What is a peptic ulcer

A peptic ulcer is a lesion that develops in the lining of your stomach or duodenum (first part of your bowel).

What are the causes of peptic ulcer

The most common cause is a bacteria called Helicobacter pylori (H.pylori). Other causes include regular use of some medications including aspirin and Non-steroidal anti inflammatory drugs (NSAIDS) such as ibuprofen, naproxen, diclofenac. Other risk factors include smoking and alcohol.

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What are the symptoms of peptic ulcer

Symptoms vary but most commonly include reflux/heartburn, upper abdominal pain, nausea, bloating or belching. More rarely the ulcer can present with vomiting and occasionally vomiting blood or dark black/tarry stools. Symptoms can be worse on an empty stomach and relieved by taking some antiacid medications such as omeprazole, lanzoprazole, ranitidine or gaviscon.
However a large number of patients may be asymptomatic and the ulcer is picked up incidentally.


Investigations include determining whether H.pylori is present which can be done with a breath test or testing a sample of stool. An endoscopy is often performed which allows visulisation of any ulcer as well the opportunity to take biopsies and test for H.pylori.


Treatment will depend on the cause of the ulcer.
H.pylori is treated with antibiotics and anti-acid medications such as a proton pump inhibitor (omeprazole, lansoprazole).
In some cases the ulcers may fail to heal and this may be because there is another cause or the bacteria is resistant to the antibiotics being used.

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