digestive disorders
Peptic Ulcer Disease
Introduction
A peptic ulcer is a round or oval sore where the lining of the stomach or duodenum has been eaten away by stomach acid and digestive juices. Peptic ulcers can result from infection withHelicobacter pyloribacteria or from use of medications, such asaspirinor other nonsteroidal anti-inflammatory drugs (NSAIDs), that weaken the lining of the stomach or duodenum. Discomfort caused by ulcers comes and goes and tends to be related to meals (sometimes better after eating and sometimes worse after eating). The diagnosis of peptic ulcer disease is based on symptoms of stomach pain and on the results of an examination of the stomach with a flexible viewing tube (upper endoscopy) and ofHelicobacter pyloritesting. Medications are given to reduce acid in the stomach, and antibiotics often are given to eliminateHelicobacter pylori. (See also Introduction to Gastritis and Peptic Ulcer Disease .) Ulcers penetrate into the lining of the stomach or duodenum (the first part of the small intestine). Ulcers may range in size from several millimeters to several centimeters. Ulcers can occur at any age, including infancy and childhood, but are most common among middle-aged adults. Gastritis (stomach inflammation) may develop into ulcer disease. The names given to specific ulcers identify their anatomic locations or the circumstances under which they developed. Duodenal ulcers,the most common type of peptic ulcer, occur in the first few inches of the duodenum. Gastric ulcers (stomach ulcers)are less common and usually occur in the lower part of the stomach. Marginal ulcerscan develop when part of the stomach has been removed surgically, at the point where the remaining stomach has been reconnected to the intestine. Stress ulcers,like those that form in acute stress gastritis, can occur as a result of the stress of severe illness, skin burns, or injury. Stress ulcers occur in the stomach and the duodenum. 