Topic Overview
What is a peptic ulcer?
A
peptic ulcer is a sore in the inner lining of the stomach or upper small
intestine (duodenum). Ulcers develop when the intestine or stomach's protective
layer is broken down. When this happens, digestive juices can damage the
intestine or stomach tissue. These strong juices, which contain hydrochloric
acid and an
enzyme called pepsin, also can injure the esophagus.
The esophagus is the tube that leads from your throat to your stomach.
Peptic ulcers are no longer a condition that most people have to live
with their entire lives. Treatment cures most ulcers. And symptoms go away
quickly.
Peptic ulcers that form in the stomach are called
gastric ulcers. Those that form in the upper small intestine are called
duodenal (say "doo-uh-DEE-nul" or "doo-AW-duh-nul") ulcers.
See a
picture of the
stomach and duodenum.
What causes peptic ulcers?
The two most common
causes of peptic ulcers are:
H. pylori and NSAIDs break down
the stomach or intestine’s protective mucus layer. The mucus layer prevents
digestive juices from damaging the stomach and intestine.
What are the symptoms?
Symptoms include:
- A burning, aching, gnawing pain between the
belly button (navel) and the breastbone. Some people also have back pain. The
pain can last from a few minutes to a few hours and may come and go for
weeks.
- Pain that usually goes away for a while after you take an
antacid or acid reducer.
- Loss of appetite and weight
loss.
- Bloating or nausea after eating.
-
Vomiting.
- Vomiting blood or material that looks like coffee
grounds.
- Passing black stools that look like tar, or stools that contain dark red blood.
Different people have different symptoms, and some people
have no symptoms at all.
How are peptic ulcers diagnosed?
Your doctor will
ask you questions about your symptoms and your general health, and he or she
will do a physical exam.
If
your symptoms are not severe and you are younger than 55, your doctor may do
some simple tests (using your blood, breath, or stool) to look for signs of
H. pylori infection.
The only way for you
and your doctor to know for sure if you have an ulcer is to do a more
complicated test, called an
endoscopy, to look for an ulcer and to test for
H. pylori infection. An endoscopy allows the doctor to
look inside your esophagus, stomach, and small intestine. An endoscopy is
usually done by a
gastroenterologist, a doctor who specializes in
digestive diseases.
How are they treated?
To treat peptic ulcers, most
people need to take medicines that reduce the amount of acid in the stomach. If
you have an H. pylori infection, you will also need to
take antibiotics. If your doctor prescribes antibiotics to treat your
infection, take them as directed. Do not stop
taking them just because you feel better. You need to take the full course of antibiotics. It is much more likely that the
infection will be cured if you take all the antibiotics.
You can
help speed the healing of your ulcer and prevent it from coming back if you
quit smoking and limit alcohol. Continued use of medicines such as aspirin,
ibuprofen, or naproxen may increase the chance of your ulcer coming
back.
Ignoring symptoms of an ulcer is not a good idea. This
condition needs to be treated. While symptoms can go away for a short time, you
may still have an ulcer. Left untreated, an ulcer can cause life-threatening
problems. Even with treatment, some ulcers may come back and may need more
treatment.
Frequently Asked Questions
|
Learning about peptic ulcer disease:
|
|
|
Being diagnosed:
|
|
|
Getting treatment:
|
|
|
Ongoing concerns:
|
|
Cause
The two most common causes of
peptic ulcer disease are infection with
Helicobacter pylori (H. pylori) bacteria and use of
nonsteroidal anti-inflammatory drugs (NSAIDs).
Although many people are infected with H. pylori
bacteria, only a few of them will develop peptic ulcer disease. Certain factors
make a person with an H. pylori infection more likely to
get an ulcer. Some of these factors, not all of which are well understood,
include:
- The use of certain medicines, such as aspirin, ibuprofen (Advil,
Motrin), or other NSAIDs.
- Smoking.
- Excessive alcohol
use.
- Prior history of ulcers.
- Physical stress caused by
a severe illness or injury (such as a major trauma, the need to be on a
ventilator to assist breathing, or surgery).
Most peptic ulcers that are not caused by an
H. pylori infection are caused by the
use of NSAIDs. NSAIDs may be prescribed to control pain or inflammation
caused by long-term (chronic) diseases such as arthritis or headaches. When
used for weeks or months, NSAIDs can damage the lining of the digestive tract,
causing an ulcer or making an existing ulcer worse.
A rare cause
of peptic ulcers is
Zollinger-Ellison syndrome. In this condition, the
stomach greatly overproduces acid, damaging the stomach lining.
Although there is no evidence to prove that emotional or mental stress
causes ulcers, it does seem to make ulcers worse in some people. But the
connection is still controversial. And there are no specific recommendations
for using
counseling or psychotherapy to treat peptic
ulcers.
Symptoms
The symptoms of a
peptic ulcer vary and, by themselves, are not a
reliable way to tell whether you have an ulcer. Also, some people may not have
symptoms.
The symptoms of an ulcer often can be confused with
other abdominal conditions, such as
dyspepsia or
gastroesophageal reflux disease (GERD).
Common ulcer symptoms include:
- A burning, aching pain—or a pain that feels
like hunger—between the navel and the breastbone. The pain sometimes extends to
the back.
- Belly pain that can last from a few minutes to a few
hours and usually goes away for a while after taking an antacid or acid
reducer.
- Weeks of pain that comes and goes and may alternate with
pain-free periods.
- Loss of appetite and weight
loss.
- Bloating or nausea after eating.
Less common but more serious symptoms of ulcers
include:
- Vomiting after meals.
- Vomiting
blood and/or material that looks like coffee grounds.
- Black stools
that look like tar, or stools that contain dark red blood.
Symptoms of ulcers in the upper small intestine (duodenal
ulcers) and in the stomach (gastric ulcers) are similar, except for when pain
occurs.
- Pain from a duodenal ulcer may occur several
hours after eating (when the stomach is empty) and may improve after eating.
Pain also may wake you frequently in the middle of the night.
- Pain
from a gastric ulcer may occur shortly after eating (when food is still in the
stomach).
Some ulcers do not cause symptoms. These are known as
silent ulcers. Silent ulcers are more common in older adults, people who have
diabetes, or people who use
nonsteroidal anti-inflammatory drugs (NSAIDs), such as
aspirin, ibuprofen (Advil), or naproxen (Aleve).
Complications of an ulcer include bleeding,
perforation, penetration, or obstruction of the digestive tract. Complications
can happen in both silent ulcers and ulcers that cause symptoms.
In children, symptoms vary with age:
- Toddlers and young children may complain of
general stomach pain.
- Teenagers may have symptoms more like those
experienced by adults.
What Happens
Many people who have
peptic ulcers may not seek medical attention when
their symptoms begin. Their symptoms, such as belly pain, may come and go for
some time and may alternate with pain-free periods. Even without treatment,
some ulcers will heal by themselves.
And even with treatment, some
ulcers may come back. Certain factors such as cigarette smoking and continued
use of
nonsteroidal anti-inflammatory drugs (NSAIDs) increase
the risk of ulcer recurrence.
Sometimes
ulcers can cause complications, such as bleeding,
perforation, penetration, or obstruction.
Most peptic ulcers without complications heal, regardless of the cause.
But an ulcer is likely to come back if you have an H. pylori infection that is not successfully treated. Recurring ulcers
caused by reinfection with H. pylori are not common in
the United States, except in areas that are overcrowded or have poor
sanitation.
If you have a history of ulcers, taking NSAIDs
regularly raises your chances of getting another ulcer. If you stop using
these medicines, you can reduce your chances of getting another ulcer.
What Increases Your Risk
Risk factors you can control
The following factors
can increase your chance of developing a
peptic ulcer and may slow the healing of an ulcer if
you already have one. You may be able to reduce the risk of developing an ulcer
by controlling or eliminating these factors, which include:
Risk factors you cannot control
Some factors that
you cannot control may increase your risk of developing an ulcer. These
include:
- A
Helicobacter pylori (H. pylori) infection, which is the most common cause of
ulcers.
- Physical stress caused by a severe illness or injury (such
as a major trauma, the need to be on a ventilator to assist breathing, or
surgery).
- Excess secretion of stomach acid.
- A family
history of ulcers.
What is not a risk factor
In the past, eating
spicy foods or drinking caffeine or moderate amounts of alcohol were thought to
increase your risk of getting an ulcer. This is no longer believed to be
true. But although certain foods or certain beverages may not increase your
risk of developing an ulcer, they may cause symptoms of heartburn or
indigestion. You may need to avoid them if they bother you.
Although there is no evidence to prove that emotional or mental stress
causes ulcers, it does seem to make ulcers worse in some people. But the
connection is still controversial. And there are no specific recommendations
for using
counseling or psychotherapy to treat peptic
ulcers.
When To Call a Doctor
If you have been diagnosed with
a
peptic ulcer, call 911 or other emergency services immediately if you have:
- Symptoms that could indicate a
heart attack or
shock.
- Sudden severe, continuous abdominal
pain or vomiting.
- Frequent feelings of dizziness or
lightheadedness, especially when moving from lying down to a seated or standing
position.
- Blood in your vomit or something that looks like coffee grounds
(partially digested blood) in your vomit.
- Stools that are black or
that look like tar, or stools that contain dark red or maroon blood.
Call your doctor if you have been diagnosed with a peptic
ulcer and:
- Your symptoms continue or become worse after 10
to 14 days of treatment.
- You begin to lose weight without
trying.
- You are vomiting.
- You have new belly pain or
belly pain that does not go away.
Watchful Waiting
If you have been diagnosed with a peptic ulcer
and medical treatment is not helping, call your doctor. Waiting until your
symptoms get worse can be serious.
If you do not know if you have
a peptic ulcer and you do not have any of the emergency symptoms listed above,
you may try taking an antacid or nonprescription acid reducer and other home
treatment, such as making changes to your diet.
- If your symptoms don't get better after 10 to
14 days, call your doctor.
- If your symptoms go away after taking
antacids or acid reducers and trying home treatment but then symptoms come
back, call your doctor.
Who To See
To evaluate your symptoms, see your:
If further testing or specialized treatment is needed,
you may need to see someone who specializes in the treatment of diseases of the
digestive tract (gastroenterologist).
If surgery is
needed, your doctor may refer you to a general surgeon. But surgery is rarely
needed to treat ulcers.
To prepare for your appointment, see the topic Making the Most of Your Appointment.
Exams and Tests
The tests needed to diagnose
peptic ulcer disease may depend on your symptoms and
on a medical history and physical exam.
If you are a younger adult
who is having ulcer symptoms for the first time, your doctor may begin
treatment with medicines based only on your symptoms and the results of your
medical history and physical exam. But it is becoming more common to test your
blood, breath, or stool immediately for
Helicobacter pylori (H. pylori) infection whenever someone has common ulcer
symptoms.
If you are older than 55, you may require more testing
because you may be at increased risk for stomach cancer. Although the risk of
stomach cancer is small, it is important to
distinguish between a gastric and duodenal ulcer. If
you have a stomach ulcer, it will be tested for cancer. In rare cases, stomach
ulcers contain cancer cells. Further testing is needed, especially for those
people older than 55 who have:
- Ulcer symptoms for the first
time.
- Ulcer symptoms that return before or after treatment is
completed.
- A family history of stomach
cancer.
- Additional symptoms may point to a more serious
problem, such as stomach cancer. These include:
- Blood in the stool.
- Weight loss
of more than 10% of body weight.
- Anemia.
- Difficulty swallowing
(dysphagia).
- Jaundice.
- Abdominal mass.
Tests to diagnose peptic ulcer disease
When a
person has symptoms of a peptic ulcer, the following tests may be used to look
for the ulcer:
-
Endoscopy.
Endoscopy
allows the doctor to look at the inside of the stomach and upper small
intestine to see whether ulcers are present. It also allows the doctor to
collect a tissue sample (biopsy) that can be tested for the presence of
H. pylori bacteria or other problems (such as cancer) in
the stomach.
-
Upper gastrointestinal (UGI) series. An X-ray
exam of the esophagus and stomach (upper GI series) may be used to diagnose peptic ulcer disease, although this test
is being used less frequently.
A
fecal occult blood test (FOBT) may be done to detect
blood in the stool, which may be caused by a peptic ulcer or another serious
problem, such as colon cancer. By itself, an FOBT cannot diagnose peptic ulcer
disease, but it may show if an ulcer is bleeding.
A
complete blood count (CBC) also may be done to look
for anemia, which may be caused by a bleeding ulcer.
Tests for H. pylori infection
Many people are infected with H. pylori bacteria,
but most of them will not have symptoms of peptic ulcer disease. Because of
this, the American College of Gastroenterology advises testing for
H. pylori infection for people who:1
- Have active peptic ulcer disease or a past
history of a peptic ulcer.
- Are known to have or have a family
history of a condition called gastric mucosa-associated lymphoid tissue (MALT)
lymphoma, which is a type of stomach cancer.
- Have a new case of
dyspepsia, are younger than 55, and do not have
bleeding, weight loss, or other symptoms that may be caused by a more serious
condition.
Some doctors prefer to test for H. pylori infection in everyone who has common ulcer
symptoms.
Your doctor may advise a screening for H. pylori before long-term NSAID use is begun. Screening and
treatment for H. pylori infection has been shown to
reduce the risk of ulcers for people starting long-term NSAID use.2 Anyone taking NSAIDs should discuss with his or her doctor
the potential risks of long-term NSAID use.
Helicobacter pylori tests cannot diagnose peptic ulcer
disease or other conditions that may cause symptoms similar to an ulcer. These
tests can only determine whether H. pylori bacteria are
present. The most common tests used to detect an infection with H. pylori bacteria include:
-
Blood test for H. pylori
antibodies. A blood test for H. pyloriantibodies is a quick, easy, and inexpensive test to
detect them. This blood test may make it possible to avoid having an upper
endoscopy exam. But it cannot distinguish between a past or current infection
with H. pylori bacteria, so it is not useful for
determining whether an infection has been cured.
-
Urea breath test. A urea breath test for
H. pylori is very accurate. Unlike the blood test, it
will detect only those H. pylori bacteria that are
present at the time of the test. This makes it a good test for checking to see
whether an H. pylori infection has been cured. The test
is somewhat expensive.
-
Stool antigen test. This test checks for antigens
for H. pylori in the stool. It can be used to diagnose
H. pylori bacteria as a cause of peptic ulcer disease
and to see whether treatment has cured the infection.
-
Biopsy of the stomach lining. During an upper
endoscopy exam, a biopsy of the stomach lining will be collected to test for
H. pylori bacteria. A biopsy is the most accurate way to
test for H. pylori. It also allows the doctor to check
for other possible causes of symptoms (such as cancer). A biopsy is expensive
and requires an upper endoscopy exam, which is more invasive than other tests
used to detect H. pylori.
Some people who have received therapy with
medicines to treat an H. pylori infection need
follow-up testing to make sure that the infection is
cured.
Treatment Overview
Treatment for peptic ulcer disease includes one or more of the following:
- If you have been diagnosed with a
peptic ulcer caused by infection with Helicobacter pylori (H. pylori)
bacteria, you will need treatment with antibiotic medicines to kill the
bacteria.
- If your ulcer is caused by the use of nonsteroidal
anti-inflammatory drugs (NSAIDs), stop using them. NSAIDs slow or prevent the
healing of an ulcer.
- Medicines that reduce the amount of acid
produced by the stomach are used to treat all forms of peptic ulcer disease.
These include H2 blockers and proton pump inhibitors (PPIs).
- Lifestyle changes, such as quitting smoking and not drinking too
much alcohol, are important for helping ulcers heal. Limit alcohol to 2 drinks
a day for men and 1 drink a day for women.
- Ulcers that do not respond to treatment may have developed
complications or may actually be cancer. You may need an endoscopy so that your
doctor can look at the inside of your stomach and your upper small intestine to
check for H. pylori or can collect a tissue sample
(biopsy) that can be tested for cancer. But sometimes when symptoms do not get
better with treatment, they are caused by something else that may or may not be
a serious problem. Make sure you talk with your doctor to get to the bottom of
your symptoms.
- Because the medicines now used to treat peptic ulcer
disease work so well, surgery is rarely used to treat peptic ulcer disease.
Surgery generally is reserved for people who have a life-threatening
complication of an ulcer, such as severe bleeding,
perforation, or obstruction. In some cases, even these complications can be
treated without surgery.
Initial treatment
Initial treatment of
peptic ulcer disease depends on its cause.
-
H. pylori
infection. Treatment to eliminate
Helicobacter pylori (H. pylori) bacteria usually involves combining two antibiotics
with an acid reducer such as a proton pump inhibitor or sometimes a bismuth
compound. Curing the infection speeds the healing of an ulcer and makes the
ulcer less likely to recur. It is important to take all the medicine your
doctor prescribes so that the bacteria are killed and do not come back. Do not
stop taking the medicine just because you feel better. If the bacteria are not
eliminated by the antibiotics, they may become even more difficult to kill
later (resistant).
-
NSAIDs. If at all possible, you will need to stop
taking
nonsteroidal anti-inflammatory drugs (NSAIDs). If you
must continue taking an NSAID, other medicines may be used to protect the
stomach. For more information, see the Medications section of this
topic.
-
Hypersecretory condition. Acid reducers are most
often used to treat an ulcer caused by a hypersecretory condition (a condition
in which your stomach produces excessive acid). Also, your doctor may
want to conduct other tests to find out whether there is another cause for the
ulcer.
-
Unknown cause. If no cause can be found (idiopathic
ulcer), your ulcer will usually be treated with an acid reducer. Long-term
treatment depends on the severity of the ulcer and other factors, such as the
size of the ulcer, whether you have had complications, and what other
treatments have been used.
No matter what is causing your ulcer, it is important
to stop taking NSAIDs and to quit smoking.
Ongoing treatment
If you feel that you need to
continue to use nonsteroidal anti-inflammatory drugs (NSAIDs) after being
diagnosed with a
peptic ulcer, work with your doctor to find an
alternative pain reliever. Use of NSAIDs can slow the healing of an ulcer or
even prevent it from healing. If you must continue to use NSAIDs, your
doctor may recommend that you take an NSAID that is less likely to cause ulcers. Or your doctor may prescribe a medicine that you take daily to help prevent ulcers. Medicines that help prevent ulcers include:
- Proton pump inhibitors (such as omeprazole).
- H2 blockers (such as famotidine).
- Prostaglandin analogs (such as misoprostol).
If ulcer symptoms do not respond to
treatment,
follow up with your doctor to be sure
Helicobacter pylori (H. pylori) bacteria have been identified and treated. Most
peptic ulcers are caused by infection with H. pylori
bacteria. Persistent infection will likely be treated with an alternate
combination of medicines. Antibiotic treatment for H. pylori should be taken exactly according to your doctor's instructions
for it to be effective.
Tests such as the urea breath test and a
stool antigen test can determine whether an H. pylori
infection has been cured. If you have a history of
ulcer complications or a family history of stomach
cancer, you may need an
endoscopy so that your doctor can look at the inside
of your stomach and upper small intestine to see whether an ulcer is present.
An endoscopy can also be used to collect a tissue sample (biopsy) that can be
tested for H. pylori or cancer. For more information on
these tests, see the Exams and Tests section of this topic.
Treatment if the condition gets worse
Recurring ulcers
caused by an infection with
Helicobacter pylori (H. pylori) bacteria will likely be treated with a different
combination of medicines.
Your doctor may conduct
follow-up tests to find out whether an infection with
H. pylori has continued or returned. Tests for
H. pylori may include a test of your breath or stool and a biopsy of your stomach lining. For more information on these tests,
see the Exams and Tests section of this topic.
If you have
experienced significant
complications from a
peptic ulcer such as bleeding or obstruction, you may
need an
endoscopy, even if you have already had one. If your
stomach or intestine has a perforation or your ulcer continues to bleed despite
treatment, you may require surgery. But surgery is rarely used to treat an
ulcer.
What To Think About
Risk of not treating ulcers
- Left untreated, many ulcers eventually
heal. But ulcers often recur if the cause of the ulcer is not eliminated or
treated. If ulcers keep coming back, you have an increased risk of developing a
serious complication.
- If treatment for your ulcer does not work to
heal the ulcer, your doctor will most likely suggest that you see a
gastroenterologist. The gastroenterologist will do an
endoscopy to look at your ulcer and to take a tissue sample (biopsy).
Prevention
You can greatly reduce the chance that you
will get a
peptic ulcer if you:
-
Don't start smoking. If you smoke, quit. Smokers
are much more likely to develop ulcers than nonsmokers. For ways to quit
smoking, see the topic
Quitting Smoking.
-
Avoid taking certain medicines. Avoid taking
aspirin, ibuprofen, and other
nonsteroidal anti-inflammatory drugs (NSAIDs) for
longer than a few days at a time. If you are taking aspirin regularly for heart
problems, ask your doctor about taking another medicine to help protect your
stomach and intestines from ulcers.
-
Drink alcoholic beverages only in moderation. Limit
alcohol to 2 drinks a day for men and 1 drink a day for women. Never drink
alcohol on an empty stomach.
Home Treatment
If you are being treated for a
peptic ulcer, your doctor will likely prescribe
medicines and encourage you to try some home treatment methods. To stop
symptoms and help an ulcer heal, you can:
-
Stop smoking.
-
Try nonprescription medicines that reduce acid production. Make sure you
tell your doctor about any medicines you are taking.
-
Make changes to your diet, such as eating smaller, more frequent meals. These
changes may improve your symptoms, but they will not help your ulcer
heal.
- Drink alcohol only in moderation, or avoid drinking alcohol.
Limit alcohol to 2 drinks a day for men and 1 drink a day for women. Drinking
too much alcohol may make an ulcer heal more slowly and may make your symptoms
worse.
Many people who have mild symptoms that could be caused by
a peptic ulcer first try home treatment for a short time without seeing a
doctor. But if you have ulcer symptoms that do not improve after 10 to 14 days
of home treatment, or if you have other symptoms such as weight loss, nausea
after eating, or consistent pain, it is be sure to see your doctor to make
certain you have an ulcer and not some other more serious illness. This is even
more important if you are middle-aged or older, because the risk for cancer or other illnesses that cause symptoms similar to peptic ulcer disease
increases with age.
Medicines are usually a very effective
treatment for ulcers. The bland diets that in the past were part of ulcer
treatment are no longer required. This means people with peptic ulcers do not
have to drink lots of milk or avoid spicy foods.
Medications
Most
peptic ulcers can be cured and prevented from
coming back by eliminating
Helicobacter pylori (H. pylori) infections and avoiding nonsteroidal anti-inflammatory drugs (NSAIDs).
Medicines are used to:
- Treat peptic ulcer disease by reducing the amount of acid
produced by the stomach.
- Kill H. pylori
bacteria when it is determined that they are infecting the stomach
lining.
- Prevent NSAID-related peptic ulcer disease by helping
protect the lining of the stomach and upper small intestine (duodenum) from
injury caused by NSAIDs.
Medication Choices
Medicines to reduce acid production
Medicines
that reduce the amount of acid produced by the stomach are used to treat all
forms of peptic ulcer disease.
Proton pump inhibitors may be taken with antibiotics if
the ulcer is caused by an H. pylori infection.
Medicines to kill H. pylori
bacteria
Doctors prescribe
combination drug therapy to cure infection with
H. pylori bacteria. Combination drug therapy usually
includes at least two antibiotics, a proton pump inhibitor, and sometimes a
bismuth compound.
Medicines to prevent ulcers
Medicines used to protect the stomach from damage caused by frequent use of aspirin or other NSAIDs include:
-
Proton pump inhibitors (PPIs) (such as omeprazole). These medicines have been shown to prevent ulcers and problems from ulcers (such as bleeding) in people taking NSAIDs long-term.
-
H2 blockers (such as cimetidine). These medicines may help prevent ulcers in people taking NSAIDs long-term.
-
Prostaglandin analogs (such as misoprostol). These medicines also work to prevent ulcers and problems from ulcers (such as bleeding) in people taking NSAIDs long-term.
What To Think About
Ulcers in the stomach (gastric
ulcers) often heal more slowly than ulcers in the upper small intestine
(duodenal ulcers).
You can get some H2 blockers and PPIs without a prescription (over-the-counter or OTC). If you are using OTC acid
reducers (such as Prilosec or Pepcid) to help with your symptoms for
more than 10 to 14 days at a time, or if your symptoms are very bad, be sure to see your doctor.
Surgery
Surgery is rarely needed to treat
peptic ulcers. Very effective medicine treatments are
available to help heal ulcers. Treatment of a
Helicobacter pylori (H. pylori) infection prevents most ulcers from coming
back.
Surgery is needed sometimes to treat:
Surgery Choices
When surgery is done to treat an ulcer, it usually
involves one or more of the following:
- Cutting one or more of the nerves to the
stomach (vagotomy).
- Widening the opening of the bottom of the
stomach (pyloroplasty).
- Removing part of the stomach (partial
gastrectomy).
What To Think About
Because medicine for peptic
ulcers works so well, surgery is rarely needed. If surgery is suggested, you
may want to:
- Seek a second opinion and ask whether all
medicine treatment options have been tried.
- Compare the cost of
long-term medicine treatment to the one-time cost of
surgery.
- Remember that no surgery can completely prevent ulcers
from returning.
- Find a surgeon who has a lot of experience with this type of
surgery.
Other Treatment
There is no other treatment
available for uncomplicated
peptic ulcers at this time.
Other Places To Get Help
Organizations
|
American College of
Gastroenterology
|
| P.O. Box 342260 |
| Bethesda, MD 20827-2260 |
| Phone: |
(301) 263-9000 |
| Web Address: |
www.acg.gi.org |
| |
|
The American College of Gastroenterology is an organization of
digestive disease specialists. The Web site contains information about common
gastrointestinal problems.
|
|
|
American Gastroenterological
Association
|
| 4930 Del Ray Avenue |
| Bethesda, MD 20814 |
| Phone: |
(301) 654-2055 |
| Fax: |
(301) 654-5920 |
| Web Address: |
www.gastro.org |
| |
|
The American Gastroenterological Association is a
society of doctors who specialize in the digestive system
(gastroenterologists). This Web site can help you find a gastroenterologist in
your area. They also have patient information on many gastrointestinal diseases
and disorders.
|
|
|
National Digestive Diseases Information Clearinghouse
|
| 2 Information Way |
| Bethesda, MD 20892-3570 |
| Phone: |
1-800-891-5389 |
| Fax: |
(703) 738-4929 |
| TDD: |
1-866-569-1162
toll-free |
| Email: |
nddic@info.niddk.nih.gov |
| Web Address: |
www.digestive.niddk.nih.gov |
| |
|
This clearinghouse is a service of the U.S. National
Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the
U.S. National Institutes of Health. The clearinghouse answers questions;
develops, reviews, and sends out publications; and coordinates information
resources about digestive diseases. Publications produced by the clearinghouse
are reviewed carefully for scientific accuracy, content, and readability.
|
|
References
Citations
-
Chey WD, et al. (2007). American College of
Gastroenterology guideline of the management of Helicobacter pylori infection. American Journal of Gastroenterology, 102(8): 1808–1825.
-
Lanza FL, et al. (2009). Guidelines for prevention of NSAID-related ulcer complications. American Journal of Gastroenterology, 104(3): 728–738.
Other Works Consulted
- Lew E (2009). Peptic ulcer disease. In
NJ Greenberger et al., eds., Current Diagnosis and Treatment: Gastroenterology, Hepatology, and Endoscopy, pp. 175–183. New York:
McGraw-Hill.
- Rostom A, et al. (2007). Gastrointestinal safety of cyclooxygenase-2 inhibitors: A Cochrane collaboration systematic review. Clinical Gastroenterology and Hepatology, 5(7): 818–828.
- Treatment of peptic ulcers and GERD (2008). Treatment Guidelines From the Medical Letter, 6(72): 55–60.
Credits
|
By
|
Healthwise Staff |
|
Primary Medical Reviewer
|
Kathleen Romito, MD - Family Medicine |
|
Specialist Medical Reviewer
|
Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology |
|
Last Revised
|
February 24, 2010 |