Peptic Ulcer Disease
Peptic ulcer disease occurs when open sores develop in the lining of the stomach or the upper portion of the small intestine (duodenum). These ulcers form when the protective lining of the digestive tract is disrupted, allowing stomach acid to cause irritation and tissue damage.
The most common causes include infection with Helicobacter pylori (H. pylori) and frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin. At The Medical Group of New Jersey, our board-certified gastroenterologists provide comprehensive evaluation, targeted treatment, and follow-up care to help ulcers heal fully and prevent recurrence.
Symptom Onset and Initial Evaluation
Ulcer symptoms may range from mild discomfort to severe abdominal pain. Many patients describe a dull or burning pain in the upper abdomen that may improve after eating or taking antacids. Other symptoms may include:
- Bloating, nausea, or a feeling of fullness after small meals
- Fatigue or lightheadedness due to anemia
- Dark, tarry stools or vomiting material that resembles coffee grounds, which may indicate bleeding
If symptoms worsen or become severe, immediate medical attention is required. Warning signs include sudden intense abdominal pain, vomiting blood, black or bloody stools, dizziness, fainting, or severe weakness.
During your initial visit, your gastroenterologist will review your medical history, medications, and lifestyle factors to identify possible causes. Determining whether an ulcer is related to infection, medication use, or another condition helps guide the most effective treatment plan.
Diagnosis
Accurate diagnosis is essential to confirm the presence of an ulcer and determine its underlying cause. Diagnostic testing may include:
- Upper endoscopy (EGD): Allows direct visualization of the stomach and duodenum and enables biopsy for H. pylori testing.
- Noninvasive H. pylori testing: Including stool antigen testing, urea breath testing, or blood tests.
- Blood work: Evaluates for anemia, infection, or other complications.
Our gastroenterology team uses advanced endoscopic and laboratory testing to detect ulcers early and tailor treatment to each patient’s needs.
Treatment Options
Treatment focuses on relieving symptoms, promoting healing, and preventing recurrence.
Eradicating H. pylori
If H. pylori infection is identified, combination therapy with antibiotics and a proton pump inhibitor (PPI) is prescribed for 10 to 14 days. Follow-up testing is performed to confirm eradication of the infection.
Reducing Stomach Acid
- Proton pump inhibitors (PPIs) or H2 blockers reduce acid production and support ulcer healing.
- Antacids may provide temporary symptom relief.
- Long-term use of acid-suppressing medications is carefully reviewed to balance effectiveness and safety.
Lifestyle and Medication Adjustments
- Avoiding alcohol, smoking, and excessive caffeine
- Discontinuing NSAIDs when possible or using protective therapy if pain relief is necessary
- Eating smaller,