Peptic Ulcer Disease

Peptic Ulcer Disease

Peptic Ulcer Disease

by Swedish Staff and Contributors

Peptic Ulcer Defined
What Causes a Peptic Ulcer
Risk Factors

Symptoms of a Peptic Ulcer

Symptoms are not always present with peptic ulcers. If you do have symptoms, they may range from mild to severe and may come and go. Symptoms can include:

  • Cramping, burning or hunger-like pain in the stomach area, often in the middle of the night or 1-3 hours after eating a meal
  • Pain that worsens or improves with eating
  • Lack of appetite
  • Weight loss
  • Nausea or vomiting (vomit may be bloody or look like coffee grounds)
  • Black, tarry, or bloody stools which may be a sign that the ulcer is bleeding

Peptic Ulcer Defined

A peptic ulcer is a sore or eroded area in the lining of your stomach or duodenum (the first part of your small intestine). An ulcer can cause pain and lead to serious complications such as bleeding or a perforation (hole) in your stomach or duodenum. This is a life-threatening condition. Scarring from ulcers can also block the flow through your stomach and/or duodenum causing repeated vomiting, weight loss and intense pain. People diagnosed with peptic ulcers due to an infection from Helicobacter pylori (H. pylori) bacteria have a higher rate of stomach cancer than others.

What Causes a Peptic Ulcer

A peptic ulcer can be caused by:

  • Infection from H. pylori bacteria
  • Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) for pain, such as aspirin, ibuprofen and naproxen

An ulcer forms when the mucous coating protecting the lining of your stomach and your intestine is disrupted. Strong digestive juices erode the lining, causing an ulcer. The mucous coating can be disrupted by a bacterial infection from H. pylori or by irritating medications, such as NSAIDs. It was once thought that lifestyle factors such as diet and stress were responsible for causing peptic ulcers. Researchers now know that most ulcers are due to H. pylori infection or NSAID use.

Peptic ulcers can occur in the stomach or duodenum.


A physical exam is needed to diagnose a peptic ulcer. Your doctor will ask about your medical history and any symptoms you may be experiencing. Tests will also be done to confirm the problem and help determine if an ulcer is caused by H. pylori. Tests may include:

  • Blood, stool, or breath tests. These tests are done to check for H. pylori and other problems. Blood and stool tests require small samples of your blood and stool to be taken, sent to a lab and analyzed. During a breath test you'll drink a liquid that contains a harmless compound. H pylori bacteria cause the compound to break down and release carbon dioxide gas. The air you breathe out after you drink the liquid will be tested and the doctor will be able to tell if the bacteria are present.
  • Upper endoscopy. This test involves inserting a thin, lighted tube (fiber-optic scope) through your mouth and down into your stomach or duodenum to check for ulcers. If needed, tools may be passed through the scope to take tissue samples (biopsy). Treatment can also be done at the same time if the ulcer is bleeding or other problems are detected.
  • Upper gastrointestinal (GI) series. This test is done to take X-rays of the upper digestive tract from your mouth to your small intestine, allowing the doctor to check for ulcers. An upper GI involves drinking a chalky liquid that contains a substance called barium. The barium coats your upper digestive tract so that it will show up clearly on X-rays.


The most common treatment for peptic ulcers is medication. These include:

  • Antibiotics. Used to kill H. pylori bacteria. Many patients need to take at least two types of antibiotics.
  • Proton pump inhibitors. These block your stomach from making any acid.
  • H2 blockers. These reduce the amount of acid your stomach makes.
  • Bismuth subsalicylate. This helps protect the lining of your stomach and duodenum from acid.

Take all medications exactly as prescribed. Do not stop taking a medication, even if you feel better, without first talking to your doctor. Some medications may cause side effects. In severe peptic ulcer cases, other treatments may be done, including procedures with an endoscope or surgery.

Risk Factors

While most ulcers are due to H. pylori infection or NSAID use, you may have an increased risk of peptic ulcers if you:

  • Smoke. In people who are infected with H. pylori, smoking may increase the risk of peptic ulcers.
  • Drink alcohol. Alcohol increases the amount of acid produced in your stomach, irritating and eroding your stomach’s mucous lining.


Take the following steps to help prevent a peptic ulcer:

  • Reduce your risk of H. pylori infection. While it’s not known exactly how H. pylori is spread from person to person, many researchers think that it can be passed through food or water contaminated by an infected person. As a precaution, the Centers for Disease Control and Prevention (CDC) recommends following basic hygiene standards. These include:
    • Always washing your hands with warm water and soap after using the bathroom and before handling food.
    • Drinking water only from safe sources.
  • Avoid NSAIDs. Work with your doctor to change your medication or to reduce the amount of NSAIDs you take. If you must take NSAIDs, talk to your doctor first. There are medications that can help protect your stomach and duodenum.


This content was created using EBSCO’s Health Library. Edits to original content made by Swedish

Diagnosis and Treatment

For more information:



Swedish Digestive Health Network