Peptic Ulcer: A Gastroenterologist's Perspective

Today, I would like to provide detailed information about Peptic Ulcer. Peptic Ulcer is defined as open sores or lesions that develop in the stomach or duodenum. This condition usually arises when stomach acid erodes the protective mucosal lining of the stomach or duodenum.

There are two main types of Peptic Ulcer: gastric ulcer and duodenal ulcer. A gastric ulcer forms on the inner surface of the stomach, while a duodenal ulcer occurs in the duodenum. Both types can cause similar symptoms, but their treatment approaches and risk factors may vary slightly.

Causes of Peptic Ulcer 

The most common causes of Peptic Ulcer include Helicobacter pylori infection and certain painkillers (particularly, non-steroidal anti-inflammatory drugs, or NSAIDs). H. pylori is a bacterium that can lead to chronic inflammation in the stomach lining and eventually to ulcer formation. NSAID painkillers, on the other hand, thin the protective mucus layer of the stomach, increasing the risk of ulcers.

In addition to these, stress, alcohol consumption, smoking, and genetic factors can also play a role in the development of peptic ulcers. While stress and poor dietary habits are not direct causes of ulcers, they can contribute to the worsening of existing ulcers.

Symptoms of Peptic Ulcer 

The symptoms of Peptic Ulcer can vary from person to person, but the most common symptoms include abdominal pain, heartburn, indigestion, bloating, and nausea. Abdominal pain typically worsens after eating or at night, and some patients report that the pain radiates to their back.

In more severe cases, ulcers can lead to bleeding or perforation (a hole in the stomach or duodenum). In such cases, patients may experience symptoms like blood in the stool (melena), vomiting blood (hematemesis), or severe and sudden abdominal pain. These symptoms require urgent medical attention.

Diagnosis and Diagnostic Methods 

The diagnosis of Peptic Ulcer usually begins with patient history and physical examination. However, some tests are necessary for a definitive diagnosis. One of the most common diagnostic methods is endoscopy. During an endoscopy, we examine the inner surfaces of the stomach and duodenum using an endoscope, a flexible tube with a camera. During this procedure, a biopsy may be taken to check for the presence of H. pylori infection.

In addition, non-invasive tests such as blood tests, stool tests, and urea breath tests can also be used to detect H. pylori infection.

Treatment Methods 

The treatment of Peptic Ulcer varies depending on the cause and severity of the ulcer. If H. pylori infection is detected, we initiate antibiotic therapy to eradicate this bacterium. This treatment is usually combined with proton pump inhibitors (PPIs) or H2 receptor antagonists. These medications reduce the production of stomach acid, aiding in the healing of the ulcer.

If the ulcer is caused by NSAID use, discontinuation of these drugs or the choice of alternative pain relief methods may be necessary. Additionally, antacids or protective medications that neutralize stomach acid may be added to the treatment.

Lifestyle Changes 

In addition to treatment, certain lifestyle changes are important in managing Peptic Ulcer. These include maintaining a healthy and balanced diet, quitting smoking, limiting alcohol consumption, and avoiding stress. Also, not lying down immediately after meals and consuming meals in small portions can reduce the pressure on the stomach.

In conclusion… 

Peptic Ulcer is a condition that can be managed with accurate diagnosis and treatment. However, if left untreated, it can lead to serious complications. Therefore, if you are experiencing the symptoms mentioned above, I recommend consulting a healthcare professional and seeking more information or personalized treatment recommendations from a gastroenterologist.

Wishing you healthy and happy days…

Dr. Hasan Gürel 

Gastroenterology Specialist