What is peptic ulcer?

Peptic ulcer is a mucosal break involving the stomach (gastric ulcer) or the first part of the small intestine (duodenal ulcer). Peptic ulcer is a common disease among busy city dwellers.

What are the causes?

Peptic ulcer may develop when there is an imbalance between the stomach acid production and the protective mucus production by the lining of stomach and duodenum. Common causes include:

• Infection with a kind of bacteria known as Helicobacter pylori - associated with as many as 90% of duodenal ulcers and 70-75% of gastric ulcers.
  
• Drugs such as non-steroidal anti-inflammatory drugs (NSAID), aspirin and steroids.
  
• Burn injury, surgical operation or severe medical illness
  In addition, smoking, alcohol abuse and stress are associated with this condition.

In addition, smoking, alcohol abuse and stress are associated with this condition.

What are the symptoms?

Patients may experience the following symptoms:

• A gnawing or burning pain above the navel (epigastric pain). This pain may be associated with meals or hunger, and may occur at night.
  
• Nausea and vomiting.
  
• Loss of appetite, belching and bloating.
  
• Chest discomfort.
  
• Unexplained weight loss.
  

When there is bleeding from the peptic ulcer, the patient may have coffee-ground vomitus and/or black tarry stool. When the peptic ulcer is perforated, there may be intense abdominal pain

What are the complications?

Peptic ulcer with chronic bleeding may cause anaemia. Perforated peptic ulcer may cause peritonitis that needs emergency treatment.

How to prevent peptic ulcer?

You can reduce your risk of peptic ulcer by the following ways:

• Do not take non-prescribed drugs, especially NSAID, aspirin and steroid.
  
• Quit smoking.
  
• Reduce or avoid alcohol intake.
  
• Avoid too much stress.
  

The doctor will assess your clinical condition and arrange the necessary investigations to make a diagnosis. Such investigations may include blood tests, breath tests and upper gastrointestinal endoscopy with biopsy for detection of Helicobacter pylori.

The majority of patients with peptic ulcer can be successfully treated with eradication of Helicobacter pylori infection, drugs to reduce the secretion of stomach acid and avoidance of risk factors like NSAID. The doctor will recommend suitable treatment according to the patient's condition and any other associated diseases.

In case of active bleeding or perforation, emergency surgery may be needed to stop the bleeding or to repair the perforation.