More Than a Bellyache — What to Know About Peptic Ulcer Disease

It may have been a gut punch for music fans when Bruce Springsteen recently postponed a round of shows to deal with effects of peptic ulcer disease, but The Boss’s sickness can leave someone feeling on fire with the aching pain associated with this condition.

An estimated 1% to 6% of the U.S. population is affected by peptic ulcers, which are painful sores that form in the inner lining of the stomach or in the upper part of the small intestine, also known as the duodenum. They develop when the digestive juices of the stomach eat away the protective mucus lining of the digestive tract.

What causes peptic ulcers?

Peptic ulcers are commonly caused by an infection with the Helicobacter pylori (H. pylori) bacteria or the overuse of aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs), commonly known as ibuprofen or naproxen.

About half of the global population has a H. pylori infection, but most people don’t have any symptoms. Only about 10% to 15% of those infected develop ulcers from the bacteria.

Peptic ulcer disease also can be caused by the extended use of aspirin, NSAIDs and prescribed blood thinners, such as clopidogrel or rivaroxaban. Like the H. pylori bacteria, these medications — especially if taken together — can weaken the lining of the digestive tract.

What are the symptoms of peptic ulcer disease?

Symptoms of a peptic ulcer can include a burning, aching or gnawing pain between the belly button and the breastbone, along with belly pain that can be relieved by taking an antacid. Some people also experience back pain, loss of appetite, bloating, nausea and vomiting.

Eating be painful for some people with peptic ulcers who wind up feeling bloated when they’re done or feel full soon after beginning a meal.

In serious cases, peptic ulcers can cause unexplained weight loss, stool that resembles tar, or vomiting that looks like blood or coffee grounds. Call your provider right away if you see this, as it can be a sign of excessive bleeding.

Diagnosis and treatment

To determine if your discomfort is caused by a peptic ulcer, your provider may do some simple tests using your blood, breath or stool. These tests look for signs of H. pylori infection.

You also may have an endoscopy, which involves inserting a long, flexible tube called an endoscope down your throat and into your esophagus. A tiny camera allows views of your esophagus, stomach and the beginning of your small intestine. Gastric or duodenal ulcers can be seen during endoscopy. Small, shallow biopsy samples are taken to check H. pylori.

To treat peptic ulcers, most people take medicines that reduce acid in the stomach. It can take several weeks for an ulcer to heal, and the ulcer can return if the underlying cause isn’t treated.

If an ulcer is caused by H. pylori, antibiotics will be prescribed. If it’s caused by NSAIDs use, often stopping these medications can allow the stomach lining to heal.

Tips for taking pain relievers

It’s a good idea to speak with your provider about pain relievers if you have a history of peptic ulcer disease. A non-NSAID pain reliever, such as acetaminophen, may be a better choice. Here are some other tips:

• If you have to take an NSAID, take the lowest effective dose and be sure to eat food with the medication.
• Quit smoking.
• Avoid alcohol, especially if you are taking an NSAID. Mixing alcohol and NSAIDs can increase your risk of gastrointestinal bleeding.
• Follow the medication instructions and use as directed.
• Be sure to tell your provider about all medications, herbs and over-the-counter products you consume.

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