Table of Contents
Peptic Ulcer Disease Definition
Peptic Ulcer Disease – a condition in which ulcers form in the lining (mucosa) of the lower STOMACH and upper DUODENUM (first segment of the SMALL INTESTINE). The two most common causes of peptic ulcer disease are INFECTION with HELICOBACTER PYLORI and chronic or long-term use of NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS). Peptic ulcer disease affects millions of Americans. In most situations, appropriate treatment cures the condition.
Symptoms of Peptic Ulcer Disease and Diagnostic Path
The symptoms of peptic ulcer disease range from mild and intermittent to severe and unrelenting. Severe symptoms suggest a perforated ulcer, which carries the risks of bleeding and infection. A perforated ulcer requires immediate medical attention.
Typical symptoms of peptic ulcer disease include
- DYSPEPSIA (heartburn or stomach upset), commonly occurring one to three hours after eating or at night
- NAUSEA and VOMITING
- GASTROINTESTINAL BLEEDING
- loss of APPETITE or intolerance for spicy or fatty foods
- unintended weight loss
Symptoms typically improve with ANTACIDS or acid-reducing medications. Some people experience CHEST PAIN mistaken for HEART ATTACK. ENDOSCOPY to examine the ESOPHAGUS, stomach, and duodenum often makes the diagnosis, allowing the gastroenterologist to visualize the ulcers and extent of damage. Biopsy of a tissue sample or an urea breath test can determine whether H. pylori infection is present.
Peptic Ulcer Disease Treatment Options and Outlook
H. pylori infection accounts for nearly 80 percent of peptic ulcer disease. Treatment with appropriate ANTIBIOTIC MEDICATIONS to eradicate the BACTERIA allows the ulcers to heal. Chronic NSAID use is the second-most common cause of peptic ulcer disease; ulcers typically heal when the person stops taking the NSAID. Regardless of cause, the treatment of choice for peptic ulcer disease is acidreducing medication to decrease irritation to the damaged tissue.
Gastroenterologists typically prescribe H2 ANTAGONIST (BLOCKER) MEDICATIONS or PROTON PUMP INHIBITOR (PPI) MEDICATIONS for this purpose. After the ulcers heal, most people no longer need to take the medication. Severe ulcers may require surgery, particularly if they are bleeding. The primary complication of peptic ulcer disease is perforation (an ulcer that “eats through” or penetrates the wall of the duodenum or stomach), which can result in life-threatening bleeding and usually requires surgery. There also is some evidence linking long-term peptic ulcer disease, particularly that resulting from H. pylori infection, with an increased risk for STOMACH CANCER.
Risk Factors and Preventive Measures
Doctors once believed stress was the primary cause of peptic ulcer disease, though now know this is not the case. The causes of peptic ulcer disease, are largely treatable (H. pylori infection) or preventable (NSAID overuse).