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Duodenal ulcers

Peptic ulcer disease
Synonyms Peptic ulcer, stomach ulcer, gastric ulcer, duodenal ulcer
Deep gastric ulcer.png
Deep gastric ulcer
Specialty Gastroenterology, general surgery
Symptoms Upper abdominal pain, belching, vomiting, weight loss, poor appetite
Complications Bleeding, perforation, blockage of the stomach
Causes Helicobacter pylori, non-steroidal anti-inflammatory drugs, tobacco smoking, Crohn disease
Diagnostic method Based on symptoms, confirmed by endoscopy or barium swallow
Similar conditions Stomach cancer, coronary heart disease, inflammation of the stomach lining, gallbladder inflammation
Treatment Stopping smoking, stopping NSAIDs, stopping alcohol, medications
Medication Proton pump inhibitor, H2 blocker, antibiotics
Frequency 87.4 million (2015)
Deaths 267,500 (2015)
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Peptic ulcer disease (PUD), is a break in the lining of the stomach, first part of the small intestine, or occasionally the lower esophagus. An ulcer in the stomach is known as a gastric ulcer while that in the first part of the intestines is known as a duodenal ulcer. The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain or upper abdominal pain that improves with eating. With a gastric ulcer the pain may worsen with eating. The pain is often described as a burning or dull ache. Other symptoms include belching, vomiting, weight loss, or poor appetite. About a third of older people have no symptoms. Complications may include bleeding, perforation, and blockage of the stomach. Bleeding occurs in as many as 15% of people.

Common causes include the bacteria Helicobacter pylori and non-steroidal anti-inflammatory drugs (NSAIDs). Other less common causes include tobacco smoking, stress due to serious illness, Behcet disease, Zollinger-Ellison syndrome, Crohn disease and liver cirrhosis, among others. Older people are more sensitive to the ulcer-causing effects of NSAIDs. The diagnosis is typically suspected due to the presenting symptoms with confirmation by either endoscopy or barium swallow.H. pylori can be diagnosed by testing the blood for antibodies, a urea breath test, testing the stool for signs of the bacteria, or a biopsy of the stomach. Other conditions that produce similar symptoms include stomach cancer, coronary heart disease, and inflammation of the stomach lining or gallbladder inflammation.


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