A peptic ulcer is a sore that develops in the lining of the upper gastrointestinal tract. The upper gastrointestinal tract includes the esophagus, stomach and beginning of the small bowel (duodenum).
- A stomach ulcer is a sore that develops in the lining of the stomach. It is also called a gastric ulcer.
- The most common type of peptic ulcer is a duodenal ulcer. This type of ulcer is found in the first part of the small intestine or duodenum.
- Sometimes, an ulcer can develop in the esophagus.
An upper endoscopy with biopsy is an examination of the esophagus, stomach and upper part of the small intestine (duodenum). It may be recommended if you have symptoms of an ulcer.
- The procedure is done using a thin, lighted tube with a camera on the end. The tube is called an endoscope.
- A biopsy is when a small sample of tissue is taken for testing.
The stomach produces acid and other substances that help break down (digest) the food we eat. Normally, the lining of the stomach and small bowel is protected from potential harmful effects of acid.
- Sometimes the lining of the stomach breaks down and an ulcer develops.
- In most cases, the ulcer develops in the first layer of the lining. However, sometimes the ulcer penetrates through the entire lining. This event is called a perforation of the lining and is a medical emergency.
About half of all peptic ulcers are associated with the bacterium Helicobacter pylori, or simply H. pylori. However, most people who carry H. pylori do not develop ulcers.
- In about 30 percent of people, peptic ulcer disease may be associated with long-term use of nonsteroidal anti-inflammatory medications (NSAIDs), such as aspirin or ibuprofen. These medications can irritate the lining of the gastrointestinal tract.
- In a small percentage of people, peptic ulcers are caused by cancerous or malignant tumors in the stomach or pancreas (the gland that produces enzymes the body needs to digest food).
- Tobacco products and alcohol may also increase the risk of developing a peptic ulcer.
- Heredity may also play a role in the development of a peptic ulcer.
For many people, the symptoms of a peptic ulcer are mild or barely noticeable.
- The most common symptom is a dull or burning abdominal pain that comes and goes.
- The pain typically starts two to three hours after eating or in the middle of the night.
- Eating may help the pain go away for a while.
Other symptoms of a peptic ulcer may include:
- Bloating and burping
- Decreased appetite
- Nausea and vomiting
- Weight loss
Severe symptoms associated with a peptic ulcer include:
- Abdominal pain that may spread to the right shoulder
- Black or bloody stools
- Vomit that looks bloody or resembles coffee grounds
Contact your healthcare provider if you have symptoms of a peptic ulcer. He or she will ask questions about your medical history and do a physical examination.
- An upper gastrointestinal endoscopy may be recommended if your symptoms are persistent or severe.
- This involves placing a small tube through the mouth into the stomach and beginning of the small intestine. The tube has a camera that allows the healthcare provider to examine the lining of the esophagus, stomach and the beginning of the small intestine.
If your healthcare provider recommends an upper gastrointestinal endoscopy, prior to the procedure tell them about any medications you are taking (including over-the-counter medications and supplements). Ask about specific instructions you should follow before the procedure. These may include:
- Medications you should not take before the procedure, such as blood thinners or aspirin
- Regular medications you should continue to take on the day of your procedure
- How many hours you should stop eating and drinking before the procedure
- Any activity or dietary restrictions you should follow during your recovery
Remember to arrange for transportation to and from the facility and for help at home.
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Make an appointment with your healthcare provider if you have symptoms of a peptic ulcer.
- Bring a copy of your medical history (past illnesses, surgeries, and hospitalizations)
- Make a list of your medications (including over-the-counter)
- Write down any questions, symptoms or concerns you want to talk about.
- If your healthcare provider prescribes a medication for you, ask for a generic version. If your doctor thinks that a generic version is not right for you or is not available, ask for a medication on the lowest available tier of your Prescription Drug List (PDL).
If an upper gastrointestinal endoscopy is recommended, what should I ask before the procedure?
- What is my diagnosis and reason for the procedure?
- How many upper GI endoscopies have you performed? How many have resulted in complications?
- What are the possible complications?
- How will I feel after the procedure and will I have to modify my activity? If so, for how long?
- Is there a chance my ulcer could be malignant?
- Is there any special preparation for the procedure? (If so, get clear instructions on what you need to do.)
- Will I have sedation or anesthesia? What are the benefits or drawbacks of each?
After your endoscopy, your healthcare provider should provide a description of any problems found during the procedure and how they treated them. You should also understand all home care instructions (including medications and side effects) and follow-up plans.