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Peptic ulcer

• Overview
• Symptoms
• Treatment
• Prevention

Alternative Names:

Ulcer - peptic; Ulcer - duodenal or gastric; Duodenal ulcer

Treatment:

You should see a doctor if you have symptoms of an ulcer. Treatment often involves a combination of medications to kill the Helicobacter pylori bacteria, reduce acid levels, and protect the GI tract. This combination strategy allows your ulcer to heal and reduces the chance it will come back. Take all of your medications exactly as prescribed.

The medications may include one or more of the following:

• Antibiotics to kill Helicobacter pylori
• Acid blockers (like cimetidine, ranitidine, or famotidine)
• Proton pump inhibitors (such as omeprazole)
• Medications that protect the tissue lining (like sucralfate)
• Bismuth (may help protect the lining and kill the bacteria)

If a peptic ulcer bleeds a lot, an EGD may be needed to stop the bleeding. If bleeding cannot be stopped using an EGD procedure or the ulcer has caused a perforation, then surgery may be required.

Expectations (prognosis):

Peptic ulcers tend to come back if untreated. If you follow the treatment instructions from your doctor and take all of your medications, the Helicobacter pylori infection will be eliminated and you are much less likely to get another ulcer. Your symptoms will also improve if you follow some preventive lifestyle steps.

Complications:

• Bleeding internally
• Perforation of the intestine and peritonitis
• Bowel obstruction

Calling your health care provider:

Call 911 if you:

• Suddenly develop sharp abdominal pain.
• Have symptoms of shock like fainting, excessive sweating, or confusion.
• Are vomiting blood or have blood in your stool (especially if maroon or dark, tarry black)
• Have a rigid, hard abdomen that is tender to touch.

Call your doctor if:

• You have ulcer symptoms.
• You feel dizzy or lightheaded.

References:

Spechler, SJ. Peptic Ulcers. In: Feldman, M, Friedman, LS, Sleisenger, MH, eds. Gastrointestinal and Liver Disease , 7th ed. Philadelphia, PA; WB Saunders Company; 2002:747-772.

Noble J. Textbook of Primary Care Medicine . 3rd ed. St. Louis, MO: Mosby; 2001:910-918.

Mahachai V, Thomson AB, Vilaichone RK. Effect of Helicobacter pylori infection and NSAIDs on the risk of peptic ulcer bleeding. J Med Assoc Thai . 2004 Sep;87 Suppl 2:S295-9. Review.

• Review Date: 5/3/2007
• Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Jefferson Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network.

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