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Peptic ulcer disease
Other Resources UpToDate PubMed

Peptic ulcer disease

Contributors: Michael W. Winter MD, Christine Osborne MD, Desiree Rivera-Nieves MD, Khaled Bittar MD, Nishant H. Patel MD
Other Resources UpToDate PubMed


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.


K27.9 – Peptic ulcer, site unspecified, unspecified as acute or chronic, without hemorrhage or perforation

13200003 – Peptic ulcer

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Drug Reaction Data

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.

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Last Reviewed:09/25/2017
Last Updated:07/06/2021
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Patient Information for Peptic ulcer disease
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Contributors: Medical staff writer


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.


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.
Your health care provider may perform an endoscopy to analyze the ulcer, to see if it is improving, or to see if it requires surgery. Although very unlikely, surgery may be necessary to remove an ulcer that is severe or not healing properly.
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Peptic ulcer disease
A medical illustration showing key findings of Peptic ulcer disease : Nausea, Vomiting, Epigastric pain, Heme+ stool, Dyspepsia, RBC decreased
Copyright © 2023 VisualDx®. All rights reserved.