Peptic ulcers occur in two main locations: the stomach (gastric ulcer) and the first part of the small intestine (duodenal ulcer). While they share common causes, they present differently and require tailored treatment approaches.

Symptoms: How They Differ

Gastric Ulcer: Pain worsens after eating (30-60 minutes). May lead to weight loss.

Duodenal Ulcer: Pain relieved by food but worsens 2-3 hours later or at night. Often leads to weight gain due to frequent eating for relief.

Causes & Risk Factors:

Helicobacter pylori (H. pylori): A bacterial infection that damages the stomach lining.

NSAID Use: Medications like ibuprofen and aspirin can erode the stomach lining.

Smoking & Alcohol: Increase acid production and slow healing.

Stress & Diet: Can aggravate symptoms but are not direct causes.

Diagnosis: How Ulcers Are Identified:

Endoscopy (OGD) – Direct visualization and biopsy to rule out cancer.

H. pylori Testing – Urea breath test, stool antigen, or biopsy.

Blood Tests – To check for anaemia due to ulcer-related bleeding.

Treatment: Managing & Healing Ulcers;

Medications

Proton Pump Inhibitors (PPIs): Omeprazole, Lansoprazole (4-8 weeks for gastric, 4-6 weeks for duodenal ulcers).

H. pylori Eradication: PPI + Clarithromycin + Amoxicillin/Metronidazole (Triple Therapy).

Antacids: For symptom relief.

Lifestyle Adjustments

Avoid NSAIDs, alcohol, and smoking.

Eat small, frequent meals (for duodenal ulcers).

Complications: When to Worry:

Bleeding – Vomiting blood, black stools.

Perforation – Severe pain, requiring emergency surgery.

Obstruction – Vomiting due to ulcer-related scarring.

Cancer Risk – Higher in gastric ulcers.

References

NICE Guidelines – Peptic Ulcer Disease (2023).

American College of Gastroenterology (2022).

Mayo Clinic – Peptic Ulcers Overview.

Dr Geranmayeh