A peptic ulcer is an open sore in the lining of the upper part of the gastrointestinal (GI) tract. It may be present in the stomach (gastric ulcer) or the first part of the small intestine called the duodenum (duodenal ulcer).
Symptoms of a peptic ulcer include stomach pain and upset. Nausea, vomiting, bloating, belching, or bleeding may sometimes occur. The bleeding may be seen as fresh blood in vomit or vomit that looks like coffee grounds. There may be black tarry stools as well.
The two most common causes of peptic ulcer are infection with the bacteria called H. pylori and the use of a type of pain medicine called nonsteroidal anti-inflammatory drugs (NSAIDs).
Many people have H. pylori in their bodies. Most of the time, it causes no problems. In some people, though, the H. pylori infection irritates the stomach lining. This may make the lining more likely to be damaged by normal stomach acids. H. pylori may also increase the amount of acid in the stomach. It is not clear why this infection leads to problems in some people and not in others.
NSAIDs, such as aspirin, ibuprofen, and naproxen, can cause peptic ulcers. The risk is higher when they are used for a longer time. They make the stomach lining more vulnerable to damage and ulcer formation. Other drugs, such as corticosteroids and bisphosphonates, may also cause peptic ulcers.
Tests may be done to check for H. pylori infection. These include a breath test and a stool test. Sometimes a blood test may be done. In some cases, a procedure using an upper endoscopy may be done. During this procedure, a thin, flexible tube with a camera and light on the end is put into the mouth and down the throat. The doctor can look at the esophagus, stomach, and duodenum through this tube. During this procedure, a tiny sample of stomach lining (biopsy) is usually taken and tested for H. pylori.