Stomach and Duodenal Ulcers (Peptic Ulcers)

What is a stomach or duodenal ulcer?

An ulcer is an open sore, or lesion, usually found on the skin or mucous membrane areas of the body.

  • An ulcer in the lining of the stomach or duodenum, where hydrochloric acid and pepsin are present, is referred to as a peptic ulcer
  • When the ulcer is in the stomach, it is called a gastric ulcer.
  • When the ulcer is in the duodenum, it is called a duodenal ulcer.

What causes gastric and duodenal ulcers?

  • Helicobacter pylori- research shows that most ulcers develop as a result of infection with a bacterium call Helicobacter pylori (h. pylori). the bacterium produces substances that weaken the stomach's protective mucus and make it more susceptible to the damaging effects of acid and pepsin.
  • smoking- studies show smoking increases the chances of getting an ulcer, slows the healing process of existing ulcers, and contributes to ulcer recurrence.
  • caffeine- stimulates the acid secretion in the stomach, which can aggravate the pain of an existing ulcer.
  • stress- people with ulcers often report that emotional stress increases ulcer pain. Physical stress, however, may increase the risk of developing ulcers, particularly in the stomach. 
  • acid and pepsin-  hydrochloric acid and pepsin, contributes to ulcer formation.
  • nonsteroidal anti-inflammatory drugs (NSAIDs)-  These drugs (such as aspirin, ibuprofen, and naproxen sodium) make the stomach vulnerable to the harmful effects of acid and pepsin

What are the symptoms of a gastric and duodenal ulcers?

  • anemia
  • bloating
  • belching
  • nausea and vomiting 
  • poor appetite
  • loss of weight
  • feeling tired and weak

What are some complications from ulcers?

  • bleeding-  As the lining of the stomach or duodenal wall is eroded, blood vessels may also be damaged, causing bleeding.
  • perforation- an inflammation of the abdominal cavity and wall.
  • narrowing and obstruction- Ulcers located at the end of the stomach can cause swelling and scarring, which can narrow or close the intestinal opening. This obstruction can prevent food from leaving the stomach and entering the small intestine, resulting in vomiting the contents of the stomach.

How are ulcers diagnosed?

  • upper GI (gastrointestinal) series-  Examination of the esophagus, stomach, and duodenum with an endoscope.
  • endoscopy- A test that uses a small, flexible tube with a light and a camera lens at the end (endoscope) to examine the inside of part of the digestive tract
  • blood, stool, breath, and stomach tissue test-  Performed to detect the presence of H. pylori. Research shows that these tests can still be accurate in detecting the bacteria.

What is the treatment for stomach and duodenal ulcers?

Specific treatment will be determined by your child's doctor based on the following

  • your child's age, overall health, and medical history
  • the extent of the disease
  • your child's tolerance for specific medications, procedures, or therapies
  • the expectations for the course of the disease
  • your opinion or preference
Recommended treatment may include lifestyle change- Doctors advised people with ulcers to avoid spicy, fatty, or acidic foods. However, a bland diet is now known to be ineffective for treating or avoiding ulcers. No particular diet is helpful for most ulcer patients.

Smoking has been shown to delay ulcer healing and has been linked to ulcer recurrence.

  • antibiotics- used to kill the bacteria.
  • h2-blockers- reduce the amount of acid the stomach produces by blocking histamine.
  • proton pump inhibitors- completely block stomach acid production by stopping the stomach's acid pump--the final step of acid secretion.
  • mucosal protective agents- Shield the stomach's mucous lining from the damage of acid, but do not inhibit the release of acid.
  • surgery- anti-ulcer medicines heal ulcers quickly and effectively, and eradication of H. pylori prevents most ulcers from recurring. However, rarely people do not respond to medication and may require surgery.


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