Dr Ian Berkowitz

GASTROENTEROLOGIST

Peptic Ulcer Disease.

Peptic ulcers are open sores that develop on the inside lining of your stomach and the upper portion of your small intestine. The most common symptom of a peptic ulcer is stomach pain.

Peptic ulcers include:

Gastric ulcers that occur on the inside of the stomach

Duodenal ulcers that occur on the inside of the upper portion of your small intestine (duodenum)

The most common causes of peptic ulcers are infection with the bacterium Helicobacter pylori (H. pylori) and long-term use of aspirin and certain other painkillers, such as ibuprofen (Advil, Motrin, others) and naproxen sodium (Aleve, Anaprox, others). Stress and spicy foods do not cause peptic ulcers. However, they can make your symptoms worse.

Symptoms:

Burning stomach pain

Feeling of fullness, bloating or belching

Fatty food intolerance

Heartburn

Nausea

The most common peptic ulcer symptom is burning stomach pain. Stomach acid makes the pain worse, as does having an empty stomach. The pain can often be relieved by eating certain foods that buffer stomach acid or by taking an acid-reducing medication, but then it may come back. The pain may be worse between meals and at night.

Nearly three-quarters of people with peptic ulcers don't have symptoms.

Less often, ulcers may cause severe signs or symptoms such as:

Vomiting or vomiting blood — which may appear red or black

Dark blood in stools, or stools that are black or tarry

Trouble breathing

Feeling faint

Nausea or vomiting

Unexplained weight loss

Appetite changes

How Are Ulcers Diagnosed?

Your doctor may suspect you have an ulcer just by talking with you about your symptoms. However, to confirm the diagnosis one of several tests should be taken. First, your doctor may ask you to take an acid-blocking medication, such as those used to treat heartburn, for a short period of time to see if symptoms improve.

If needed, your doctor may recommend a procedure called an upper endoscopy. It involves inserting a small, lighted tube (endoscope) through the throat and into the stomach to look for abnormalities. This procedure is usually given if you are having severe or recurring symptoms of ulcers.

Doctors sometimes treat for ulcers without confirming the diagnosis using endoscopy.

How Are Ulcers Treated?

If not properly treated, ulcers can lead to serious health problems. There are several ways in which ulcers can be treated, including making lifestyle changes, taking medication, and/or undergoing surgery.

Lifestyle Changes to Treat an Ulcer

To treat an ulcer, first eliminate substances that can be causing the ulcers. If you smoke or drink alcohol, stop. If the ulcer is believed to be caused by the use of NSAIDs, they need to be stopped.

Ulcer Medications

Ulcer medications can include:

Proton pump inhibitors (PPI). Proton pump medications reduce acid levels and allow the ulcer to heal. They include dexlansoprazole (Dexilant), esomeprazole (Nexium), lansoprazole (Prevacid), omeprazole (Prilosec), pantoprazole (Protonix), rabeprazole (Aciphex), and omeprazole/sodium bicarbonate (Zegerid).

Antibiotics . If you have H. pylori infection, then antibiotics are also used. There are multiple combinations of antibiotics that are taken for one to two weeks along with a PPI. Bismuth is also part of some treatment regimens.

Upper endoscopy . Some bleeding ulcers can be treated through an endoscope.

Surgery. Sometimes an operation is needed if the ulcer has created a hole in the wall of the stomach, or if there is serious bleeding that can't be controlled with an endoscope.

How Can I Prevent Ulcers?

To reduce the risk of developing ulcers:

Don't smoke.

Avoid alcohol.

Don't overuse aspirin and/or NSAIDs.

If you have symptoms of an ulcer, contact your health care provider.

Phone for appointment

Mon - Friday: 

08:30 - 16:30 

Tel: +27(0)11 482 8556/7