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What is a Peptic Ulcer?

A peptic ulcer is an open sore that develops on the inner lining of the stomach, the upper portion of the small intestine, or the esophagus. The different types of peptic ulcers include:

  • Gastric Ulcers: These occur inside the stomach.
  • Duodenal Ulcers: These occur on the inside of the upper portion of the small intestine.
  • Oesophageal Ulcers: These occur in the esophagus or food pipe just above the stomach.

Causes of Peptic Ulcer

Common causes of peptic ulcers include:

  • Infection with the bacterium Helicobacter pylori (H. pylori)
  • Regular use of certain pain relievers like aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs).
  • Genetic factors
  • Smoking
  • Regular consumption of alcohol and spicy foods
  • Using large doses of corticosteroid
  • Mental stress

Symptoms of Peptic Ulcer

Signs and symptoms of a peptic ulcer include:

  • Burning stomach pain
  • Feeling of fullness, bloating, or belching
  • Heartburn
  • Nausea or vomiting
  • Dark blood in stools
  • Trouble breathing
  • Feeling faint
  • Unexplained weight loss
  • Appetite changes
  • Chest pain

Diagnosis of Peptic Ulcer

To diagnose a peptic ulcer, your doctor will discuss the signs and symptoms, check your medical history, and conduct a physical examination. Tests used to diagnose peptic ulcer include:

  • Laboratory tests for H. pylori: A sample of your blood or stool may be tested to determine whether the bacterium H. pylori is present in your body.
  • Breath test: This test makes use of radioactive carbon to detect the presence of H. pylori. The procedure involves breathing into a bag after consuming radioactive carbon-containing food or drink. The bag will contain radioactive carbon in the form of carbon dioxide in case you are infected, as H. pylori react with the carbon in your stomach.
  • Barium swallow study: A barium swallow test is a special type of imaging test that uses barium to produce a clear outline of the upper esophagus on X-ray images obtained while you are swallowing.
  • Endoscopy: An endoscope is a thin tube with a camera that can be inserted through the mouth to look directly at the inner walls of the esophagus, stomach, and upper portion of the small intestine.

Treatment of Peptic Ulcer

Treatment for peptic ulcers depends on the cause. The different types of medications that may be prescribed include:

  • Antibiotic medications to kill H. pylori.
  • Proton pump inhibitors to block the cells that produce acid.
  • Acid blockers reduce the stomach acid released into your digestive tract.
  • Antacids neutralize stomach acid and provide rapid pain relief.
  • Cytoprotective agents protect the lining of your stomach and small intestine.

These medications are generally very successful in treating peptic ulcers. On the rare occasions that the peptic ulcer persists despite medical management, peptic surgery may be necessary. The surgery may be performed endoscopically or laparoscopically and may involve the following procedures:

  • Graham Patch: This is the placement of a patch of fatty tissue to cover the peptic ulcer.
  • Partial Gastrectomy: This involves excising the part of the stomach containing the ulcer and surgically closing the incision.
  • Vagotomy: This involves surgically cutting branches of the vagus nerve to reduce acid production.


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Dr. Gyawali is exclusively available at

Mubadala Health – Jumeirah, Dubai

Sunset Mall - First Floor
Jumeirah Beach Rd Jumeirah 3
Dubai, UAE

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I was referred to Dr Gyawali for a manometry test. He carefully studied my medical history. and realised that my previous doctor had repeatedly missed a significant diagnosis. He immediately referred me on to the necessary specialists for urgent treatment. I cannot thank him enough..

Patient at Queen's Hospital

29th February 2020