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Peptic Ulcer Disease

Gastric and Duodenal Ulcers — Etiology, Diagnosis, and Healing

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Dahiliye (İç Hastalıkları) department. Book Appointment →

What is Peptic Ulcer Disease?

Peptic ulcers are defects penetrating through the muscularis mucosa of the stomach or duodenum caused by acid-peptic injury exceeding mucosal defense.

Leading causes are H. pylori infection and nonsteroidal anti-inflammatory drug (NSAID) use; less common causes include Zollinger-Ellison syndrome, stress, and malignancy.

Duodenal ulcers typically cause postprandial pain relief whereas gastric ulcers may worsen with eating; both may present with bleeding or perforation.

Upper endoscopy is the diagnostic test of choice with biopsy for H. pylori and malignancy rule-out in gastric ulcers.

Symptoms

Epigastric burning or gnawing pain, often nocturnal
Postprandial pain (gastric) or relief after eating (duodenal)
Nausea, vomiting, early satiety, and bloating
Hematemesis, coffee-ground emesis, or melena from bleeding ulcer
Unexplained iron-deficiency anemia and weight loss
Sudden severe abdominal pain and peritoneal signs if perforated

Risk Factors

Helicobacter pylori chronic infection
Chronic NSAID or aspirin use, especially with anticoagulants or steroids
Tobacco smoking and heavy alcohol intake
Older age (over 65) and prior ulcer history
Physiologic stress (ICU, burns, head trauma — Cushing and Curling ulcers)
Zollinger-Ellison syndrome (gastrinoma) and hypercalcemia

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Persistent epigastric pain unresponsive to over-the-counter therapy
  • Hematemesis, melena, hematochezia, or syncope from bleeding
  • Sudden severe abdominal pain suggestive of perforation

Treatment Methods

01
Proton-pump inhibitor full-dose for 4–8 weeks (duodenal) or 8–12 weeks (gastric ulcer)
02
H. pylori eradication: quadruple bismuth therapy or concomitant therapy for 14 days when positive
03
Discontinuation of NSAIDs or co-prescription of PPI if continuation necessary
04
Endoscopic hemostasis (clips, thermal, injection) for actively bleeding ulcer; IV PPI infusion
05
Repeat endoscopy at 8–12 weeks for gastric ulcer to confirm healing and exclude malignancy
06
Surgery (oversewing, partial gastrectomy) for perforation, intractable bleeding, or obstruction

Which Department to Visit?

You can visit our Dahiliye (İç Hastalıkları) department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Dahiliye (İç Hastalıkları) Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.