of peptic ulcers? How are peptic ulcers diagnosed and treated?

Understanding Peptic Ulcers

A peptic ulcer is a sore or lesion that forms in the lining of the stomach or the first part of the small intestine, known as the duodenum. These ulcers are caused by an imbalance between the digestive acids produced by the stomach and the protective mechanisms that normally shield the stomach and duodenal lining.

Common Causes of Peptic Ulcers

The two most common causes of peptic ulcers are:

1. Helicobacter pylori (H. pylori) infection: H. pylori is a type of bacteria that can infect the stomach and cause inflammation, leading to the development of peptic ulcers. It is present in 50-70% of people with duodenal ulcers and 30-50% of those with stomach ulcers.
2. Use of nonsteroidal anti-inflammatory drugs (NSAIDs): Medications such as aspirin, ibuprofen, and naproxen can weaken the protective lining of the stomach and duodenum, making them more susceptible to damage from stomach acid.

Other Factors that Contribute to Peptic Ulcers

While H. pylori infection and NSAID use are the primary causes, other factors can also play a role in the development of peptic ulcers:

• Smoking: People who smoke are more likely to develop peptic ulcers, and their ulcers tend to heal more slowly and are more likely to recur.
• Alcohol: Although alcohol can increase stomach acid production, moderate alcohol consumption does not appear to directly cause peptic ulcers or delay their healing.
• Stress: There is some evidence that high levels of stress can contribute to the development of peptic ulcers, particularly in the context of severe illness, injury, or traumatic events.
• Genetics: Individuals with a family history of peptic ulcer disease are more likely to develop the condition themselves, especially in the case of duodenal ulcers.

Symptoms of Peptic Ulcers

The symptoms of peptic ulcers can vary depending on the location of the ulcer and the individual’s age. Common symptoms include:

• Abdominal pain or discomfort, which may be worse on an empty stomach or improved after eating
• Nausea or vomiting
• Bloating or a feeling of fullness
• Loss of appetite
• Unexplained weight loss

It’s important to note that some individuals, particularly older adults, may experience atypical or no symptoms at all, making the diagnosis more challenging.

Diagnosing Peptic Ulcers

To diagnose a peptic ulcer, healthcare providers typically perform the following:

1. Medical history and physical examination: The healthcare provider will ask about the patient’s symptoms and medical history to determine the likely cause of the ulcer.
2. Upper endoscopy: This procedure involves inserting a flexible, lighted tube with a camera (endoscope) down the throat and into the stomach and duodenum to visually inspect the lining and identify any ulcers.
3. Helicobacter pylori testing: The healthcare provider may order a test to detect the presence of H. pylori bacteria, which can be done through a blood, breath, or stool test.

Treating Peptic Ulcers

The treatment for peptic ulcers typically involves a combination of medications and lifestyle changes:

• Medications: Healthcare providers may prescribe medications to reduce stomach acid production, such as proton pump inhibitors (PPIs) or histamine-2 (H2) blockers. If H. pylori is present, antibiotics may also be prescribed to eradicate the infection.
• Lifestyle changes: Patients may be advised to avoid irritants like NSAIDs, quit smoking, and reduce stress levels, as these factors can contribute to the development and recurrence of peptic ulcers.

With appropriate treatment, most peptic ulcers can heal within 4 to 8 weeks. However, it’s important to follow the healthcare provider’s recommendations to prevent the ulcer from returning.

Preventing Peptic Ulcers

To help prevent the development of peptic ulcers, individuals can take the following steps:

• Avoid or limit the use of NSAIDs, especially if you have a history of peptic ulcers
• Quit smoking and limit alcohol consumption
• Manage stress through relaxation techniques, exercise, and other healthy coping mechanisms
• Maintain a balanced and nutrient-rich diet

By understanding the causes, symptoms, and management of peptic ulcers, individuals can take proactive steps to prevent and address this common digestive health issue.