Tulane Doctors ~ Gastroenterology ~ Stomach Ulcers


Peptic ulcer disease or stomach ulcers, commonly known as PUD, is damage in the lining of the stomach or first part of the small intestines. PUD is likely due to 1 of 3 things:

  1. A bacteria in the stomach known as Helicobactor pylori (H. pylori)
  2. Excessive use of pain killers known as NSAIDs, or non-steroidal anti-inflammatory drugs, which include aspirin (BayerTM), ibuprofen (AdvilTM, MotrinTM), naproxen (NaprosynTM, AleveTM), and head ache powders (Goody's PowderTM and BCTM).
  3. Excessive acid production from a tumor known as Zollinger-Ellison syndrome

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Other risk factors for ulcers include drinking alcohol, smoking, age older than 50, or close family members with ulcers.

While PUD can cause many different symptoms, the most common is typically abdominal pain. The pain can be anywhere from your belly button to your breastbone, typically burning or gnawing in nature, and will be worse 1-2 hours after eating. Other symptoms include belching, bloating, nausea, and vomiting.

  • Vomiting red blood or old blood (which looks like "coffee-grounds")
  • Severe pain

Ulcers can be diagnosed several different ways. If your pain is typical of ulcer pain, you may not need further studies and can be treated with close monitoring by your primary care doctor. However, you may need to undergo upper endoscopy (which is a scope with a light and camera that is passed through your mouth to the stomach). This will need to be done by a gastroenterologist, who can directly see the ulcer in your stomach or small intestines.

Treating an ulcer will depend on the underlying cause. Ulcers created by taking excessive NSAIDs will heal with acid blockers called Proton Pump Inhibitors, or PPIs, and stopping the NSAID medication.

If the ulcer is caused by H. pylori, you will need a course of antibiotics as well as a PPI. Finishing the antibiotics is very important as untreated infections can cause stomach cancer.

Severe, bleeding ulcers will need an upper endoscopy to help stop the bleeding. Your gastroenterologist will inject the bleeding directly with medication, and clip or burn the area to prevent re-bleeding. Surgery is usually not necessary for ulcers.

You can help prevent ulcers by knowing and understanding the risk factors. If you are concerned about your risk, speak with your primary care doctor.

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