Peptic Ulcer

Peptic Ulcer is the ulceration (erosion) of the lining of the stomach and small intestine, leading to sore formation. 

When the ulcer is present in the stomach, it is called gastric ulcers. When it is present in the intestine, it is called duodenal ulcer because the ulcer is located in the duodenum, which is the first part of the small intestine.

The presentation of Gastric ulcers is different from Duodenal ulcers due to the location of the ulcer. 

Why does ulcer occur in the stomach? The stomach lining is protected from the gastric acid (hydrochloric acids) with a layer of mucus by prostaglandins produced by COX-1. Anything that interferes with the protective layer or the prostaglandins from being produce will cause the harsh hydrochloric acids to deal directly with the stomach lining leading to erosions of the lining, which is an ulcer.

We at Mayor Boss support healthy well-being, so we’ve decided to share with you the symptoms and everything you need to know about Peptic Ulcer.  

We have a lot of things to discuss, so let’s jump right in.

Peptic Ulcer symptoms

Here are symptoms specific to duodenal ulcer:

  • Upper abdominal pain (epigastric pain)that gets better with food but pain appears about 3 hours later after meal
  • Abdominal pain at night that interrupts sleep
  • Weight gain
  • Dark stool as a result of bleeding which is a complication of peptic ulcer
  • Diarrhea

Here are symptoms specific to stomach ulcer:

  • Burning or dull Abdominal pain that gets worse with meals and last longer than 30minutes
  • Abdominal pain does not interrupt sleep
  • Weight loss/ problems eating due to fear of pain
  • Nausea and vomiting
  • Belching
  • Bloating and having a stuffed feeling
  • Heartburn which is burning feeling in the chest  
  • Constipation

A peptic ulcer is triggered by so many factors, some of which are preventable. 

How is peptic ulcer caused?

Causes of Peptic ulcer are:

  • Long term use of NSAIDs (nonsteroidal anti-inflammatory drugs): They block COX-1, therefore, prevents the production of prostaglandins
  • Bacterium Helicobacter pylori( The primary cause of peptic ulcer)
  • Stress ulcers: are not ulcers gotten from mental stress. This ulcer is acquired by people undergoing physical stress from a major disease that has put them in the intensive care unit for a while. General stress from work or emotional problems do not cause peptic ulcer but can worsen the prognosis of an already existing peptic ulcer.
  • Chronic alcohol consumption rarely cause stomach ulcers, but it has been proven to worsen an already existing ulcer 
  • Cytomegalovirus(CMV)
  • Crohn’s disease
  • Gastrinomas(Zollinger-Ellison syndrome)
  • Abdominal radiotherapy

Complications of Peptic Ulcer:

  • Gastrointestinal perforation
  • Gastrointestinal Bleeding (vomiting blood)
  • Penetration(is a severe perforation that leads to nearby organs such as pancreas and liver)
  • Malignancy
  • Gastric outlet obstruction (narrowing of pyloric canal)

Diagnosis of peptic ulcer:

  • Endoscopy( a tube is inserted down the throat into the esophagus, stomach and small intestine to view ulcers and collect tissue for biopsy)
  • Blood test: To examine for the presence of H.pylori antibodies
  • Stool test for the presence of H.pylori 
  • Urea breath test
  • Barium swallow
  • CT scan

Treatment of Peptic Ulcer:

  • Triple therapy that consists of 2 antibiotics and one proton pump inhibitor: amoxicillin, clarithromycin, and pantoprazole.
  • Quadruple therapy: omeprazole, tetracycline, metronidazole, and bismuth salt
  • Antacids(Pepto-Bismol, Maalox, milk of magnesia)
  • Proton pump inhibitors(PPI)

Ulcer truths:

  • Stress does not cause any ulcer. It only worsens the symptoms of a preexisting peptic ulcer
  • Spicy food doesn’t cause an ulcer. It only worsens the symptoms of a preexisting peptic ulcer
  • Anxiety doesn’t cause peptic cause