H. pylori & Peptic Ulcer Disease | Diagnosis

What is peptic ulcer disease?

Peptic ulcer disease is an open sore or multiple sores inside the digestive tract. Ulcers can be painful, often described as a burning sensation. Sometimes called PUD, peptic ulcers commonly fall into the following categories:

Stomach ulcers (gastric ulcers) develop on the inside of the stomach
Duodenal ulcers occur in the top of the small intestine (duodenum)

Peptic ulcers are often caused by a Helicobacter pylori (H. pylori) infection or excessive use of certain over-the-counter medications called NSAIDs (nonsteroidal anti-inflammatory drugs), such as aspirin and ibuprofen. Identifying the underlying cause is important for determining the appropriate treatment.

At MedStar Health, our experts offer the most advanced diagnostic tools and therapeutic options in one place. With an expansive network of gastroenterologists, as well as specialists in other fields, you’ll benefit from comprehensive, coordinated care wherever you see us for care.

What are gastric ulcers?

A gastric ulcer is a cut or sore in the lining of the stomach that results from damage or injury. Watch this video to learn more about the symptoms and causes of gastric (stomach) ulcers.

Stomach ulcer symptoms

PUD symptoms vary depending on the location of the ulcer. Some people with small stomach ulcers may not experience any pain, while others may have abdominal pain that worsens when they eat. In contrast, people with duodenal ulcers may notice that pain is more severe when they aren’t eating, such as overnight.

Other symptoms of peptic ulcers may include:

Belching
Bloating
Nausea
Vomiting

Additional symptoms can appear if an ulcer worsens and begins to bleed or grow larger. If you are throwing up blood or have dark, tarry stools, it’s important to seek care.

Risk factors and causes

There are two many PUD causes:

Helicobacter pylori infections: H. pylori is a common bacteria that affects nearly half of the world. Most of the time, we never know we have it because it doesn’t cause any problems. In other cases, it can cause inflammation in the gastrointestinal tract, which can lead to stomach ulcers. If your provider identifies H. pylori as the underlying cause of your ulcers, antibiotics will be necessary to clear the infection. This is important because an H. pylori infection can increase your risk of stomach cancer.
Frequent use of certain medications: Aspirin, ibuprofen, and other commonly used pain relievers are called NSAIDs, or non-steroidal anti-inflammatory drugs (NSAIDs). Over time, repeated use of these medications can cause inflammation in your stomach and small intestine, leading to PUD.

Other factors that can increase your risk of peptic ulcers include smoking and drinking alcohol.

Diagnosis

Your healthcare provider will begin your evaluation with a physical exam and asking thorough questions about your medical history. In most cases, a gastroenterologist will use upper endoscopy (EGD) to examine your stomach and upper small intestine. Endoscopy involves the use of a small camera attached to a thin, flexible tube inserted into the nose or mouth. This allows your doctor to visualize ulcers in the GI tract, take a biopsy, and stop any ulcer bleeding, if necessary.

Treating peptic ulcer disease

PUD treatment typically involves acid-suppressing medications called proton pump inhibitors (PPI). Common PPIs include omeprazole (Prilosec, Zegerid), lansoprazole (Prevacid), pantoprazole (Protonix), rabeprazole (Aciphex), esomeprazole (Nexium), and dexlansoprazole (Kapidex).

Other treatments will vary based on the underlying cause of your PUD. Some ulcers are caused by a systemic illness, such as vasculitis, or from a mass that breaks through the gastric mucosa. In other cases, patients with an H. pylori infection will need antibiotics to kill the bacteria. If your stomach ulcers are related to NSAID use, your doctor may recommend that you stop taking those over-the-counter medications and swap them for an alternative pain reliever.