Peptic Ulcer Disease
Peptic Ulcer Disease is a common cause of abdominal pain and gastrointestinal bleeding. Patients may present with burning epigastric discomfort (that may improve with food), black stool, vomiting blood or very dark material or simply iron deficiency anemia. After evaluation by a gastroenterologist, an upper endoscopy may be performed to make the diagnosis. Under sedation, a flexible endoscope is passed through the mouth and the esophagus, stomach and first portion of the small intestine or duodenum, which are examined carefully.
The vast majority of ulcers are caused by a bacteria known as Helicobacter pylori, which can be found in at least 50% of patients over the age of 60 in the United States. The gold standard for diagnosing H. pylori is by taking a biopsy at the time of endoscopy, although less sensitive and specific blood and breath tests are available. The use of aspirin and NSAIDs (non-steroidal anti-inflammatory drugs such as ibuprofen and naprosyn) are the other most common causes of ulcers. An extremely small proportion of gastric ulcers are malignant. Treatment of peptic ulcer disease includes acid suppression (typically with a class of medications known as proton pump inhibitors), eradication of H. pylori, if present, (with a two week course of antibiotics) and discontinuation of NSAIDs, if medically possible. Severe gastrointestinal bleeding may be controlled at the time of endoscopy with electrocautery or injections of medication. Your physician can discuss other details regarding diagnosis, treatment and the appropriate follow-up with you in the office.
