Peptic ulcer disease

Peptic Ulcer Disease

What is Peptic Ulcer Disease?

Peptic Ulcer Disease affects roughly 1 in 10 people in the U.S. It is defined as the presence of ulcers or sores in the lining of the intestinal tract, usually in your stomach or duodenum (which is part of the intestine attached to the stomach). These ulcers can sometimes bleed, and cause symptoms such as mid-upper abdominal pain or burning, nausea, vomiting, and weight loss.

What are the causes?

These ulcers are most commonly caused by aspirin or NSAID use (such as ibuprofen), or the presence of bacteria called Helicobacter Pylori. This bacteria is a major culprit for PUD, although it is commonly found in many people and not all who carry the bacteria have PUD.

Older age is also a predisposing factor for PUD. Less common causes include hypersecretion of acid, Crohn's disease, alcoholism, viral infections, or cancer, vascular insufficiency, radiation therapy, cancer chemotherapy, medications such as steroids or alendronate (Fosamax). Environmental factors may also play a role, such as emotional stress and smoking.

How do I know if I have PUD?

People present with symptoms such as pain in the upper mid region of their stomach below their breastbone. (see graphic or animation) Most people with pain in their upper abdomen do not have PUD, but a more benign condition called dyspepsia or gastritis. Ulcer pain is relieved by eating or by taking antacids, and usually occurs 2-3 hrs after a meal.

Other symptoms of PUD include: weight loss, poor appetite, nausea, vomiting, or bloating.

Your doctor will examine you and determine if you have PUD. He or she may possibly order tests, such as a blood count or CBC, a blood test for H. Pylori, or an x-ray or endoscopy of your stomach. An endoscopy is a procedure in which a long tube is placed in your stomach to look for ulcers or changes in your stomach lining. It is the most accurate way of diagnosing PUD, as well as other diseases. Other ways to check for H. Pylori include biopsies taken during endoscopy, a stool test, or a breath test.

How is it diagnosed?

Your doctor will examine you and determine if you have PUD. He or she may possibly order tests, such as a blood count or CBC, a blood test for H. Pylori, or an x-ray or endoscopy of your stomach. An endoscopy is a procedure in which a long tube is placed in your stomach to look for ulcers or changes in your stomach lining. It is the most accurate way of diagnosing PUD, as well as other diseases. Other ways to check for H. Pylori include biopsies taken during endoscopy, a stool test, or a breath test.

You may be given medication to eradicate the bacteria, H.Pylori, if you are found to carry it.

This will require usually 10-14 days of several different medicines, sometimes called "triple therapy". Taking this combination of medicines may permanently cure you of PUD if you are an H. Pylori carrier. After treatment, you will most likely need to be tested again for H. Pylori to ensure eradication since there is sometimes antibiotic resistance-this repeat test is usually done 4-8 wks after treatment.

Other medications work whether you carry H Pylori or not. These need to be taken for at least 4-6 weeks or longer to heal an ulcer. They include:

1) H2 blockers that decrease the amount of acid: (cimetidine, famotidine, or ranitidine)

2) Proton Pump Inhibitors which block acid production:examples lansoprazole, or omeprozole.

3) Other pills or medicines that protect the stomach may also be prescribed by your doctor.

Serious complications of PUD:

Occasionally, ulcers can cause obstruction of your food passageway, which might necessitate surgery. This has become more rare given the medications available for treatment of PUD.

If untreated, ulcers can also bleed and cause you to lose large amounts of blood (you may become anemic). This may be life-threatening if the bleeding is uncontrollable and persistent. Sometimes ulcers can be so deep that the stomach is ruptured. These situations require emergent medical attention and treatment.

Please contact your doctor immediately if you have any of these warning symptoms:

Copyright 2007, MD Kiosk