Peptic Ulcer

A peptic ulcer is a break in the lining of the stomach (gastric ulcer) or the first part of the small intestine (duodenal ulcer). Most are caused by Helicobacter pylori infection or by long-term use of NSAID painkillers. Smoking, alcohol, and severe stress contribute.

Symptoms

• Burning or gnawing pain in the upper middle abdomen.
• Pain that eases after eating, then returns 1-3 hours later (classic duodenal ulcer pattern), or worsens with food (gastric ulcer).
• Night-time pain that wakes you.
• Nausea, reduced appetite, bloating.
• Some ulcers cause no pain — especially in older adults on painkillers.

Red flags — dial 112 or go to hospital

• Vomiting blood or coffee-ground material.
• Black tarry stools or fresh blood in stool.
• Severe, sudden, worsening abdominal pain (possible perforation).
• Fainting, fast heartbeat, pale or sweaty (possible bleed).

Diagnosis

Upper endoscopy sees the ulcer directly and allows a biopsy for H. pylori and to rule out cancer. Non-invasive tests for H. pylori — stool antigen, urea breath test, or blood test — are also used in selected cases.

Treatment

• Acid-suppressing medicines (proton pump inhibitors) for 4-8 weeks.
• H. pylori eradication — a 10-14 day course of antibiotics with acid suppression — highly effective.
• Stop NSAIDs — substitute non-NSAID pain relief where possible; if NSAIDs are essential, a Health Expert may co-prescribe protection.
• Cut alcohol and smoking.
• Large or bleeding ulcers may need endoscopic treatment or rarely surgery.

India-specific practical note

H. pylori infection is very common in India — estimated to affect a majority of adults by middle age. Most don't get ulcers, but anyone with persistent upper-belly symptoms deserves testing. Courses are inexpensive and highly effective when the right antibiotics are used; a Health Expert chooses based on local resistance patterns. Avoid self-prescribing random antibiotics for "acidity" — this drives resistance and can make real ulcers harder to treat.