Peptic ulcer Health Article

Symptoms

Small ulcers may not cause any symptoms. Some ulcers can cause serious bleeding.

Abdominal pain is a common symptom but it doesn't always occur. The pain can differ a lot from person to person.

• Feeling of fullness -- unable to drink as much fluid
• Hunger and an empty feeling in the stomach, often 1 - 3 hours after a meal
• Mild nausea (vomiting may relieve symptom)
• Pain or discomfort in the upper abdomen
• Upper abdominal pain that wakes you up at night

Other possible symptoms include:

• Bloody or dark tarry stools
• Chest pain
• Fatigue
• Vomiting, possibly bloody
• Weight loss

Signs and tests

To diagnose an ulcer, your doctor will order one of the following tests:

• Esophagogastroduodenoscopy (EGD) is a special test performed by a gastroenterologist in which a thin tube with a camera on the end is inserted through your mouth into the GI tract to see your stomach and small intestine. During an EGD, the doctor may take a biopsy from the wall of your stomach to test for H. pylori.
• Upper GI is a series of x-rays taken after you drink a thick substance called barium.

Your doctor may also order these tests:

• Hemoglobin blood test to check for anemia
• Stool guaiac to test for blood in your stool

Treatment

Treatment involves a combination of medications to kill the H. pylori bacteria (if present), and reduce acid levels in the stomach. This strategy allows your ulcer to heal and reduces the chance it will come back.

Take all of your medications exactly as prescribed.

If you have a peptic ulcer with an H. pylori infection, the standard treatment uses different combinations of the following medications for 5 - 14 days:

• Two different antibiotics to kill H. pylori, such as clarithromycin (Biaxin), amoxicillin, tetracycline, or metronidazole (Flagyl)
• Proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium)
• Bismuth (the main ingredient in Pepto-Bismol) may be added to help kill the bacteria

If you have an ulcer without an H. pylori infection, or one that is caused by taking aspirin or NSAIDs, your doctor will likely prescribe a proton pump inhibitor for 8 weeks.

You may also be prescribed this type of medicine if you must continue taking aspirin or NSAIDs for other health conditions.

Other medications that may be used for ulcer symptoms or disease are:

• Misoprostol, a drug that may help prevent ulcers in people who take NSAIDs on a regular basis
• Medications that protect the tissue lining (such as sucralfate)

If a peptic ulcer bleeds a lot, an EGD may be needed to stop the bleeding. Surgery may be needed if bleeding cannot be stopped with an EGD, or if the ulcer has caused a perforation.