Peptic Ulcer Disease
(Stomach Ulcers · Ulcers · Gastric Ulcers · Duodenal Ulcers)
In this condition factsheet:
Diagnosing Peptic Ulcer Disease
If you have the typical symptoms of PUD, your doctor will perform a physical exam and may order one or more of the following tests:
A breath test (drinking a fluid and exhaling into a tube), blood test, or stool test may be used to check for H. pylori infection. If you have H. pylori, treatment may be given to cure the infection without the need for more invasive tests.
A series of GI (gastrointestinal) X-rays may be done. These are X-rays of your stomach, duodenum, and esophagus (the swallowing tube). To make the ulcer easier for the doctor to see, you'll first need to swallow a chalky liquid called barium.
Endoscopy is another test used to detect ulcers. After numbing the throat, the doctor carefully guides a thin tube with a tiny camera on its end into the mouth and down the throat to get close-up pictures of the esophagus, stomach, and duodenum. A doctor can do a biopsy during the endoscopy to confirm the presence of H. pylori and whether the ulcer is cancerous.
If ulcers are detected by these tests, then appropriate treatment will be prescribed.
Finally, all people older than 55 years who, for the first time, show symptoms suggestive of a stomach acid-related disorder, and anyone of any age with "alarm" features such as vomiting, bleeding, anemia, an abdominal mass, unexplained weight loss, or trouble swallowing should have an endoscopy to identify the cause quickly and to rule out cancer.
Treating and Preventing Peptic Ulcer Disease
Medical treatment focuses on eliminating the H. pylori bacteria in people where it has been detected. The majority of peptic ulcers caused by H. pylori can be cured with a combination of antibiotics, antacids (bismuth subsalicylate), and proton pump inhibitors (PPIs; e.g., omeprazole, lansoprazole, esomeprazole, pantoprazole, rabeprazole).
Other combinations may also be used (e.g., 2 antibiotics and a PPI without bismuth subsalicylate) to treat H. pylori induced ulcers. There are several different combinations, but most of them require taking medications for 14 days. For some people, several courses of treatment may be needed to get rid of H. pylori. In this case, at least one of the antibiotics will be different from the initial combination used.. Follow-up testing to make sure H. pylori is cleared can be done through the breath test or checking the stool.
When an ulcer is not associated with H. pylori or is caused by NSAIDs, treatment with a PPI is prescribed for 4 to 8 weeks. Some people may need to continue treatment for longer periods of time. Another type of acid reducer, H2-antagonists (e.g., ranitidine, nizatidine), may also be used.
If the peptic ulcer was caused by NSAIDs, such as ASA, your doctor will most often recommend that you stop taking them if possible. Some people are more susceptible to peptic ulcers caused by NSAIDs, including those who:
- are seniors
- are smokers
- have a history of a peptic ulcer
- are also taking glucocorticoids (e.g., prednisone, dexamethasone)
- are taking high doses of NSAIDs or ASA
- have several medical conditions
- are taking more than one NSAID or ASA
If you're taking a NSAID and have one of these risk factors, your doctor may prescribe a protective medication to take along with it. Acid-suppressing medications (e.g., PPIs) or misoprostol may be used for this. Misoprostol encourages the stomach to produce its protective mucus coating and improves blood flow.
It's important for people with PUD to quit smoking. Smoking can delay healing and can cause ulcers to return.
Very rarely, surgical treatment may be needed for PUD and its complications.
*All medications have both common (generic) and brand names. The brand name is what a specific manufacturer calls the product (e.g., Tylenol®). The common name is the medical name for the medication (e.g., acetaminophen). A medication may have many brand names, but only one common name. This article lists medications by their common names. For information on a given medication, check our Drug Information database. For more information on brand names, speak with your doctor or pharmacist.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Peptic-Ulcer-Disease
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