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Peptic Ulcer

A peptic ulcer is a sore in the lining of the stomach or the first part of the small intestine (duodenum). Two kinds of peptic ulcers occur, in two places:

  • Gastric ulcers - stomach
  • Duodenal ulcers - duodenum

Peptic Ulcer
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Upsets in the balance of stomach acid and digestive juices can lead to an ulcer, caused by:

  • Helicobacter pylori ( H. pylori) infection
  • Use of nonsteroidal anti-inflammatory drugs (NSAIDs)
  • Less common causes include:
    • Zollinger-Ellison syndrome
    • Radiation therapy
    • Bacterial or viral infections
    • Alcohol abuse
    • Tumors
    • Severe stress such as surgery, trauma, head injury, shock or burns

Peptic Ulcer Symptoms

Peptic ulcers do not always cause symptoms. Symptoms may come and go. Food or fluids sometimes make symptoms better. Having an empty stomach may make symptoms worse. However, symptoms can occur at any time and can include:

  • Abdominal discomfort or pain
  • Pain that changes when you eat
  • Burning or gnawing feeling, similar to hunger pain
  • Nausea
  • Vomiting
  • Loss of appetite
  • Weight loss

Ulcers can cause serious problems and severe abdominal pain. One problem is bleeding. Bleeding symptoms may include:

  • Bloody or black, tarry stools
  • Vomiting what looks like coffee grounds or blood
  • Weakness
  • Lightheadedness

A perforated ulcer — a break through the wall of the stomach or duodenum —  causes sudden and severe pain.

Diagnostic Procedures

Testing for ulcers may include blood test, stool test, breath test and/or X-rays.


Your doctor may also perform an upper endoscopy with biopsy to diagnose peptic ulcer disease. A gastrointestinal endoscopy allows your doctor to examine the mucous lining of your upper gastrointestinal tract.

You receive sedation and sleep during the procedure. Your doctor then inserts a lighted tube, or endoscope,  through your mouth into the stomach and duodenum. The endoscope transmits an image of the esophagus, stomach and duodenum to a monitor that your doctor watches. Biopsy forceps may be inserted into the endoscope to remove a tissue sample.

An esophagogastroduodenoscopy (EGD) is a specific endoscopic exam to diagnose peptic ulcer disease. This test can identify the ulcer, its location and size. 


Treatment may include antibiotics, medications that heal the ulcer and protect the stomach and lifestyle changes. Ulcers that bleed, obstruct, perforate or don't heal with other treatments may require surgery.

Lifestyle Changes

You may need to:

  • Quit smoking
  • Limit alcohol intake
  • Avoid NSAIDs (over-the-counter drugs like aspirin and ibuprofen)

Make an Appointment

Speak with your doctor to get a referral. If you don't have a primary care doctor, we can help you find one. Call us at 434.243.3675.

Content was created using EBSCO’s Health Library. Edits to original content made by Rector and Visitors of the University of Virginia. This information is not a substitute for professional medical advice.

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