Peptic Ulcer

Peptic Ulcer

Last Reviewed : 12/24/2020
Peptic Ulcer

Peptic ulcer disease (PUD), also known as a peptic ulcer or stomach ulcer, is a break in the lining of the stomach, first part of the small intestine, or occasionally the lower esophagus. An ulcer in the stomach is known as a gastric ulcer while that in the first part of the intestines is known as a duodenal ulcer. The most common symptoms are waking at night with upper abdominal pain or upper abdominal pain that improves with eating. The pain is often described as a burning or dull ache. Other symptoms include belching, vomiting, weight loss, or poor appetite. About a third of older people have no symptoms. Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of people.

Common causes include the bacteria Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs). Other less common causes include tobacco smoking, stress due to serious illness, Behcet disease, Zollinger-Ellison syndrome, Crohn disease and liver cirrhosis, among others. Older people are more sensitive to the ulcer causing effects of NSAIDs. The diagnosis is typically suspected due to the presenting symptoms with confirmation by either endoscopy or barium swallow. H. pylori can be diagnosed by testing the blood for antibodies, a urea breath test, testing the stool for signs of the bacteria, or a biopsy of the stomach. Other conditions that produce similar symptoms include stomach cancer, coronary heart disease, and inflammation of the stomach lining or gallbladder.

Diet does not play an important role in either causing or preventing ulcers. Treatment includes stopping smoking, stopping NSAIDs, stopping alcohol, and medications to decrease stomach acid. The medication used to decrease acid is usually either a proton pump inhibitor (PPI) or an H2 blocker with four weeks of treatment initially recommended. Ulcers due to H. pylori are treated with a combination of medications such as amoxicillin, clarithromycin, and a PPI. Antibiotic resistance is increasing and thus treatment may not always be effective. Bleeding ulcers may be treated by endoscopy, with open surgery typically only used in cases in which it is not successful.

Peptic ulcers are present in around 4% of the population. They newly began in around 53 million people in 2013. About 10% of people develop a peptic ulcer at some point in their life. They resulted in 301,000 deaths in 2013 down from 327,000 deaths in 1990. The first description of a perforated peptic ulcer was in 1670 in Princess Henrietta of England. H. pylori was first identified as causing peptic ulcers by Barry Marshall and Robin Warren in the late 20th century, a discovery for which they received the Nobel Prize in 2005.

We researched this topic for you and found the following best online resources. They are categorized into basic, advanced, and research level based on the extent of information you need. You will be taken to the respective websites by pressing on the links below.



Basic information: web md what is peptic ulcer disease? medline plus peptic ulcer health line what is a stomach ulcer? health line peptic ulcer american college of gastroenterology peptic ulcer mayoclinic peptic ulcer merck manuals(professional version) peptic ulcer disease better health peptic ulcer kids health peptic ulcer university of maryland medical center peptic ulcer net doctor peptic ulcer cleveland clinic peptic ulcer bupa peptic ulcer everyday health peptic ulcer live science stomach ulcers: causes, symptoms & treatments healthy children peptic-ulcers


Advanced information: emedicine health peptic ulcer medicine net peptic ulcer patient stomach (gastric) ulcer medscape peptic ulcer medical news today what is a peptic ulcer? what causes peptic ulcers? newyork times gastric ulcer in-depth report radiopedia peptic ulcer disease upto date patient information: peptic ulcer disease (beyond the basics) peptic ulcer disease by kalyanakrishnan ramakrishnan, md, frcse, and robert c. salinas, md, university of oklahoma health sciences center, oklahoma city, oklahoma am fam physician. 2007 oct 1;76(7):1005-1012.


Research: issn 2278- 4136 zdb-number: 2668735-5 ic journal no: 8192 volume 2 issue 1 online available at journal of pharmacognosy and phytochemistry vol. 2 no. 1 2013 page | 235 a review on medicinal plants with anti-ulcer activity by rahul a. wandre et al., helicobacter pylori and gastroduodenal pathology: new threats of the old friend by niyaz ahmed and leonardo a sechi annals of clinical microbiology and antimicrobials20054:1 doi: 10.1186/1476-0711-4-1

al dhahab h, mcnabb-baltar j, al-taweel t, barkun a. state-of-the-art management of acute bleeding peptic ulcer disease. saudi j gastroenterol [serial online] 2013 [cited 2016 jul 1];19:195-204. available from: : ponce j, calvet x, gallach m, ponce m, the esophagitis study group of the asociacio´n espan˜ola de gastroenterologi´a (aeg) (2011) esophagitis in a high h. pylori prevalence area: severe disease is rare but concomitant peptic ulcer is frequent. plos one 6(10): e25051. doi:10.1371/journal.pone.0025051 graziella guariso and marco gasparetto, “update on peptic ulcers in the pediatric age,” ulcers, vol. 2012, article id 896509, 9 pages, 2012. doi:10.1155/2012/896509 molecules 2008, 13(12), 3198-3223; doi:10.3390/molecules13123198 review:gastric and duodenal antiulcer activity of alkaloids: a review by heloina de sousa falcão et al., nonoperative management for perforated peptic ulcer: who can benefit? by feng cao et al., asian journal of surgery volume 37, issue 3, july 2014, pages 148–153 doi:10.1016/j.asjsur.2013.10.002 psychosocial factors in peptic ulcer and inflammatory bowel disease by susan levenstein journal of consulting and clinical psychology, inc. 2002, vol. 70, no. 3, 739–750


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Other articles: parrah jd, moulvi ba, gazi ma, makhdoomi dm, athar h, dar s and mir aq (2013) gastric ulceration in dog: a review, world 6(7):449-454, doi:10.5455/vetworld.2013.449-454


Related videos: peptic ulcer disease pathophysiology how a peptic ulcer develops peptic ulcer disease explained (usmle tutorial) peptic ulcer 3d animation - medical videos 11 home remedies for peptic ulcer peptic ulcer disease and h. pylori


Presentations/quiz/newspaper articles: daily mail why milk isn't the answer for stomach ulcers by dr john briffa, daily mail

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