Dr C.K. Leow
Liver, Pancreas, Colon and General Surgery
Information

Peptic Ulcers and You

Peptic ulcer is a collective term for stomach and duodenal ulcers. This condition has no respect for age. It can affect the young as well as the aged. Most peptic ulcer disease nowadays is due to an infection of the lining of your stomach or duodenum by a bacterium called Helicobacter Pylori.

Symptoms

Although there are differences in the nature of the symptoms between duodenal and stomach ulcers, the spectrum of symptoms are pretty similar. The common symptoms of peptic ulcer disease are:

  1. Pain — This is the most common symptom. Most patients will use the term ‘indigestion’ to describe the discomfort they experience with an underlying ulcer. It can occur before a meal and eating can lead to relief. In some, the discomfort seems to occur a short period into the meal. When the discomfort is severe enough it can make you stop eating.
  2. Vomitting — This can occur after a meal. The vomitus may contain ingested food or brownish black fluid termed coffee ground. This brownish black discolouration is due to small amount of underlying bleeding from the ulcer. If the bleeding is quite brisk and recent, the vomitus may contain semi-fresh blood or blood clots.
  3. Black motion — An underlying ulcer that has been bleeding will lead to a change in the colour of your motion. The stool will become jet black in colour and tends to smell more than normal.

Diagnosis

Although a good clinical history can be quite accurate for making a diagnosis of peptic ulcer disease, a definite diagnosis cannot be made based on history alone. The most accurate method to diagnose an ulcer is to perform an examination of your stomach and duodenum with an endoscope (called oesophago-gastro-duodenoscopy, OGD in short). The endoscope is a thin, flexible tube with a camera within and this is passed through the mouth into the stomach. This is normally done under local anaesthetic. The procedure is not painful and most patients will say it is just uncomfortable.

OGD allows the doctor to look at the oesophagus (‘swallowing pipe’), stomach and duodenum. If an ulcer is present, the doctor may decide to remove a small piece of tissue (called biopsy) for microscopic examination. If there is evidence of recent bleeding, via the endoscope it would be possible to perform injection or other manoeuvres to prevent further bleeding.

An alternative method to diagnose peptic ulcer disease is by performing an X-ray study of the stomach. Although this is an acceptable method, it may not detect small ulcers or demonstrate inflammation of the lining of the stomach and duodenum.

Treatment

Peptic ulcers can now be treated easily with medication. If there is H. Pylori infection as well, then the ulcer healing medication together with antibiotics will be prescribed. The antibiotics are for one week but the ulcer healing medication is for a few months.

Comments

Peptic ulcers are common in the population. Its treatment is relatively easy nowadays. If left untreated, peptic ulcers can lead to significant bleeding requiring hospitalization or even surgery. Untreated peptic ulcers can suddenly perforate thus precipitating an emergency operation.