| Subject | Contents |
| Definition | A gastric ulcer is a break in the normal tissue lining the stomach. See also duodenal ulcer , which is a break in the normal tissue lining the duodenum (the first part of the small bowel).
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| Alternative Names | Ulcer - stomach; Peptic disease; Stomach ulcer
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| Causes, incidence, and risk factors | Benign gastric ulcers are caused by an imbalance between the secretion of acid and an enzyme called pepsin and the defenses of the stomach mucosal lining. This leads to inflammation and may be precipitated by aspirin and nonsteroidal anti-inflammatory medications (NSAIDs) such as ibruprofen. Risk factors for benign gastric ulcers include the following: use of aspirin and NSAID Helicobacter pylori infectionChronic gastritis Smoking Increasing age. Stress does not cause or worsen gastric ulcers. |
| Symptoms | Abdominal pain May wake you at night May be relieved by antacids or milk May occur 2 to 3 hours after a meal May be worse if you don't eat NauseaAbdominal indigestionVomiting , especially vomiting blood Blood in stools or black, tarry stools Weight lossFatigue Note: There may be no symptoms. |
| Signs and tests | EGD (esophagogastroduodenoscopy) and biopsy showing a benign gastric ulcerUpper GI series showing a gastric ulcer |
| Treatment | For people with Helicobacter pylori infection, the main goal is eradication of the organism which causes the problem. Multiple regimens are effective and usually include either an H2 receptor antagonist such as famotidine (Pepcid) or nizatidine (Axid) or a proton pump inhibitor such as omeprazole (Prilosec) or esomeprazole (Nexium) to suppress acid, combined with two antibiotics. For people without H. pylori infection, ulcer-healing medications such as antacids, H2 receptor antagonists, or proton pump inhibitors are usually effective. Long-term treatment may be required. In the event of bleeding from the ulcer, endoscopic therapy can control bleeding in most cases. Surgical intervention may be recommended for people who do not respond to medical therapy or to endoscopic therapy for bleeding. A vagotomy (cutting the vagus nerve, which controls the stomach's production of gastric acid ) or a partial gastrectomy (removal of part of the stomach) may be necessary. Self-help measures include: Avoiding smoking Avoiding tea, coffee , and soft drinks containing caffeine Avoiding alcohol Avoiding aspirin and NSAIDs Eating several small meals a day at regular intervals |
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| Expectations (prognosis) | Most ulcers heal with medication in 6 to 8 weeks. Recurrence is common but is less likely if H. pylori infection is treated and acid-blocking medications are continued. |
| Complications | Bleeding from the ulcer Perforation (hole) in the stomach Obstruction of the passage of stomach contents Complications are often corrected by medication, through an endoscope, or (in rare instances) with surgery. |
| Calling your health care provider | Call your health care provider if symptoms of gastric ulcer develop. |
| Prevention | Use caution in taking aspirin and NSAIDs if prone to gastric ulcers. |
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