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(PUD; Duodenal Ulcer; Ulcer, Peptic; Ulcer, Duodenal)
by Debra Wood, RN
A peptic ulcer is a sore in the lining of the stomach or the first part of the small intestine. This area of the small intestine is called the duodenum. Peptic ulcers may be named by their location:
Upsets in the balance of stomach acid and digestive juices can lead to an ulcer. This can be caused by:
Less common causes include:
Risk Factors TOP
Factors that may increase the chances of a peptic ulcer include:
Peptic ulcers do not always cause symptoms. Symptoms may come and go. Food or fluids sometimes make symptoms better. Having an empty stomach may make symptoms worse. However, symptoms can occur at any time.
Symptoms may include:
Ulcers can cause serious problems and severe abdominal pain. One problem is bleeding. Bleeding symptoms may include:
A perforated ulcer is a break through the wall of the stomach or duodenum. It causes sudden and severe pain.
The doctor will ask about your symptoms and medical history. A physical exam will be done.
Tests may include:
Talk to your doctor about the best treatment plan for you. Treatment options may include one or more of the following:
Your doctor may recommend:
You and your doctor will discuss lifestyle changes. In general:
Surgery and Endoscopy TOP
Surgery and/or endoscopy may be recommended for:
This may be done to stop bleeding. A thin, lighted tube is inserted down the throat into the stomach or intestine. Heat, electricity, epinephrine, or a substance called fibrin glue can then be applied to the area. This should stop the blood flow.
Surgery for peptic ulcers is rare, but it can greatly reduce acid production. Common procedures include:
To help reduce the chances of H. pylori infection:
To help reduce the chances of a peptic ulcer from NSAIDs:
American College of Gastroenterology
American Gastroenterological Association
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Fashner J, Gitu AC. Diagnosis and treatment of peptic ulcer disease and H. pylori infection. Am Fam Physician. 2015;91(4):236-242.
Peptic ulcer disease. American College of Gastroenterology website. Available at:
...(Click grey area to select URL)
Accessed April 4, 2018.
Peptic ulcer disease. American Gastroenterological Association website. Available at:
...(Click grey area to select URL)
Updated July 2017. Accessed April 4, 2018.
Peptic ulcer disease. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated April 2, 2018. Accessed April 4, 2018.
Peptic ulcers (stomach ulcers). National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/digestive-diseases/peptic-ulcers-stomach-ulcers. Accessed April 4, 2018.
Last reviewed April 2018 by EBSCO Medical Review Board Daus Mahnke, MD
Last Updated: 5/7/2014
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