Signs and Symptoms of Peptic Ulcer Disease

Peptic ulcers are characterized as sores that form on the lining of the stomach or duodenum. Peptic ulcers are of two types, gastric and duodenal ulcers. Approximately 1-6% of people in the United States have peptic ulcers. Pain in the upper part of the abdomen between the breastbone and the belly button is the most common symptom of peptic ulcers. Other symptoms include bloating, nausea, vomiting, frequent burping, and feeling too full or uncomfortable after a meal.

The two most common causes of peptic ulcers are infection with the bacteria Helicobacter pylori (H. pylori) and intake of nonsteroidal anti-inflammatory drugs (NSAIDs). 

Contact your healthcare provider if you are experiencing early symptoms of peptic ulcers. If left untreated, peptic ulcers can become chronic, leading to severe complications such as internal bleeding, penetration to other organs, perforation (tearing) of the stomach or duodenal wall, and even the development of gastric cancer.

Common Symptoms

About 70% of people with peptic ulcers do not experience any symptoms at first. Symptoms may not occur until the condition reaches an advanced stage.

The most common symptom of peptic ulcer is pain in the upper part of the abdomen. The pain can occur anywhere between your belly button and breastbone. The pain may be burning or dull and can last for a few minutes to a few hours. It can come and go for several days or weeks. You may experience worsening pain when your stomach is empty or after eating. You may feel relief for a short while after eating or taking antacids (medications that neutralize stomach acid).

Other common symptoms of peptic ulcer include:

• Bloating
• Nausea
• A feeling of fullness during a meal
• Feeling uncomfortable after a meal
• Vomiting
• Excessive burping 

Advanced Symptoms

Peptic ulcers can become chronic and lead to several complications if left undiagnosed and untreated. These include:

• Internal bleeding: Bleeding in your stomach or duodenum is a common complication of peptic ulcers, which can result in anemia (reduced red blood cell count).
• Perforation: Peptic ulcers can create a hole in the wall of your duodenum or stomach. This can further cause peritonitis, an abdominal cavity infection.
• Penetration: Ulcers can penetrate through the duodenum or stomach to a nearby organ, causing various complications. 
• Obstruction: Peptic ulcers can block the passage of food from the stomach to the duodenum, leading to malnutrition and unintended weight loss.
• Gastric cancer: Peptic ulcers can lead to gastric cancer if they result from infection with H. pylori.

Such complications can result in serious symptoms including:

• Blood in stool, causing tarry or black stools
• Dizziness or fainting
• Sharp and severe abdominal pain that does not go away
• Blood in vomit, which may resemble coffee grounds
• An increased heart rate
• Fatigue
• Shortness of breath

Symptoms by Type

Peptic ulcers can be of two types, gastric ulcers and duodenal ulcers. As the name suggests, gastric ulcers occur in the stomach while duodenal ulcers occur in the duodenum. You can have either one of the ulcers or both the ulcers at the same time. 

The two types of ulcers mostly share similar symptoms. However, there are a few differences:

• Gastric (stomach) ulcer: For gastric ulcers, abdominal pain occurs about 15-30 minutes after a meal and may result in nausea or vomiting that leads to weight loss.
• Duodenal ulcer: For duodenal ulcers, abdominal pain occurs 2-3 hours after a meal when the stomach is empty. The pain decreases after eating something and can result in weight gain.

Symptoms in Children

Peptic ulcers are quite uncommon in children and are classified as primary or secondary. Primary ulcers mostly occur in the duodenum due to Helicobacter pylori infection of the stomach and other rare conditions that cause increased secretion of stomach acids, such as short bowel syndrome, G-Cell hyperplasia, and Zollinger-Ellison syndrome. Secondary ulcers can occur in the duodenum or stomach due to stress, certain drugs, and diseases like type 1 diabetes, sepsis, systemic lupus erythematosus (lupus), and sickle cell disease.

Primary ulcers are common among children older than 10 years while secondary ulcers are common among younger children who are younger than 10 years.

The symptoms of peptic ulcer disease in children include:

• Abdominal pain
• Nausea
• Recurrent vomiting
• Weight loss
• Poor growth

Children may also experience gastrointestinal tract bleeding in severe cases. This requires immediate medical attention.

When to Contact a Healthcare Provider

You may want to visit your healthcare provider if you are experiencing symptoms of peptic ulcers, especially if symptoms occur over the course of an extended period of time. It is advisable not to delay your visit since it can cause serious complications such as blood in stool, fainting, persistent and sharp abdominal pain, and blood in vomit.

Your healthcare provider may ask about your family and medical history as well as recommend a few tests to confirm the diagnosis of peptic ulcer disease. A few of these tests include blood tests, stool tests, urea breath test, and upper gastrointestinal tract endoscopy. Such tests will also help them identify the cause and check for complications.

A Quick Review

Peptic ulcers are sores that form on the lining of the stomach or duodenum. A few common symptoms of peptic ulcers include pain in the upper part of the abdomen, nausea, vomiting, excessive burping, and feeling uncomfortable after meals. Some people experience worsening symptoms after a meal while others experience them due to an empty stomach.

You may want to contact your healthcare provider if you are experiencing symptoms of peptic ulcers to manage the condition at an early stage. If left untreated, peptic ulcers can cause several complications and can result in serious symptoms such as blood in stool, blood in vomit, fainting, and others.