Peptic Ulcer Disease

Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.

What is peptic ulcer disease?

Peptic ulcer disease is a condition in which there are painful sores or ulcers in the lining of the stomach or the first part of the small intestine (the duodenum). Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing for ulcers to occur.

Who is more likely to get peptic ulcer?

You may be more likely to develop an ulcer if you:

Are infected with the pylori bacterium

Take NSAIDs (such as aspirin, ibuprofen, naproxen, and many others)

Have a family history of ulcers

Have another illness, such as liver, kidney, or lung disease

Drink alcohol regularly


What Causes Ulcers?

No single cause has been found for ulcers. However, it is now clear that an ulcer is created by an imbalance, or unevenness, between the digestive fluids hydrochloric acid and pepsin (a digestive enzyme) in the stomach and duodenum.

Ulcers can be caused by:


Infection with a type of bacteria called _Helicobacter pylori (_H. pylori


Use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (Aleve®, Anaprox®, Naprosyn®, and others), ibuprofen (Motrin®, Advil®, Midol®, and others), and many others that are available by prescription. Even aspirin that is coated with a special substance can still cause ulcers.


Excessive acid production from a condition called Zollinger-Ellison syndrome (gastrinoma). A gastrinoma is a tumor of the acid-producing cells of the stomach that increases acid output.

Symptoms of Ulcers

An ulcer may or may not have symptoms. When symptoms occur, they include:

A gnawing or burning pain in the middle or upper stomach between meals or at night



Nausea or vomiting

In severe cases, symptoms can include:

Dark or black stool (due to bleeding)


Weight loss

Severe pain in the mid- to upper abdomen

How are ulcers diagnosed?

Your doctor may be able to make the diagnosis just by talking with you about your symptoms. However, to confirm the diagnosis, one of several tests should be taken.

Upper Endoscopy

If needed, your doctor may recommend a procedure called an upper endoscopy. In this procedure, the doctor inserts a small, lighted tube (endoscope) through the throat and into the stomach to look for abnormalities. This procedure is usually done if you are having severe ulcer symptoms.

Often, doctors will treat without confirming the diagnosis with endoscopy. If the cause is not likely to be from taking NSAIDs, then it is very likely to be from H. pylori. Most doctors will now test for H. pylori and will treat specifically for that, in addition to giving medications to reduce the symptoms.

H. pylori can be discovered either directly by taking a sample during an upper endoscopy, or indirectly, with a blood test or a breath test.

How are Ulcers Treated?

There are several ways in which ulcers can be treated, including:

Making changes to your lifestyle

Taking Medication

Having Surgery

Undergoing Endoscopy

How can I Prevent Ulcers?

If you smoke, quit. People who smoke are twice as likely to develop ulcers. Ulcers also heal more slowly in people who smoke.

Don’t drink too much alcohol.

Contact your doctor

Don’t overuse NSAIDs.


If you have an ulcer, you should first eliminate substances that can be causing it. If you smoke or drink alcohol, stop. If the ulcer is believed to be caused by the use of NSAIDs, they need to be stopped.








Proton pump inhibitors (PPI): Proton pump inhibitors reduce acid and allow the ulcer to heal. PPIs include Prilosec®, Prevacid®, Aciphex®, Protonix®, and Pariet®.


Antibiotics: Antibiotics are used to treat pylori. There are multiple combinations of antibiotics that are taken for two weeks, along with a PPI. Some doctors also recommend taking Pepto-Bismol®.


Some bleeding ulcers can be treated through the endoscope.


An operation may be needed if the ulcer has created a hole in the stomach wall or if there is serious bleeding.

Will drinking milk help cure an ulcer?

No. Milk can make your ulcer worse. Milk provides brief relief of ulcer pain because it coats the stomach lining. But milk also causes your stomach to produce more acid and digestive juices, which can make ulcers worse.

Am I at a greater risk for an ulcer if I take NSAIDs regularly?

The risk of an ulcer is related to the dose of the NSAID
(meaning the more you take, the greater the risk).

The risk increases with:

Age (more likely over age 60)

Gender (occurs more often in women than men)

Use of corticosteroids (such as those taken for asthma or lupus) and NSAIDs together

The length of time you have been taking NSAIDs

A history of ulcer disease