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Peptic
Ulcer Disease (PUD)
Patient Education Handout associated with UMHS Clinical Care Guideline |
This information is not a tool for self-diagnosis or a substitute for medical treatment. You should speak to your health-care provider or make an appointment to be seen if you have questions or concerns about this information or your medical condition.
What is an ulcer?
An ulcer is a sore or lesion that forms in the lining of the stomach or duodenum. The duodenum is the first part of the small intestine. Ulcers that are located in the stomach are called gastric ulcers. Ulcers located in the duodenum are called duodenal ulcers. Millions of PUD cases occur each year.
How does it occur?
- An infection with a bacterium that infects the stomach called Helicobacter pylori (H. pylori)
- Increased acid in the stomach
- Use of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) (such as ibuprofen found in Nuprin, Motrin, and Advil or naproxen, found in Aleve)
It has recently been found that 90% of duodenal ulcers not caused by NSAIDs are associated with an infection in the stomach with H. pylori. H. pylori can be diagnosed by a blood test, a stool test, or from a biopsy of the stomach. Getting rid of H. pylori greatly increases the chance that ulcers will not come back and will heal. It is not known how the bacterium is transmitted from person to person. Many people have the H. pylori bacterium in their stomach, but do not have an ulcer.
What are the symptoms?
- Gnawing or burning pain in the stomach
- Stomach pain 1 to 3 hours after eating
- Stomach pain that wakes you from sleep
- Stomach pain that is relieved with antacids and/or eating
- Stomach pain that is associated with nausea and vomiting, loss of appetite, weight loss or indigestion
If your most frequent symptom is heartburn, it is probably not a symptom of peptic ulcer disease.
How is it treated?
For ulcers caused by NSAIDs:
- Stop taking NSAIDs and symptoms should improve within 1 to 2 weeks
- Take the medication exactly as prescribed by your provider
- To relieve pain, you may use an antacid, as directed by your provider, which helps to reduce stomach acid. Antacids include Maalox, Mylanta or Tums
- If you smoke, STOP! Ulcers are more common in smokers and they take longer to heal.
For ulcers caused by H. pylori:
- Antibiotics and medications that block acid production in your stomach may be prescribed by your provider. It is very important to finish all of your medication even if you are feeling better after a couple of days.
Some ulcers do not respond to treatment. If you continue to have symptoms after treatment, call your physician. You may be scheduled to see a gastroenterologist who specializes in problems with the stomach to confirm the diagnosis and/or suggest a different treatment.
How can I take care of myself?
Your physician may prescribe one or more of the following medications to treat your PUD. Possible side effects for these medications are also listed:
- Amoxicillin - Rash, nausea, vomiting and diarrhea
- Omeprazole (Prilosec) - Abdominal or stomach pain, constipation, diarrhea, headache, skin rash
- Metronidazole (Flagyl) - Nausea, dizziness, diarrhea, headache, loss of appetite, stomach pain or cramps, vomiting and dark urine (this will go away when you stop the medication). Do not drink alcoholic beverages or use other alcohol-containing preparations while taking this medication and for at least one day after stopping it. Alcohol may cause severe stomach pain, nausea, vomiting, headache, or redness of the face.
- Clarithromycin - Abnormal taste, diarrhea, headache, nausea, stomach pain or discomfort, vomiting
- Pepto-Bismol - Dark tongue and/or stools (this will go away when you stop the medication).
When should I call the doctor?
- There is blood in your stools
- You have black, tarry stools
- You have nausea with vomiting
- You have severe stomach pain
- There is no improvement in symptoms within 2 weeks