Dr. Tim Chen is a gastroenterologist at Pacifica Digestive Health. He is also the Vice President and was one of the co-founders of Pacifica Digestive Health. His clinical interests include therapeutic endoscopy, hepatitis, inflammatory bowel disease, and esophageal motility disorders.
What is Peptic Ulcer Disease?
Peptic ulcer disease is a condition where ulcerations, or sores, form on the lining of the stomach or intestines, although ulcers can form anywhere along the gastrointestinal tract.
What Are the Symptoms of Peptic Ulcer Disease?
Common and minor symptoms that may be associated with peptic ulcer disease include
Heartburn
Burning stomach pain
Food intolerance and loss of appetite
Feeling bloated, full and belching
Nausea
Rare, but severe symptoms of peptic ulcer disease include
Vomiting or vomiting blood
Having bloody stools, or black and tarry stools
Having trouble breathing
Sudden, severe abdominal pain
Unexpected weight loss
What Are the Causes of Peptic Ulcers?
Common Causes: In the United States, more than 90% of peptic ulcers are caused by a bacteria called Helicobacter Pylori, as well as a class of pain relief medications called NSAIDs (Non-Steroidal Anti-Inflammatory Drugs). The bacteria and drugs may act to decrease the protective mucous coating of the stomach, and increase the risk of developing peptic ulcers.
Uncommon Causes:
Other medications- steroids, bisphosphonates (used to treat and prevent osteoporosis).
Zollinger-Ellison Syndrome- a rare disease in which a tumor causes increased stomach acid production.
How is Peptic Ulcer Disease Diagnosed?
Upper GI Endoscopy: otherwise known as esophagogastroduodenoscopy (EGD), it is a test where your doctor inserts a camera through the mouth to examine your esophagus, stomach and duodenum. If an ulcer is found, your doctor may perform biopsies to examine for Helicobacter Pylori.
Upper GI series: sometimes known as a Barium swallow, is a test where you drink a white liquid (Barium) which coats your digestive tract and makes ulcers visible under X rays. This is less invasive and technically easier. However, this test can miss small or shallow ulcers.
How Can Peptic Ulcers Be Prevented?
Factors that increase an individual's risk of peptic ulcers include:
Age
Smoking
Alcohol
Long term NSAID use
Alcohol and smoking can increase the risk of developing peptic ulcers, and slow healing of existing ulcers.
What is the Treatment of Peptic Ulcer Disease?
Determining and treating the cause:
Stopping NSAIDs and switching to a different painkiller if necessary
Testing and treating for Helicobacter Pylori infections, typically done with a combination of antibiotics and acid suppression medications.
Treating the ulcer:
PPI (Proton Pump Inhibitors)
H2 blockers
Other Medications (sucralfate)
In case of severe ulcer disease, one can manifest with severe abdominal pain or bleeding, in which hospitalization and endoscopy are required. It is very important to tell your doctor about these symptoms, any new symptoms, and follow-up as instructed.