Peptic ulcers are cavitary erosions in the lining of the stomach or duodenum--the first part of the small intestine. Peptic ulcers in the stomach are called gastric ulcers; those in the duodenum are called duodenal ulcers. Peptic ulcers form when the normal defenses that protect the lining of the stomach and duodenum from the digestive chemicals are overwhelmed. Peptic ulcers are common. The American Gastroenterological Association states that 1 in 10 Americans will develop a peptic ulcer over a lifetime. The characteristic symptoms of peptic ulcers vary from person to person and according to the location of the ulcer.
Episodic Epigastric Pain
Episodic epigastric pain is the most common symptom of both gastric and duodenal ulcers. The pain is characteristically located between the belly button and the lower end of the breast bone. It is usually described as burning, sharp, gnawing or aching in nature, and may be severe enough to wake you up at night. The pain of duodenal ulcers is typically relieved within a few minutes of eating or taking an antacid. It often recurs when the stomach is empty. The pain associated with gastric ulcers is less predictable than that of duodenal ulcers; it may be relieved or aggravated by food.
Constant, Severe Abdominal Pain
Typical episodic epigastric pain that suddenly becomes a severe, constant abdominal pain may indicate a peptic ulcer perforation--when the ulcer goes through the stomach or duodenal wall creating a hole. This is an urgent and potentially life threatening complication of peptic ulcer disease.
Nausea and Vomiting
Nausea and vomiting may occur with gastric ulcers. This symptom is uncommon with duodenal ulcers unless the flow of stomach contents is obstructed. If the ulcer is causing bleeding, the vomitus may contain blood. You may notice reddish streaks if the blood is fresh or small bits of dark brown material that resemble coffee grounds. The dark brown material is blood that has been chemically changed by stomach acid. Roughly 25 percent of gastric ulcers cause bleeding.
Black Stools
High volume bleeding from peptic ulcers may cause black, tarry, foul-smelling stools. The color, consistency and odor of the stools are due to the presence of blood from the upper digestive track.
Weight Loss
Weight loss is uncommon with duodenal ulcers, but may occur with gastric ulcers--especially if eating causes pain.
References
- "Harrison's Principles of Internal Medicine, 16th Edition"; Anthony S. Fauci, M.D., Eugene Braunwald, M.D., J. Larry Jameson, M.D., Ph.D., Dennis L. Kasper, M.D., Stephen L. Hauser, M.D., Dan L. Longo, M.D., Editors; 2004
- American Gastroenterological Association: Understanding peptic ulcer disease
- Medline Plus: Peptic ulcer
- National Institute of Diabetes and Digestive and Kidney Diseases: H. pylori and peptic ulcer
- National Institute of Diabetes and Digestive and Kidney Diseases: NSAIDs and peptic ulcer
