Peptic ulcer disease
An open sore in the lining of the stomach or the first part of the small intestine (duodenum), where stomach acid has eroded the protective lining. The main causes are Helicobacter pylori infection and anti-inflammatory painkillers. It typically causes burning upper-abdominal pain and can bleed.
What it is
A peptic ulcer is a break in the lining of the stomach (a gastric ulcer) or the first part of the small intestine (a duodenal ulcer). It happens when the balance between stomach acid and the mucus that protects the lining is upset, allowing acid to erode through the surface. Two causes dominate: infection with the bacterium Helicobacter pylori, which damages the protective lining, and regular use of non-steroidal anti-inflammatory painkillers (NSAIDs) such as ibuprofen and aspirin, which reduce the lining's defences. Less commonly, heavy alcohol, smoking, severe physical stress and, rarely, acid-oversecreting tumours contribute. The typical symptom is a gnawing or burning pain in the upper abdomen, often related to eating — classically relieved by food or worsened a few hours after a meal in duodenal ulcers — along with bloating, nausea and heartburn. The important complications are bleeding, which can show as vomiting blood or as black, tarry stools and can cause anaemia, and, rarely, a perforation (a hole through the wall) which is a surgical emergency. Diagnosis is usually confirmed by endoscopy, and treatment targets the cause: eradicating H. pylori with antibiotics, stopping NSAIDs where possible, and reducing acid with medication to let the ulcer heal.
Key lab markers
- H. pylori testing — a key step; a stool antigen or breath test confirms active infection (an antibody test shows exposure but not necessarily active infection).
- Haemoglobin — may be low if the ulcer has been bleeding (anaemia).
- Ferritin and iron studies — a low ferritin points to iron-deficiency anaemia from chronic slow blood loss.
- Note — the diagnosis of the ulcer itself is made by endoscopy, not by a blood test.
Symptoms
- Burning or gnawing pain in the upper abdomen
- Pain related to eating — relieved by food or worse a few hours after a meal (duodenal), or worse with food (gastric)
- Bloating, belching and heartburn
- Nausea, and sometimes vomiting
- Feeling full quickly or a reduced appetite
- Signs of bleeding — vomiting blood, or black, tarry stools
- Tiredness and pallor if anaemia has developed
Related symptoms
Related lab panels
When to discuss with a doctor
See a doctor for persistent or recurring upper-abdominal pain, indigestion that does not settle, or pain clearly related to eating, so the cause can be found and treated — often with an H. pylori test and, where indicated, an endoscopy. Certain features need urgent, sometimes emergency, attention: vomiting blood or material like coffee grounds, black tarry stools, sudden severe abdominal pain, or feeling faint — these can signal a bleeding or perforated ulcer. Unexplained weight loss, difficulty swallowing or persistent vomiting also need prompt assessment. Stopping unnecessary NSAIDs and not smoking help healing. Mediora.AI can surface the pattern of a positive H. pylori result with a low haemoglobin and ferritin that suggests a bleeding ulcer, but the diagnosis, endoscopy and treatment belong with your doctor.