Peptic ulcers

Symptoms can vary depending on the severity of your condition, but may include:

• a burning or persistent pain that develops in your stomach (abdomen)
• bleeding from the ulcer that results in blood in your stools
• pain that travels from your stomach up to your neck or through to your back
• indigestion and/or heartburn
• reduced appetite or loss of appetite
• feeling and/or being sick
• burping or feeling bloated after eating certain foods
• over time, weight loss

The only secure way to diagnose or exclude an ulcer is by gastroscopy. This is a procedure where a thin, flexible tube (endoscope) is used to look inside your food pipe (oesophagus), stomach and the first part of your small intestine. If gastroscopy is not possible your consultant may request a barium meal X-ray to detect an ulcer, but this cannot sample the gut to check for a helicobacter pylori infection (type of bacteria) or stem any bleeding.

Treatment will depend on the cause of the ulcer. A helicobacter pylori infection is treated with a combination of antibiotics and an acid suppressing drug. You'll need to come back six weeks after treatment to confirm its success with either a stool test, breath test or another gastroscopy. If the ulcer is related to the use of non-steroidal anti-inflammatory drugs (NSAIDs), they should be stopped. If this is not an option, taking a proton pump inhibitor (PPI) can give protection against ulcers. Surgery is rarely required. Oesophageal ulcers associated with severe reflux may sometimes require treatment with a surgical anti-reflux procedure.