Topic Overview

What is a peptic uIcer?

A peptic ulcer is a sore in the inner lining of the stomach or upper small
intestine (duodenum). Ulcers develop when the intestine or stomach's protective
layer is broken down. When this happens, digestive juices can damage the
intestine or stomach tissue. These strong juices, which contain hydrochloric acid
and an enzyme called pepsin, also can injure the esophagus. The esophagus is
the tube that leads from your throat to your stomach.
Peptic ulcers are no longer a condition that most people have to live with their entire lives. Treatment
cures most ulcers. And symptoms go away quickly.
Peptic ulcers that form in the stomach are called gastric ulcers. Those that form in the upper small
intestine are called duodenal (say "doo-uh-DEE-nul" or "doo-AW-duh-nul") ulcers.
Causes of peptic uIcers
The two most common causes of peptic ulcers are:
O nfection with Helicobacter pylori (H. pylori) bacteria.
O Use of nonsteroidal anti-inflammatory drugs (NSADs).
H. pylori and NSAIDs break down the stomach or intestine's protective mucus layer. The mucus
layer prevents digestive juices from damaging the stomach and intestine.
$2pto2s
Symptoms include:
O A burning, aching, gnawing pain between the belly button (navel) and the breastbone. Some people
also have back pain. The pain can last from a few minutes to a few hours and may come and go for
weeks.
O Pain that usually goes away for a while after you take an antacid or acid reducer.
O Loss of appetite and weight loss.
O Bloating or nausea after eating.
O Vomiting.
O Vomiting blood or material that looks like coffee grounds.
O Passing black stools that look like tar, or stools that contain dark red blood.
ow are peptic uIcers diagnosed?
our doctor will ask you questions about your symptoms and your general health, and he or she will do a
physical exam.
f your symptoms are not severe and you are younger than 55, your doctor may do some simple tests
(using your blood, breath, or stool) to look for signs of H. pylori infection.
The only way for you and your doctor to know for sure if you have an ulcer is to do a more complicated
test, called an endoscopy, to look for an ulcer and to test forH. pylori infection. An endoscopy allows the
doctor to look inside your esophagus, stomach, and small intestine. An endoscopy is usually done by a
gastroenterologist, a doctor who specializes in digestive diseases.
ow are the treated?
To treat peptic ulcers, most people need to take medicines that reduce the amount of acid in the stomach.
f you have an H. pylori infection, you will also need to take antibiotics. f your doctor prescribes antibiotics
to treat your infection, take them as directed. Do not stop taking them just because you feel better. ou
need to take the full course of antibiotics. t is much more likely that the infection will be cured if you take
all the antibiotics.
ou can help speed the healing of your ulcer and prevent it from coming back if you quit smoking and
limit alcohol. Continued use of medicines such as aspirin, ibuprofen, or naproxen may increase the
chance of your ulcer coming back.
gnoring symptoms of an ulcer is not a good idea. This condition needs to be treated. While symptoms
can go away for a short time, you may still have an ulcer. Left untreated, an ulcer can cause life-
threatening problems. Even with treatment, some ulcers may come back and may need more treatment.
Cause
The two most common causes of peptic ulcer disease are infection with Helicobacter pylori(H. pylori)
bacteria and use of nonsteroidal anti-inflammatory drugs (NSADs).
Although many people are infected with H. pylori bacteria, only a few of them will develop peptic ulcer
disease. Certain factors make a person with an H. pylori infection more likely to get an ulcer. Some of
these factors, not all of which are well understood, include:
O The use of certain medicines, such as aspirin, ibuprofen (Advil, Motrin), or other NSADs.
O Smoking.
O Excessive alcohol use.
O Prior history of ulcers.
O Physical stress caused by a severe illness or injury (such as a major trauma, the need to be on a
ventilator to assist breathing, or surgery).
Most peptic ulcers that are not caused by an H. pylori infection are caused by the use of NSADs. NSADs
may be prescribed to control pain or inflammation caused by long-term (chronic) diseases such
as arthritis or headaches. When used for weeks or months, NSADs can damage the lining of the
digestive tract, causing an ulcer or making an existing ulcer worse.
A rare cause of peptic ulcers is Zollinger-Ellison syndrome. n this condition, the stomach greatly
overproduces acid, damaging the stomach lining.
Although there is no evidence to prove that emotional or mental stress causes ulcers, it does seem to
make ulcers worse in some people. But the connection is still controversial. And there are no specific
recommendations for using counseling or psychotherapy to treat peptic ulcers.
!eptic UIcer Disease (cont.)
IN TI$ ARTICLE
O Peptic Ulcer Disease Topic Overview
O What Causes Peptic Ulcer Disease
O What Are the $2pto2s of !eptic UIcer Disease
O What Happens When ou Have Peptic Ulcer Disease
O What ncreases our Risk of Peptic Ulcer Disease
O When To Call a Doctor
O Peptic Ulcer Disease Exams and Tests
O Peptic Ulcer Disease Treatment Overview
O Prevention
O Home Treatment
O Medications
O Surgery
O Other Treatment
O Other Places To Get Help
O Related nformation
O References
O Credits
$2pto2s
The symptoms of a peptic ulcer vary and, by themselves, are not a reliable way to tell whether you have
an ulcer. Also, some people may not have symptoms.
The symptoms of an ulcer often can be confused with other abdominal conditions, such
as dyspepsia or gastroesophageal reflux disease (GERD).
Common ulcer symptoms include:
O A burning, aching painor a pain that feels like hungerbetween the navel and the breastbone. The
pain sometimes extends to the back.
O Belly pain that can last from a few minutes to a few hours and usually goes away for a while after
taking an antacid or acid reducer.
O Weeks of pain that comes and goes and may alternate with pain-free periods.
O Loss of appetite and weight loss.
O Bloating or nausea after eating.
Less common but more serious symptoms of ulcers include:
O Vomiting after meals.
O Vomiting blood and/or material that looks like coffee grounds.
O Black stools that look like tar, or stools that contain dark red blood.
Symptoms of ulcers in the upper small intestine (duodenal ulcers) and in the stomach (gastric ulcers) are
similar, except for when pain occurs.
O Pain from a duodenal ulcer may occur several hours after eating (when the stomach is empty) and
may improve after eating. Pain also may wake you frequently in the middle of the night.
O Pain from a gastric ulcer may occur shortly after eating (when food is still in the stomach).
Some ulcers do not cause symptoms. These are known as silent ulcers. Silent ulcers are more common
in older adults, people who have diabetes, or people who use nonsteroidal anti-inflammatory drugs
(NSADs), such as aspirin, ibuprofen (Advil), or naproxen (Aleve).
Complications of an ulcer include bleeding, perforation, penetration, or obstruction of the digestive tract.
Complications can happen in both silent ulcers and ulcers that cause symptoms.
n children, symptoms vary with age:
O Toddlers and young children may complain of general stomach pain.
O Teenagers may have symptoms more like those experienced by adults.
What appens
Many people who have peptic ulcers may not seek medical attention when their symptoms begin. Their
symptoms, such as belly pain, may come and go for some time and may alternate with pain-free periods.
Even without treatment, some ulcers will heal by themselves.
And even with treatment, some ulcers may come back. Certain factors such as cigarette smoking and
continued use of nonsteroidal anti-inflammatory drugs (NSADs) increase therisk of ulcer recurrence.
Sometimes ulcers can cause complications, such as bleeding, perforation, penetration, or obstruction.
Most peptic ulcers without complications heal, regardless of the cause. But an ulcer is likely to come back
if you have an H. pylori infection that is not successfully treated. Recurring ulcers caused by reinfection
with H. pylori are not common in the United States, except in areas that are overcrowded or have poor
sanitation.
f you have a history of ulcers, taking NSADs regularly raises your chances of getting another ulcer. f
you stop using these medicines, you can reduce your chances of getting another ulcer.
What Increases Your Risk
Risk factors ou can controI
The following factors can increase your chance of developing a peptic ulcer and may slow the healing of
an ulcer if you already have one. ou may be able to reduce the risk of developing an ulcer by controlling
or eliminating these factors, which include:
O Use of nonsteroidal anti-inflammatory drugs (NSADs) (such as aspirin).
O Cigarette smoking.
O Excessive use of alcohol.
Risk factors ou cannot controI
Some factors that you cannot control may increase your risk of developing an ulcer. These include:
O A Helicobacter pylori (H. pylori) infection, which is the most common cause of ulcers.
O Physical stress caused by a severe illness or injury (such as a major trauma, the need to be on a
ventilator to assist breathing, or surgery).
O Excess secretion of stomach acid.
O A family history of ulcers.
What is not a risk factor
n the past, eating spicy foods or drinking caffeine or moderate amounts of alcohol were thought to
increase your risk of getting an ulcer. This is no longer believed to be true. But although certain foods or
certain beverages may not increase your risk of developing an ulcer, they may cause symptoms
of heartburn or indigestion. ou may need to avoid them if they bother you.
Although there is no evidence to prove that emotional or mental stress causes ulcers, it does seem to
make ulcers worse in some people. But the connection is still controversial. And there are no specific
recommendations for using counselingor psychotherapy to treat peptic ulcers.
When To CaII a Doctor
f you have been diagnosed with a peptic ulcer,caII or other e2ergenc services i22ediateI if you
have:
O Symptoms that could indicate a heart attack or shock.
O Sudden severe, continuous abdominal painor vomiting.
O Frequent feelings of dizziness or lightheadedness, especially when moving from lying down to a
seated or standing position.
O Blood in your vomit or something that looks like coffee grounds (partially digested blood) in your vomit.
O Stools that are black or that look like tar, or stools that contain dark red or maroon blood.
Call your doctor if you have been diagnosed with a peptic ulcer and:
O our symptoms continue or become worse after 10 to 14 days of treatment.
O ou begin to lose weight without trying.
O ou are vomiting.
O ou have new belly pain or belly pain that does not go away.
WatchfuI Waiting
f you have been diagnosed with a peptic ulcer and medical treatment is not helping, call your doctor.
Waiting until your symptoms get worse can be serious.
f you do not know if you have a peptic ulcer and you do not have any of the emergency symptoms listed
above, you may try taking an antacid or nonprescription acid reducer and other home treatment, such as
making changes to your diet.
O f your symptoms don't get better after 10 to 14 days, call your doctor.
O f your symptoms go away after taking antacids or acid reducers and trying home treatment but then
symptoms come back, call your doctor.
Who To $ee
To evaluate your symptoms, see your:
O Family medicine doctor.
O nternist.
O General practitioner.
O Nurse practitioner.
O Physician assistant.
O Pediatrician (for children and teens).
f further testing or specialized treatment is needed, you may need to see someone who specializes in the
treatment of diseases of the digestive tract (gastroenterologist).
f surgery is needed, your doctor may refer you to a general surgeon. But surgery is rarely needed to treat
ulcers.
Exa2s and Tests
The tests needed to diagnose peptic ulcer disease may depend on your symptoms and on a medical
history and physical exam.
f you are a younger adult who is having ulcer symptoms for the first time, your doctor may begin
treatment with medicines based only on your symptoms and the results of your medical history and
physical exam. But it is becoming more common to test your blood, breath, or stool immediately
for Helicobacter pylori (H. pylori) infection whenever someone has common ulcer symptoms.
f you are older than 55, you may require more testing because you may be at increased risk for stomach
cancer. Although the risk of stomach cancer is small, it is important todistinguish between a gastric and
duodenal ulcer. f you have a stomach ulcer, it will be tested for cancer. n rare cases, stomach ulcers
contain cancer cells. Further testing is needed, especially for those people older than 55 who have:
O Ulcer symptoms for the first time.
O Ulcer symptoms that return before or after treatment is completed.
O A family history of stomach cancer.
O Additional symptoms may point to a more serious problem, such as stomach cancer. These include:
4 Blood in the stool.
4 Weight loss of more than 10% of body weight.
4 Anemia.
4 Difficulty swallowing (dysphagia).
4 Jaundice.
4 Abdominal mass.
Tests to diagnose peptic uIcer disease
When a person has symptoms of a peptic ulcer, the following tests may be used to look for the ulcer:
O Endoscop.Endoscopy allows the doctor to look at the inside of the stomach and upper small
intestine to see whether ulcers are present. t also allows the doctor to collect a tissue sample (biopsy)
that can be tested for the presence of H. pylori bacteria or other problems (such as cancer) in the
stomach.
O Upper gastrointestinaI (UGI) series. An X-ray exam of the esophagus and stomach (upper G series)
may be used to diagnose peptic ulcer disease, although this test is being used less frequently.
A fecal occult blood test (FOBT) may be done to detect blood in the stool, which may be caused by a
peptic ulcer or another serious problem, such as colon cancer. By itself, an FOBT cannot diagnose peptic
ulcer disease, but it may show if an ulcer is bleeding.
A complete blood count (CBC) also may be done to look for anemia, which may be caused by a bleeding
ulcer.
Tests for H. pylori infection
Many people are infected with H. pylori bacteria, but most of them will not have symptoms of peptic ulcer
disease. Because of this, the American College of Gastroenterology advises testing for H. pylori infection
for people who:
1

O Have active peptic ulcer disease or a past history of a peptic ulcer.
O Are known to have or have a family history of a condition called gastric mucosa-associated lymphoid
tissue (MALT) lymphoma, which is a type of stomach cancer.
O Have a new case of dyspepsia, are younger than 55, and do not have bleeding, weight loss, or other
symptoms that may be caused by a more serious condition.
Some doctors prefer to test for H. pylori infection in everyone who has common ulcer symptoms.
our doctor may advise a screening for H. pylori before long-term NSAD use is begun. Screening and
treatment for H. pylori infection has been shown to reduce the risk of ulcers for people starting long-term
NSAD use.
2
Anyone taking NSADs should discuss with his or her doctor the potential risks of long-term
NSAD use.
Helicobacter pylori tests cannot diagnose peptic ulcer disease or other conditions that may cause
symptoms similar to an ulcer. These tests can only determine whether H. pylori bacteria are present. The
most common tests used to detect an infection with H. pylori bacteria include:
O Iood test for H. pylori antibodies. A blood test for H. pyloriantibodies is a quick, easy, and
inexpensive test to detect them. This blood test may make it possible to avoid having an upper
endoscopy exam. But it cannot distinguish between a past or current infection with H. pylori bacteria,
so it is not useful for determining whether an infection has been cured.
O Urea breath test. A urea breath test for H. pylori is very accurate. Unlike the blood test, it will detect
only those H. pylori bacteria that are present at the time of the test. This makes it a good test for
checking to see whether an H. pylori infection has been cured. The test is somewhat expensive.
O $tooI antigen test. This test checks for antigens for H. pylori in the stool. t can be used to
diagnose H. pylori bacteria as a cause of peptic ulcer disease and to see whether treatment has cured
the infection.
O iops of the sto2ach Iining. During an upper endoscopy exam, a biopsy of the stomach lining will
be collected to test for H. pylori bacteria. A biopsy is the most accurate way to test for H. pylori. t also
allows the doctor to check for other possible causes of symptoms (such as cancer). A biopsy is
expensive and requires an upper endoscopy exam, which is more invasive than other tests used to
detect H. pylori.
Some people who have received therapy with medicines to treat an H. pyloriinfection need follow-up
testing to make sure that the infection is cured.
Treat2ent Overview
Treatment for peptic ulcer disease includes one or more of the following:
O f you have been diagnosed with a peptic ulcer caused by infection with Helicobacter pylori (H. pylori)
bacteria, you will need treatment with antibiotic medicines to kill the bacteria.
O f your ulcer is caused by the use of nonsteroidal anti-inflammatory drugs (NSADs), stop using them.
NSADs slow or prevent the healing of an ulcer.
O Medicines that reduce the amount of acid produced by the stomach are used to treat all forms of
peptic ulcer disease. These include H2 blockers and proton pump inhibitors (PPs).
O Lifestyle changes, such as quitting smoking and not drinking too much alcohol, are important for
helping ulcers heal. Limit alcohol to 2 drinks a day for men and 1 drink a day for women.
O Ulcers that do not respond to treatment may have developed complications or may actually be cancer.
ou may need an endoscopy so that your doctor can look at the inside of your stomach and your
upper small intestine to check for H. pylori or can collect a tissue sample (biopsy) that can be tested
for cancer. But sometimes when symptoms do not get better with treatment, they are caused by
something else that may or may not be a serious problem. Make sure you talk with your doctor to get
to the bottom of your symptoms.
O Because the medicines now used to treat peptic ulcer disease work so well, surgery is rarely used to
treat peptic ulcer disease. Surgery generally is reserved for people who have a life-
threatening complication of an ulcer, such as severe bleeding, perforation, or obstruction. n some
cases, even these complications can be treated without surgery.
InitiaI treat2ent
nitial treatment of peptic ulcer disease depends on its cause.
O H. pylori infection. Treatment to eliminate Helicobacter pylori (H. pylori) bacteria usually involves
combining two antibiotics with an acid reducer such as a proton pump inhibitor or sometimes a
bismuth compound. Curing the infection speeds the healing of an ulcer and makes the ulcer less likely
to recur. t is important to take all the medicine your doctor prescribes so that the bacteria are killed
and do not come back. Do not stop taking the medicine just because you feel better. f the bacteria are
not eliminated by the antibiotics, they may become even more difficult to kill later (resistant).
O N$AIDs. f at all possible, you will need to stop taking nonsteroidal anti-inflammatory drugs (NSADs).
f you must continue taking an NSAD, other medicines may be used to protect the stomach. For more
information, see the Medications section of this topic.
O persecretor condition. Acid reducers are most often used to treat an ulcer caused by a
hypersecretory condition (a condition in which your stomach produces excessive acid). Also, your
doctor may want to conduct other tests to find out whether there is another cause for the ulcer.
O Unknown cause. f no cause can be found (idiopathic ulcer), your ulcer will usually be treated with an
acid reducer. Long-term treatment depends on the severity of the ulcer and other factors, such as the
size of the ulcer, whether you have had complications, and what other treatments have been used.
No matter what is causing your ulcer, it is important to stop taking NSADs and to quit smoking.
Ongoing treat2ent
f you feel that you need to continue to use nonsteroidal anti-inflammatory drugs (NSADs) after being
diagnosed with a peptic ulcer, work with your doctor to find an alternative pain reliever. Use of NSADs
can slow the healing of an ulcer or even prevent it from healing. f you must continue to use NSADs, your
doctor may recommend that you take an NSAD that is less likely to cause ulcers. Or your doctor may
prescribe a medicine that you take daily to help prevent ulcers. Medicines that help prevent ulcers
include:
O Proton pump inhibitors (such as omeprazole).
O H2 blockers (such as famotidine).
O Prostaglandin analogs (such as misoprostol).
f ulcer symptoms do not respond to treatment, follow up with your doctor to be sure Helicobacter
pylori (H. pylori) bacteria have been identified and treated. Most peptic ulcers are caused by infection
with H. pylori bacteria. Persistent infection will likely be treated with an alternate combination of
medicines. Antibiotic treatment for H. pylori should be taken exactly according to your doctor's instructions
for it to be effective.
Tests such as the urea breath test and a stool antigen test can determine whether an H. pylori infection
has been cured. f you have a history of ulcer complications or a family history of stomach cancer, you
may need an endoscopy so that your doctor can look at the inside of your stomach and upper small
intestine to see whether an ulcer is present. An endoscopy can also be used to collect a tissue sample
(biopsy) that can be tested for H. pylori or cancer. For more information on these tests, see the Exams
and Tests section of this topic.
Treat2ent if the condition gets worse
Recurring ulcers caused by an infection with Helicobacter pylori (H. pylori) bacteria will likely be treated
with a different combination of medicines.
our doctor may conduct follow-up tests to find out whether an infection with H. pylori has continued or
returned. Tests for H. pylori may include a test of your breath or stool and a biopsy of your stomach lining.
For more information on these tests, see the Exams and Tests section of this topic.
f you have experienced significant complications from a peptic ulcer such as bleeding or obstruction, you
may need an endoscopy, even if you have already had one. f your stomach or intestine has a perforation
or your ulcer continues to bleed despite treatment, you may require surgery. But surgery is rarely used to
treat an ulcer.
What To Think About
Risk of not treating uIcers
O Left untreated, many ulcers eventually heal. But ulcers often recur if the cause of the ulcer is not
eliminated or treated. f ulcers keep coming back, you have an increased risk of developing a serious
complication.
O f treatment for your ulcer does not work to heal the ulcer, your doctor will most likely suggest that you
see a gastroenterologist. The gastroenterologist will do an endoscopy to look at your ulcer and to take
a tissue sample (biopsy).
!revention
ou can greatly reduce the chance that you will get a peptic ulcer if you:
O Don't start s2oking. f you smoke, quit. Smokers are much more likely to develop ulcers than
nonsmokers. For ways to quit smoking, see the topic Quitting Smoking.
O Avoid taking certain 2edicines. Avoid taking aspirin, ibuprofen, and othernonsteroidal anti-
inflammatory drugs (NSADs) for longer than a few days at a time. f you are taking aspirin regularly for
heart problems, ask your doctor about taking another medicine to help protect your stomach and
intestines from ulcers.
O Drink aIcohoIic beverages onI in 2oderation. Limit alcohol to 2 drinks a day for men and 1 drink a
day for women. Never drink alcohol on an empty stomach.
o2e Treat2ent
f you are being treated for a peptic ulcer, your doctor will likely prescribe medicines and encourage you
to try some home treatment methods. To stop symptoms and help an ulcer heal, you can:
O Stop smoking.
O Try nonprescription medicines that reduce acid production. Make sure you tell your doctor about any
medicines you are taking.
O Make changes to your diet, such as eating smaller, more frequent meals. These changes may improve
your symptoms, but they will not help your ulcer heal.
O Drink alcohol only in moderation, or avoid drinking alcohol. Limit alcohol to 2 drinks a day for men and
1 drink a day for women. Drinking too much alcohol may make an ulcer heal more slowly and may
make your symptoms worse.
Many people who have mild symptoms that could be caused by a peptic ulcer first try home treatment for
a short time without seeing a doctor. But if you have ulcer symptoms that do not improve after 10 to 14
days of home treatment, or if you have other symptoms such as weight loss, nausea after eating, or
consistent pain, it is be sure to see your doctor to make certain you have an ulcer and not some other
more serious illness. This is even more important if you are middle-aged or older, because the risk for
cancer or other illnesses that cause symptoms similar to peptic ulcer disease increases with age.
Medicines are usually a very effective treatment for ulcers. The bland diets that in the past were part of
ulcer treatment are no longer required. This means people with peptic ulcers do not have to drink lots of
milk or avoid spicy foods.
edications
Most peptic ulcers can be cured and prevented from coming back by eliminating Helicobacter pylori (H.
pylori) infections and avoidingnonsteroidal anti-inflammatory drugs (NSADs).
Medicines are used to:
O Treat peptic ulcer disease by reducing the amount of acid produced by the stomach.
O Kill H. pylori bacteria when it is determined that they are infecting the stomach lining.
O Prevent NSAD-related peptic ulcer disease by helping protect the lining of the stomach and upper
small intestine (duodenum) from injury caused by NSADs.
edication Choices
edicines to reduce acid production
Medicines that reduce the amount of acid produced by the stomach are used to treat all forms of peptic
ulcer disease.
O Proton pump inhibitors (PPs) (such as Prilosec).
O H2 blockers (such as Zantac).
O Antacids (such as Tums).
Proton pump inhibitors may be taken with antibiotics if the ulcer is caused by an H. pyloriinfection.
edicines to kiII H. pylori bacteria
Doctors prescribe combination drug therapy to cure infection with H. pylori bacteria. Combination drug
therapy usually includes at least two antibiotics, a proton pump inhibitor, and sometimes a bismuth
compound.
edicines to prevent uIcers
Medicines used to protect the stomach from damage caused by frequent use of aspirin or other NSADs
include:
O Proton pump inhibitors (PPs) (such as omeprazole). These medicines have been shown to prevent
ulcers and problems from ulcers (such as bleeding) in people taking NSADs long-term.
O H2 blockers (such as cimetidine). These medicines may help prevent ulcers in people taking NSADs
long-term.
O Prostaglandin analogs (such as misoprostol). These medicines also work to prevent ulcers and
problems from ulcers (such as bleeding) in people taking NSADs long-term.
What To Think About
Ulcers in the stomach (gastric ulcers) often heal more slowly than ulcers in the upper small intestine
(duodenal ulcers).
ou can get some H2 blockers and PPs without a prescription (over-the-counter or OTC). f you are
using OTC acid reducers (such as Prilosec or Pepcid) to help with your symptoms for more than 10 to 14
days at a time, or if your symptoms are very bad, be sure to see your doctor.
$urger
Surgery is rarely needed to treat peptic ulcers. Very effective medicine treatments are available to help
heal ulcers. Treatment of a Helicobacter pylori (H. pylori) infection prevents most ulcers from coming
back.
Surgery is needed sometimes to treat:
O Ulcers that do not heal (intractable peptic ulcers) after extensive medicine therapy and self-care.
O Life-threatening complications of an ulcer, such as severe bleeding, perforation, or obstruction.
$urger Choices
When surgery is done to treat an ulcer, it usually involves one or more of the following:
O Cutting one or more of the nerves to the stomach (vagotomy).
O Widening the opening of the bottom of the stomach (pyloroplasty).
O Removing part of the stomach (partial gastrectomy).
What To Think About
Because medicine for peptic ulcers works so well, surgery is rarely needed. f surgery is suggested, you
may want to:
O Seek a second opinion and ask whether all medicine treatment options have been tried.
O Compare the cost of long-term medicine treatment to the one-time cost of surgery.
O Remember that no surgery can completely prevent ulcers from returning.
O Find a surgeon who has a lot of experience with this type of surgery.
Other Treat2ent
There is no other treatment available for uncomplicated peptic ulcers at this time.