Peptic Ulcer

Medically Reviewed By William C. Lloyd III, MD, FACS

What is a peptic ulcer?

A peptic ulcer is a localized area of erosion occurring in the stomach or duodenal (the beginning of the small intestine) lining, resulting in abdominal pain, possible bleeding, and other gastrointestinal symptoms. The most common cause of peptic ulcer disease is a stomach infection associated with the Helicobacter pylori (H. pylori) bacteria. Many people contract H. pylori at a young age, but symptoms most commonly occur in adulthood.

In some people, H. pylori bacteria cause an infection in the lining of the stomach, which may lead to peptic ulcers. Damage to the stomach lining from stomach acid increases the likelihood that H. pylori infection will result in an ulcer. Other risk factors for peptic ulcer disease include alcohol use, tobacco use, and medications, such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDS). Severe illness has also been associated with development of peptic ulcers.

The signs and symptoms of peptic ulcer disease can be constant or sporadic, and the disease course varies among individuals. If infection with H. pylori bacteria is the cause, the symptoms will remain as long as the infection is untreated. Some people with peptic ulcers have no symptoms at all, while others may have burning pain, severe nausea, and vomiting.

In the case of H. pylori-related peptic ulcers, the infection can be treated successfully with antibiotics. For peptic ulcers not related to H. pylori, antacids and other medications are an effective treatment. You can reduce your risk of H. pylori bacteria infection by following commonsense hygiene practices, such as washing your hands with soap and water before preparing food and after handling dirty diapers or using the bathroom.

Seek immediate medical care (call 911) for serious symptoms such as severe abdominal pain; bloody or black tarry stools; or vomiting blood or black material (resembling coffee grounds).

Seek prompt medical care if you are being treated for peptic ulcer but mild symptoms recur or are persistent.

What are the symptoms of a peptic ulcer?

Peptic ulcer disease involves inflammation and damage to the stomach lining that may result in a number of symptoms. The symptoms can vary in intensity among individuals.

Common symptoms of peptic ulcer

You may experience peptic ulcer symptoms daily or just once in a while. At times any of these common symptoms can be severe:

Serious symptoms that might indicate a life-threatening condition

In some cases, peptic ulcer can be life-threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bloody stool (blood may be red, black, or tarry in texture)
  • Severe abdominal pain
  • Vomiting blood or black material (resembling coffee grounds)

What causes peptic ulcer disease?

The most common cause of peptic ulcer disease is infection with the H. pylori bacteria. Other causes of peptic ulcers include alcohol use, tobacco use, and prolonged use of medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) that can damage the lining of the stomach and duodenum. Severe illness and radiation therapy may also be associated with peptic ulcers.

What are the risk factors for peptic ulcer disease?

A number of factors increase the risk of developing peptic ulcers. Not all people with risk factors will get peptic ulcers. Risk factors for peptic ulcers include:

  • Alcohol abuse
  • Helicobacter pylori bacterial infection
  • History of radiation therapy
  • Regularly taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), or aspirin
  • Stress or severe illness
  • Tobacco use

Reducing your risk of peptic ulcer disease

  • Not drinking alcohol or limiting alcohol intake to no more than two drinks per day for a man and one drink per day for a woman
  • Not using or minimizing the use of nonsteroidal anti-inflammatory medications
  • Not using tobacco products
  • Regular medical care

How are peptic ulcers treated?

Treatment for peptic ulcers begins with seeking medical care from your healthcare provider. To determine if you have a peptic ulcer, your healthcare provider may ask you to undergo diagnostic tests.

Antibiotic treatments for peptic ulcer

If your peptic ulcer is caused by H. pylori infection, antibiotic therapy is the mainstay of treatment. It is important to follow your antibiotic regimen precisely to avoid re-infection or recurrence. Most commonly, two antibiotics are given for 14 days. Examples of antibiotic treatments include:

  • Amoxicillin
  • Clarithromycin (Biaxin)
  • Metronidazole (Flagyl)
  • Tetracycline

Other medications to treat peptic ulcer disease

Medications such as proton pump inhibitors and histamine H2-receptor antagonists, which decrease the amount of acid in the stomach, can also be effective treatments for peptic ulcers.

Proton pump inhibitors that are effective in the treatment of peptic ulcers include:

  • Esomeprazole (Nexium)
  • Lansoprazole (Prevacid)
  • Omeprazole (Prilosec)
  • Pantoprazole (Protonix)
  • Rabeprazole (Aciphex)

Histamine H2-receptor antagonists that are effective in the treatment of peptic ulcers include:

  • Cimetidine (Tagamet)
  • Famotidine (Pepcid)
  • Nizatidine (Axid)
  • Ranitidine (Zantac)

If you have diarrhea and vomiting, fluid and electrolyte replenishment is also a component of successful treatment.

What are the potential complications of peptic ulcer?

You can help minimize your risk of serious complications of peptic ulcer disease by following the treatment plan you and your healthcare provider decide on. Complications of peptic ulcer disease include:

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  1. Peptic ulcer. PubMed Health. Accessed May 6, 2011.
  2. Helicobacter pylori and peptic ulcer disease. Centers for Disease Control and Prevention. Accessed May 6, 2011.
Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 16
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