Peptic Ulcer Disease
Peptic Ulcer refers to ulcers (break in mucosa or lining) caused by acid. It is a world wide problem and is caused by:
- Helicobacter infection: This is a bacteria that is transmitted by the feco-oral route and settles in the mucous layer of the stomach and can cause ulcers in the stomach and the duodenum (first part of the small intestine).
- Nonsteroidal Anti-inflammatory agents: Drugs like Motrin, Ibuprofen, Alieve and Aspirin can cause ulcers in any part of the GI Tract (stomach, duodenum, small bowel, colon).
What are symptoms of Peptic Ulcers?
Ulcers can cause abdominal pain, nausea or vomiting and some present with gastrointestinal bleeding (vomiting of blood or tarry black stool). Complications from ulcers include perforation, bleeding and gastric obstruction.
How are ulcers detected?
Upper endoscopy/EGD is the most accurate method of establishing a diagnosis. Biopsy can exclude cancer ( a small proportion of ulcers can be malignant) and detect Helicobacter pylori infection. Upper Gastrointestinal series (X-Rays) can also be helpful in some cases.
How are ulcers treated?
With the introduction of Proton Pump inhibitors (PPI), most ulcers heal with medications and the need for surgery has decreased considerably. It is very important to treat the underlying Helicobacter infection if present with antibiotics. If Nonsteroidal agents are felt to be the cause of the ulcers, they are best stopped until the ulcers heal and restarted if absolutely needed along with a Proton Pump inhibitor.
If a patient is treated with antibiotics for helicobacter infections; a simple breath test (Urea Breath test) to verify eradication of the bacteria is beneficial.