Peptic ulcers are sores or eroded areas that form in the lining of the digestive (gastrointestinal) tract.

They usually occur in the stomach (gastric ulcer) or in the duodenum (duodenal ulcer), which is the upper region of the small intestine. The two primary causes of peptic ulcers are infection with specific bacteria (Helicobacter pylori) and use of nonsteroidal antiinflammatory medications HOW ULCERS DEVELOP The stomach and duodenal lining have several mechanisms that help prevent ulcers from developing, including the following: A coating of mucus (mucous layer) protects the stomach lining from the effects of acidic digestive juices. Food and other substances in the stomach neutralize acid. Certain chemicals produced by the stomach protect the cells lining the stomach. If the mucous layer is damaged or if acid neutralizing substances are not present in normal amounts, digestive juices can cause irritation and breakdown of the stomach or duodenal lining, allowing an ulcer to form The body makes strong acids that digest food. A lining protects the inside of the stomach andduodenum from these acids. If the lining breakdown, the acids can damage the walls. BothH. pylori and NSAIDs weaken the lining so acidcan reach the stomach or duodenal wall. PEPTIC ULCER SYMPTOMS People with peptic ulcers may have a wide variety of symptoms, have no symptoms, or, rarely, develop potentially life-threatening complications such as bleeding. Symptoms of ulcers may include: Pain or discomfort (usually in the upper abdomen) Bloating An early sense of fullness with eating Lack of appetite Nausea Vomiting Blood in the stools Duodenal ulcer "Classic" symptoms of a duodenal ulcer include burning, gnawing, aching, or hungerlike pain, primarily in the upper middle region of the abdomen below the breastbone (the epigastric region). Pain may occur or worsen when the stomach is empty, usually two to five hours after a meal. Symptoms may occur at night between 11 PM and 2 AM, when acid secretion tends to be greatest. Gastric ulcer Symptoms of a gastric ulcer typically include pain soon after eating. Symptoms are sometimes not relieved by eating or taking antacids. PEPTIC ULCER CAUSES The two most common causes of peptic ulcers are: An infection in the stomach or duodenum caused by a type of bacteria called H. pylori Medicines called nonsteroidal anti-inflammatory drugs (NSAIDs) NSAIDs include pain-relieving medicines such as aspirin, ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand names: Aleve, Naprosyn).

How are peptic ulcers treated?

Peptic ulcers can be cured. Medicines for peptic

ulcers are proton pump inhibitors or histamine receptor blockers to stop your stomach from making acids antibiotics to kill the bacteria Depending on your symptoms, you may take one or more of these medicines for a few weeks. Theyll stop the pain and help heal your stomach or duodenum. Ulcers take time to heal. Take your medicines even if the pain goes away. If these medicines make you feel sick or dizzy, or cause diarrhea or headaches, your doctor can change your medicines.
Peptic ulcers are not usually preventable the first time around. Infection with H. pylori is extremely common. It is probably spread from person to person. Crowded living space appears to be a risk factor. Good hygiene may limit the spread of H. pylori somewhat. This includes washing your hands thoroughly before eating and after using the bathroom. Recurrent ulcers from H. pylori can usually be prevented if you get appropriate treatment for your first ulcer. This should include antibiotics that kill the bacteria. You may help to prevent peptic ulcers by: Avoiding smoking Avoiding excessive alcohol use Limiting the use of NSAIDs for pain

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Treatment

For ulcers caused by H. pylori, treatment requires a combination of medications. The goals of treatment are to: Kill H. pylori bacteria in the body Reduce the amount of acid in the stomach Protect the lining of the stomach and intestines

proton pump inhibitors (PPIs)medications that help reduce stomach acid quitting smoking and other tobacco use eating a healthy diet rich in fruits, vegetables, and whole grains not drinking more than two alcoholic beverages a day not mixing alcohol with medication washing your hands frequently to avoid infections limiting your use of ibuprofen, aspirin, and naproxen sodium
Reduce Intake of Caffeine, Acidic Foods Bleeding:Internal bleeding in the stomach or the duodenum. Perforation: When ulcers are left untreated, digestive juices and stomach acid can literally eat a hole in the intestinal lining, a serious medical problem that requires hospitalization, and often surgery. Obstruction: Swelling and scarring from an ulcer may close the outlet of the stomach, preventing food to pass and causing vomiting and weight loss.