A peptic ulcer is a sore that forms in the lining of the stomach or the beginning of the small intestines, called the duodenum. Ulcers are common, affecting an estimated 25 million Americans.

Contrary to popular belief, ulcers are not due to stress and diet. A bacterial infection brought on by the bacteria Helicobacter pylori (H. pylori) is the cause of the majority of all stomach ulcers. Prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) or pain relievers such as aspirin, ibuprofen and naproxen sodium, which affect the stomach's ability to protect itself from acidic stomach juices, also may lead to ulcers.

If you have a peptic ulcer, you may only experience very mild symptoms or none at all. However, abdominal discomfort is the most common symptom associated with ulcers. Other symptoms include:

  • Weight loss
  • Poor appetite
  • Bloating
  • Burping
  • Nausea
  • Vomiting

Your doctor may first perform an upper gastrointestinal (GI) series and endoscopy to check for ulcers.

An upper GI series involves X-rays of the esophagus, stomach and the beginning of the small intestine, called the duodenum. You will be asked to drink a chalky liquid, called barium, to make these organs appear more clearly on the X-ray.

During an endoscopy, the upper portion of the gastrointestinal tract is visualized by using a long, thin and flexible tube with a tiny video camera and light on the end, called an endoscope. The areas examined during this procedure include the esophagus, or the swallowing tube leading to the stomach, the stomach and the duodenum. The high-quality picture from the endoscope is shown on a television monitor and provides a clear, detailed view. In many cases, upper GI endoscopy is a more precise examination than X-ray studies.

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Peptic ulcers caused by the bacteria Helicobacter pylori (H. pylori) are usually treated with a combination of antibiotics that kill the bacteria as well as other drugs to reduce stomach acid and protect the stomach lining. The use of only one medication to treat H. pylori is not recommended.

At this time, the most proven effective treatment is a two-week course of treatment called triple therapy. It involves taking two antibiotics to kill the bacteria and an acid suppressor known as a proton-pump inhibitor (PPI). By decreasing the amount of acid in the stomach, PPIs are used to heal stomach ulcers, including those caused by nonsteroidal anti-inflammatory drugs (NSAIDS), and duodenal ulcers. Two-week triple therapy reduces ulcer symptoms, kills the bacteria and prevents the ulcer from recurring in more than 90 percent of patients.

Ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs) usually heal once the person stops taking the medication. To help the healing process and relieve symptoms, your doctor may recommend taking PPIs to neutralize the acid and drugs called H2-blockers to decrease the amount of acid the stomach produces.

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Reviewed by health care specialists at UCSF Medical Center.

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Gastroenterology at Mount Zion
1701 Divisadero St., Suite 120
San Francisco, CA 94115
Phone: (415) 502-4444
Fax: (415) 502-2249
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Gastroenterology at Parnassus
350 Parnassus Ave., Suite 410
San Francisco, CA 94143
Phone: (415) 502-2112
Fax: (415) 514-3300
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Esophageal Motility Center
1701 Divisadero St., Suite 120
San Francisco, CA 94115
Phone: (415) 502-4444
Fax: (415) 502-2249
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