Peptic ulcer

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	Cause of peptic ulcers	Gastroscopy procedure	Location of peptic ulcers
Stomach disease or trauma

Ulcer - peptic; Ulcer - duodenal; Ulcer - gastric; Duodenal ulcer; Gastric ulcer; Dyspepsia - ulcers

Treatment involves a combination of medications to kill the H. pylori bacteria (if present), and reduce acid levels in the stomach. This strategy allows your ulcer to heal and reduces the chance it will come back.

Take all of your medications exactly as prescribed.

If you have a peptic ulcer with an H. pylori infection, the standard treatment uses different combinations of the following medications for 5 - 14 days:

• Two different antibiotics to kill H. pylori, such as clarithromycin (Biaxin), amoxicillin, tetracycline, or metronidazole (Flagyl)
• Proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid), or esomeprazole (Nexium)
• Bismuth (the main ingredient in Pepto-Bismol) may be added to help kill the bacteria

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If you have an ulcer without an H. pylori infection, or one that is caused by taking aspirin or NSAIDs, your doctor will likely prescribe a proton pump inhibitor for 8 weeks.

You may also be prescribed this type of medicine if you must continue taking aspirin or NSAIDs for other health conditions.

Other medications that may be used for ulcer symptoms or disease are:

• Misoprostol, a drug that may help prevent ulcers in people who take NSAIDs on a regular basis
• Medications that protect the tissue lining (such as sucralfate)

If a peptic ulcer bleeds a lot, an EGD may be needed to stop the bleeding. Surgery may be needed if bleeding cannot be stopped with an EGD, or if the ulcer has caused a perforation.

Peptic ulcers tend to come back if untreated. If you follow your doctor's treatment instructions and take all of your medications as directed, the H. pylori infection will be cured and you'll be much less likely to get another ulcer.

• Bleeding inside the body (internal bleeding)
• Gastric outlet obstruction
• Inflammation of the tissue that lines the wall of the abdomen (peritonitis)
• Perforation of the stomach and intestines

Call 911 if you:

• Develop sudden, sharp abdominal pain
• Have a rigid, hard abdomen that is tender to touch
• Have symptoms of shock such as fainting, excessive sweating, or confusion
• Vomit blood or have blood in your stool (especially if it's maroon or dark, tarry black)

Call your doctor if:

• You feel dizzy or light-headed
• You have ulcer symptoms

Review Date: 08/01/2009
Reviewed By: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).