How Are Peptic Ulcers Diagnosed and Treated?

If you have a burning pain in your stomach that keeps coming back, a peptic ulcer is one possible reason for it. That’s a sore on the inside of your stomach or at the top of your small intestine.

People used to think ulcers were caused by stress or even spicy foods. But while those things can make ulcers worse, doctors now know the most common cause is a kind of bacteria called H. pylori. Using over-the-counter painkillers like aspirin, ibuprofen, and naproxen for a long time can damage the lining of your stomach and cause ulcers, too.

Your doctor can tell you if you have one and recommend treatments based on the reason behind it. Most of the time, ulcers heal quickly and don’t come back once they’re treated.

Diagnosis

If your doctor thinks you might have a peptic ulcer, he’ll probably start with a physical exam and some tests:

  • He’ll feel your belly and ask if you’ve had things like tenderness, pain, or bloating. He might use a stethoscope to listen to any sounds your stomach is making.
  • The next step will be tests to look for signs of the H. pylori bacteria. Your doctor may take samples of your blood, stool, or breath for these.
  • In some cases, especially if you’re older and your symptoms include things like weight loss or loss of appetite, he might use a long, flexible tube called an endoscope to look down your throat and into your stomach for signs of an ulcer. (You’ll be given medicine to make you sleepy.) An endoscope can also take a small sample of tissue from an ulcer that can be tested in a laboratory.
  • He might ask you to drink a milky liquid called barium before he takes X-rays of your stomach. This drink coats your digestive system and makes problems like ulcers show up more clearly.

Treatment

If you have a peptic ulcer, your doctor will recommend a treatment plan based on what’s causing it:

  • The most common remedy is a combination of antibiotic drugs to kill the H. pylori bacteria and medications to get rid of acid in your stomach. These might include proton pump inhibitors (like Aciphex or Nexium), H2 blockers (like Pepcid, Tagamet, or Zantac), or other antacids. You’ll take these drugs for 10 days to 2 weeks.
  • If your ulcer is caused by over-the-counter painkillers, you’ll need to either cut back on them or quit taking them.
  • He also may give you a drug called a protectant, which coats ulcers to protect them from stomach acid.

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Lifestyle changes can help, too. You might need to:

After treatment, your doctor may want to keep a close eye on you, depending on:

  • The size of your ulcer and where it was
  • How well the treatment worked
  • If you had any other problems

An ulcer can cause serious problems, like stomach bleeding, if it’s not treated. An untreated ulcer also can lead to a hole in your stomach, which may need to be fixed with surgery.

WebMD Medical Reference Reviewed by Neha Pathak, MD on September 20, 2017

Sources

SOURCES:

National Institute of Diabetes and Digestive and Kidney Diseases: “Peptic ulcers.”

Johns Hopkins Medicine: “Peptic ulcers.”

The Mayo Clinic: “Peptic ulcer.”

American Family Physician: “Diagnosis and Treatment of Peptic Ulcer Disease and H. pylori Infection.”

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