Diagnosing A Condition With Abdominal Pain, Vomiting, Headache
Peptic Ulcers – Causes, Symptoms, Diagnosis, and Treatment
Introduction
Peptic ulcers are open sores that develop on the inner lining of the stomach, the upper part of the small intestine (duodenum), or occasionally in the esophagus. These sores occur when the protective mucous layer that shields the digestive tract from stomach acid becomes damaged, allowing acid to erode the underlying tissue. Peptic ulcers are a common gastrointestinal problem that can range from mild discomfort to life-threatening complications if left untreated.
Types of Peptic Ulcers
Peptic ulcers are categorized based on their location:
- Gastric ulcers – Form inside the stomach lining.
- Duodenal ulcers – Occur in the upper part of the small intestine (duodenum).
- Esophageal ulcers – Develop in the lower part of the esophagus, often due to acid reflux.
Causes and Risk Factors
The most common causes include:
- Helicobacter pylori (H. pylori) infection – A spiral-shaped bacterium that damages the mucosal lining, making it more susceptible to acid.
- Long-term NSAID use – Medications such as ibuprofen, aspirin, and naproxen can irritate the stomach lining.
- Excess stomach acid production – Conditions like Zollinger-Ellison syndrome can lead to excessive acid secretion.
- Lifestyle factors – Smoking, excessive alcohol intake, chronic stress, and spicy foods may worsen symptoms (though not primary causes).
Signs and Symptoms
Peptic ulcers may present with varying symptoms depending on severity and location. Common signs include:
- Burning or gnawing abdominal pain – Often between the navel and breastbone, worse when the stomach is empty.
- Bloating and belching
- Heartburn or acid reflux
- Nausea and vomiting
- Loss of appetite or unintended weight loss
Severe symptoms (requiring urgent medical attention) include:
- Vomiting blood (may look like coffee grounds)
- Black, tarry stools
- Sudden, severe abdominal pain
Complications
If untreated, peptic ulcers can cause:
- Bleeding – The most common complication.
- Perforation – A hole in the stomach or duodenal wall, leading to peritonitis.
- Gastric outlet obstruction – Swelling or scarring blocking food passage.
Diagnosis
Doctors may use a combination of methods to confirm a diagnosis:
- Endoscopy – Direct visualization of the ulcer using a flexible camera.
- H. pylori testing – Through breath, stool, or biopsy tests.
- Barium swallow X-ray – Imaging after drinking a contrast liquid.
Treatment
The primary goals of treatment are to relieve symptoms, heal the ulcer, and prevent recurrence.
- Antibiotics – To eradicate H. pylori infection.
- Proton Pump Inhibitors (PPIs) – Such as omeprazole, to reduce stomach acid.
- H2-receptor blockers – Such as ranitidine or famotidine, to decrease acid production.
- Antacids and cytoprotective agents – To protect the stomach lining and neutralize acid.
- Lifestyle changes – Avoiding smoking, limiting alcohol, reducing NSAID use, and eating balanced meals.
Prevention
- Wash hands frequently and eat properly cooked food to prevent H. pylori infection.
- Limit long-term NSAID use; if needed, take them with meals and protective medication.
- Manage stress and avoid irritant foods if they worsen symptoms.
- Avoid excessive alcohol and smoking.
Prognosis
With proper treatment, most peptic ulcers heal completely within a few weeks. However, recurrence is possible if the underlying cause is not addressed—especially in cases of H. pylori infection or continued NSAID use.
Conclusion
Peptic ulcers remain a common but treatable condition. Advances in medical therapy, particularly the understanding of H. pylori’s role, have dramatically improved outcomes. Early diagnosis and proper management are essential to avoid serious complications and improve quality of life. Maintaining healthy lifestyle habits and adhering to treatment plans are key to preventing ulcer recurrence.
