Peptic ulcer disease refers to the formation of ulcers in the gastric or duodenal mucosa. It is most commonly caused by excessive NSAID use or Helicobacter pylori infection. The incidence of peptic ulcers that are H pylori positive has been decreasing over the past few decades. Both gastric and duodenal ulcers are characterized by a burning epigastric pain. Gastric ulcer pain typically worsens with food intake; pain from duodenal ulcers is often alleviated with food intake. Prolonged steroid use, excessive alcohol consumption, prolonged intubation, and Zollinger-Ellison syndrome can predispose to ulcer formation as well. It may be difficult to identify the cause of the ulcers.
The primary complications of peptic ulcers are acute bleeding with blood loss anemia and perforation due to ulcer erosion through the mucosal wall. These complications require either endoscopic or surgical intervention.
Codes
ICD10CM: K27.9 – Peptic ulcer, site unspecified, unspecified as acute or chronic, without hemorrhage or perforation
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
Peptic ulcers are sores that can develop in the upper digestive tract (esophagus, stomach, or the upper small intestine). Peptic ulcers are often caused by prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, Motrin, aspirin, or by Helicobacter pylori (bacterial) infection. When ulcers occur in the stomach, they are called gastric ulcers. In the esophagus (passageway from mouth to stomach), they are called esophageal ulcers, and in the upper small intestine, they are called duodenal ulcers.
Who’s At Risk
Risk factors for peptic ulcers:
Smoking
Habitual alcohol use
Helicobacter pylori infection
Extended use of NSAIDs (aspirin, ibuprofen)
Excess acid in the stomach
Signs & Symptoms
Peptic ulcer disease without symptoms is called silent peptic ulcer, often caused by certain medications. Symptoms of peptic ulcers eventually may include:
Burning pain in your stomach or chest
Indigestion, heartburn, and loss of appetite
Nausea and sometimes vomiting
Bloated, belching, feeling full
These may be signs of complications:
Blood in your stool or vomit
Weakness and fatigue
In patients with duodenal ulcers, abdominal pain typically occurs 2-3 hours after eating or at night. This pain is usually relieved by eating or taking antacids.
Patients with gastric ulcers experience pain while eating and can experience nausea and weight loss.
Self-Care Guidelines
To ease the symptoms of peptic ulcers:
Eat a healthy, balanced diet with fruits, vegetables, and whole grains
Contact a health care professional about your use of pain relievers
Manage your stress
Stop smoking
Reduce or avoid alcohol use
When to Seek Medical Care
Contact your health care provider if you have symptoms that worry you. If symptoms are not improving despite self-care or they are getting worse, contact a health care professional.
Treatments
Your health care provider may recommend a few treatments to reduce symptoms:
Medications that block acid production, such as omeprazole (Prilosec) or Iansoprazole (Prevacid)
Antibiotics to kill Helicobacter pylori if this bacteria is found in your digestive tract
Medications that can protect the lining of the stomach and small intestine, such as sucralfate (Carafate) or misoprostol (Cytotec)
Medications that reduce acid production called histamine H2 blockers
Your health care provider may recommend an antacid supplement to neutralize stomach acid.
Patient Information for Peptic ulcer disease