Summary about Disease
A peptic ulcer is a sore that develops on the lining of the stomach, small intestine, or esophagus. They occur when stomach acid damages the lining of the digestive tract. The two main types of peptic ulcers are gastric ulcers (in the stomach) and duodenal ulcers (in the first part of the small intestine).
Symptoms
Burning stomach pain (most common)
Feeling of fullness, bloating or belching
Intolerance to fatty foods
Heartburn
Nausea
In severe cases: dark or bloody stool, vomiting blood (which may look like coffee grounds), unexplained weight loss, appetite changes.
Causes
_Helicobacter pylori_ (H. pylori) infection: This bacterium is a common cause of peptic ulcers.
Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs): Examples include ibuprofen, naproxen, and aspirin.
Rarely: Zollinger-Ellison syndrome (a rare condition that causes the stomach to produce too much acid), stress, smoking, excessive alcohol consumption.
Medicine Used
Antibiotics: To kill _H. pylori_ bacteria. Typically a combination of two or three antibiotics is prescribed.
Proton pump inhibitors (PPIs): Reduce stomach acid production (e.g., omeprazole, lansoprazole).
H2 blockers: Also reduce stomach acid production (e.g., ranitidine, famotidine).
Antacids: Neutralize stomach acid for quick relief of symptoms.
Cytoprotective agents: Protect the lining of the stomach and small intestine (e.g., sucralfate, misoprostol).
Is Communicable
No, peptic ulcers themselves are not communicable. However, _H. pylori_, a common cause of peptic ulcers, *is* communicable. It can spread through contaminated food and water or through direct contact with saliva or other bodily fluids.
Precautions
If diagnosed with _H. pylori_: Follow your doctor's instructions for antibiotic treatment.
Avoid NSAIDs: If possible, use alternative pain relievers. If NSAIDs are necessary, take them with food or with a medication to protect your stomach lining.
Limit alcohol and caffeine: These can increase stomach acid production.
Quit smoking: Smoking delays healing and increases the risk of ulcer recurrence.
Eat a healthy diet: No specific diet is proven to heal ulcers, but avoiding foods that trigger your symptoms can help.
Manage stress: Stress can worsen ulcer symptoms.
How long does an outbreak last?
An "outbreak" isn't the right term for peptic ulcers. Ulcers don't "outbreak" like a rash or infection. Untreated, a peptic ulcer can persist for months or even years. With proper treatment (antibiotics for _H. pylori_ and acid-reducing medications), healing typically takes several weeks (4-8 weeks, sometimes longer). Symptoms may improve within days of starting treatment, but it's crucial to complete the entire course of medication as prescribed.
How is it diagnosed?
Upper endoscopy: A thin, flexible tube with a camera is inserted down the esophagus, stomach, and duodenum to visualize the lining and take biopsies.
_H. pylori_ testing: Can be done through a blood test, stool test, or breath test. Biopsies taken during an endoscopy can also be tested for _H. pylori_.
Barium swallow (rarely used): X-rays are taken after drinking a barium solution, which coats the digestive tract and makes ulcers visible.
Timeline of Symptoms
The onset and progression of symptoms vary.
Early symptoms: May include mild burning stomach pain, especially when the stomach is empty (between meals or at night).
Progressive symptoms: As the ulcer worsens, pain may become more frequent and severe. Other symptoms like nausea, bloating, heartburn, and loss of appetite may develop.
Complications: If untreated, symptoms can escalate to include vomiting blood, dark stools, and severe abdominal pain (indicating bleeding or perforation). This timeline is general; some people may have mild symptoms for a long time, while others experience a rapid progression of more severe symptoms.
Important Considerations
Complications: Untreated peptic ulcers can lead to serious complications such as bleeding, perforation (a hole in the stomach or small intestine), and obstruction (blockage).
Recurrence: Even after successful treatment, peptic ulcers can recur, especially if _H. pylori_ is not eradicated or if NSAIDs are continued.
Follow-up: It's important to follow up with your doctor after treatment to ensure the ulcer has healed and to check for _H. pylori_ eradication.
Self-treating is dangerous: Don't self-treat suspected ulcers with over-the-counter medications for long periods. See a doctor for proper diagnosis and treatment.
Medication Interactions: Be sure to tell your doctor about all medications and supplements you are taking, as some can increase the risk of ulcers or interact with ulcer medications.