Peptic Ulcer Disease

Peptic ulcers are sores that form on the lining of your esophagus, stomach, or duodenum. Your esophagus is the tube that carries food from your mouth down to your stomach. The duodenum is the upper part of your small intestine.

Peptic ulcers that form on the lining of your esophagus are called esophageal ulcers. Ulcers that form on the lining of your stomach are called gastric ulcers. And ulcers that form on the lining of your duodenum are called duodenal ulcers.

Most peptic ulcers are caused by common bacteria called H. pylori. The bacteria are found in many people’s stomachs, but it only causes ulcers in some people. Another common cause of ulcers is a type of medication called NSAIDs. NSAIDs stand for non-steroidal anti-inflammatory drugs. Many people take NSAIDs, but not everyone who takes them gets a peptic ulcer.


The most common symptom of a peptic ulcer is described as burning, sharp, or dull pain in your upper abdomen or chest.

The pain often occurs 1 to 3 hours after meals. It may wake you from your sleep. It may be relieved by food or antacids. The pain may occur for a few weeks, then stop for weeks or months, and then start again.

Other symptoms of a peptic ulcer include bloating, nausea, and vomiting.

One complication is internal bleeding. It can cause black, tarry stools, or vomit that looks like coffee grounds. The bleeding may be severe enough to cause shock.

Shock is a dangerous condition. It happens when there isn’t enough blood flow around the body. It can cause many organs to stop working. A person with shock needs medical help right away.

Another complication is a perforation, which is a hole in the stomach or duodenum. It causes sudden, severe pain that starts in the upper abdomen, and can move to the right shoulder. This also a serious condition that needs medical help right away.


It is important to diagnose the cause of a peptic ulcer. Tell your health care provider about your symptoms and about the medicines you take, including those you get over-the-counter without a prescription.

Your provider may test  blood, breath, or stool for the H. pylori bacteria.

Your healthcare provider may also want to look inside your stomach and duodenum. That can be done using a type of X-ray called an upper gastrointestinal (GI) series.

Another procedure that may be used is an endoscopy.

In this procedure, a flexible, lighted tube is put down your esophagus.

The tube contains a camera that allows your doctor to see the inside of your stomach and duodenum.

Sometimes a tissue sample, called a biopsy, is taken during the endoscopy.


Depending on the cause of your ulcer, your healthcare provider may prescribe one or more medicines.

Some medicines reduce stomach acid and protect the lining of your stomach and duodenum. One type is a proton pump inhibitor or P-P-I. Another type is a histamine-2 or H-2, blocker.

If H. pylori is found in your stomach, you may be given one or more antibiotics to kill the bacteria. You may also be given a medicine to coat the ulcers and protect them from stomach acid.

If your ulcer was caused by an NSAID, you might need to stop taking it and switch to another medicine. Your provider may tell you to take a smaller dose, or take a P-P-I or H-2 blocker with the NSAID.

It is important to take only the medications you are told to take. Keep taking them as directed, even if the pain goes away.

With treatment, an ulcer may heal within a few weeks.

If your ulcer does not heal or if you have serious complications, you may need surgery.

Talk with your healthcare provider about the types of surgery that may work best for your needs.

Things to Remember

  • An ulcer can be caused by bacteria. The only way to tell if you have the bacteria is with a test.
  • Be sure to tell your healthcare provider about all the medicines you are taking. Take all medications as prescribed until they are gone. Take only the medications your healthcare provider approves.

What We Have Learned

  1. An ulcer is an open sore. True or false?
    The answer is True. A peptic ulcer is a sore in the lining of your stomach, esophagus, or duodenum.

  2. Most peptic ulcers are caused by bacteria. True or false?
    The answer is True. Bacteria called H. pylori cause most peptic ulcers.

  3. A peptic ulcer hurts all the time. True or false?
    The answer is False. The pain can occur for a few weeks, stop for weeks or months, and then return.