Dr Stephen John Middleton MA MD FRCP FAHE

Consultant Gastroenterologist

Peptic Ulceration

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The term peptic ulcer is usually used to describe a patch in the stomach or duodenum where the lining has been eroded away and where acid is thought to play a major role in the damage. In the mid 1980’s an Australian Gastroenterologist, Dr Barry Marshall, and colleagues discovered that these ulcers were caused by an infection with a bacteria called Helicobacter pylori. This is now known to cause most of these ulcers, the other main cause being drugs particularly non steroidal anti-inflammatories such as Ibuprofen and also Aspirin. 
 
 
If left untreated ulcers can cause problems such as pain and can sometimes bleed or erode through the lining and cause a hole in the gut called a perforation. It is therefore important to have ulcers diagnosed and treated promptly. Ulcers often cause pain which can be related to eating, either increased in the case of stomach ulcers or reduced, which often indicates a duodenal ulcer. Your GP may whish to check for H. pylori infection, which can be done by stool or blood test and there is also a breath test.
 
H.pylori can be eradicated by a combination of acid blockers and antibiotics.  This usually stops any more ulcers forming unless the infection returns which can occur on rare occasions. If drugs are the cause an alternative should be found if possible. Sometimes no cause is found and then drugs that reduce acid may be required to prevent recurrent ulceration.
 
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