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If you’re experiencing severe abdominal pain, fever, or heavy bleeding, call 911.

Peptic Ulcer Disease

Peptic Ulcer Disease Explained

Peptic ulcer disease refers to ulcers in the stomach (gastric ulcers) or duodenum (the first part of the small intestine). These sores develop when the protective lining is weakened and acid damages the underlying tissue. The most common causes are infection with Helicobacter pylori bacteria and frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs), though other factors can contribute.

Ulcers can cause burning or gnawing upper abdominal pain, sometimes with nausea, bloating, or early fullness. If severe, they can bleed or perforate, which are medical emergencies. Effective treatments are available to eradicate H. pylori, reduce acid, and help the lining heal.

Symptoms

Symptoms vary from mild discomfort to severe pain or bleeding. Many people notice a dull or burning pain in the upper abdomen, often related to meals, but some ulcers cause few or no symptoms until a complication occurs.

Symptoms include:
Burning or gnawing pain in the upper abdomen, sometimes improving or worsening with food
Nausea or queasiness
Bloating, belching, or early fullness
Loss of appetite or unintentional weight loss
Dark, tarry stools or vomiting blood (signs of bleeding)

When to call

Call the office if you have persistent upper abdominal pain, nausea, early fullness, or unexplained weight loss, especially if you use NSAIDs regularly or have a history of ulcers. Also call if pain or heartburn do not improve on medication.

Seek emergency care immediately for vomiting blood, coffee-ground material, or black/tarry stools; sudden, severe abdominal pain; feeling faint or passing out; or signs of shock (confusion, rapid heartbeat, cold/clammy skin). These may indicate bleeding or perforation and require urgent treatment.

Evaluation & Tests
Management & Treatment

Evaluation typically includes a careful history, tests for H. pylori, and often upper endoscopy to directly visualize the stomach and duodenum, especially when there are alarm symptoms or risk factors.

Review of pain pattern, medication use (particularly NSAIDs, aspirin, blood thinners), alcohol and tobacco use
Testing for H. pylori (breath test, stool test, or biopsy at endoscopy)
Upper endoscopy to confirm an ulcer, rule out cancer (particularly in gastric ulcers), and evaluate for bleeding
Laboratory tests such as blood counts if bleeding or anemia is suspected
Follow-up endoscopy in selected cases to confirm healing (especially gastric ulcers or high-risk lesions)

Treatment focuses on removing the cause, healing the ulcer, and preventing recurrence or complications. This usually involves eradicating H. pylori when present, reducing or stopping NSAIDs when possible, and taking acid-suppressing medicine for a prescribed course.

Antibiotic-based regimens plus a PPI to eradicate H. pylori when infection is detected
Stopping or minimizing NSAIDs and other offending drugs when medically safe
Proton pump inhibitors or other acid-suppressing medicines to promote healing
Avoidance of tobacco and moderation of alcohol use
Regular follow-up to ensure symptoms resolve and to reassess if pain, anemia, or bleeding recur
This information is for general educational purposes only and is not a diagnosis or personalized medical advice. It does not replace a visit with your own healthcare provider. Always follow the specific recommendations given by your medical team. If you have urgent or worsening symptoms, contact your provider or seek emergency care right away.

At-a-glance

Abdominal painNausea / vomitingWeight loss / anemia

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Information on this website is for education only and not a substitute for medical advice.

If you’re experiencing an emergency, call 911.
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