Peptic Ulcers - Highlights

Highlights

New Research:

• Fewer people are being hospitalized for peptic ulcer disease caused by Helicobacter pylori (H. pylori) infection. The hospitalization rate dropped 21% between 1998 and 2005. Experts say the lower rate may be due to the increased use of treatments for peptic ulcers and H. pylori infection.
• Peptic ulcers can have a major effect on a patient's quality of life and finances. Research finds that complications of peptic ulcer disease can cost from $1,800 to more than $25,000 per patient.
• Some NSAIDs pose greater risks than others for ulcers and bleeding. Research finds that taking a COX-2-selective NSAID (celecoxib) poses less gastrointestinal risk than a non-selective NSAID (such as diclofenac) plus a proton pump inhibitor (PPI). However, coxibs carry a higher risk for heart attack and stroke than NSAIDs.
• Endoscopy is recommended for patients over age 50 who have new symptoms of peptic ulcers, as well as for patients under age 50 who have alarm symptoms (such as unintended weight loss, gastrointestinal bleeding, or swallowing problems). Patients under age 50 who don't have alarm symptoms can be tested for H. pylori infection and treated if they are positive. Endoscopy may also be performed if peptic ulcer symptoms don't improve with treatment.

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Overview:

• More than 6 million people in the United States have peptic ulcer disease.
• A peptic ulcer is an open sore or raw area that tends to develop in one of two places:
  • The lining of the stomach (gastric ulcer)
  • The upper part of the small intestine -- the duodenum (duodenal ulcer)
• Ulcers develop when digestive juices produced in the stomach, intestines, and digestive glands damage the lining of the stomach or duodenum.
• In 1982 two Australian scientists identified the bacteria H. pylori as the main cause of peptic ulcers.
• Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) is the second most common cause of ulcers.
• Certain drugs other than NSAIDs may aggravate ulcers.

Risk Factors Include:

• About 10 - 15% of people who are infected with H. pylori develop peptic ulcer disease. Other factors must also be present to trigger ulcers.
• Anyone who uses NSAIDs regularly is at risk for gastrointestinal problems.
• Although stress is no longer considered to be a cause of ulcers, some studies still suggest that stress may predispose a person to ulcers or prevent existing ulcers from healing.

Review Date: 07/18/2011
Reviewed By: Reviewed by: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. 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).