Peptic Ulcer Disease: Causes, Symptoms & Treatment Guide

Overview

Peptic Ulcer Disease (PUD) refers to open sores that develop on the inner lining of the stomach (gastric ulcer) or the upper part of the small intestine (duodenal ulcer). These ulcers occur when the protective mucus layer is reduced, allowing stomach acid to damage the underlying tissue. PUD is a common condition in India, often linked to Helicobacter pylori (H. pylori) infection and the use of nonsteroidal anti-inflammatory drugs (NSAIDs).

Causes

The primary causes of peptic ulcers include:

• H. pylori infection: This bacterium weakens the stomach's protective mucus, making it susceptible to acid damage.
• NSAIDs: Regular use of aspirin, ibuprofen, or other NSAIDs can irritate or inflame the stomach lining.
• Excess stomach acid: Conditions like Zollinger-Ellison syndrome cause overproduction of acid.
• Lifestyle factors: Smoking, excessive alcohol, stress, and spicy foods may aggravate symptoms but are not direct causes.

Symptoms

Common symptoms include:

• Burning stomach pain that improves or worsens with eating
• Bloating, belching, or feeling full quickly
• Nausea or vomiting
• Dark, tarry stools or blood in vomit (indicates bleeding ulcer)
• Unexplained weight loss

Some patients may have no symptoms until complications arise.

Diagnosis

Doctors diagnose PUD through:

• Upper endoscopy: A thin tube with a camera views the ulcer and allows biopsy for H. pylori.
• H. pylori tests: Breath, stool, or blood tests detect the bacteria.
• Barium X-ray: Less common, but shows ulcers as white spots.

Treatment Options

Treatment aims to heal the ulcer and prevent recurrence:

Medications

• Proton pump inhibitors (PPIs): Omeprazole, pantoprazole reduce stomach acid.
• H2 blockers: Ranitidine, famotidine lower acid production.
• Antacids: Provide quick symptom relief.
• Antibiotics: For H. pylori, triple or quadruple therapy (e.g., amoxicillin, clarithromycin, metronidazole, bismuth).

Surgery

Rarely needed for complications like perforation, bleeding, or obstruction.

Prevention

• Avoid NSAIDs or use with food and a PPI.
• Limit alcohol and quit smoking.
• Eat a balanced diet with small, frequent meals.
• Manage stress with relaxation techniques.
• Get tested and treated for H. pylori if you have symptoms.

Ayurvedic Perspective & Remedies

In Ayurveda, peptic ulcers are correlated with Pitta dosha imbalance and are called Parinama Shoola or Amlapitta. Remedies include:

• Diet: Avoid spicy, oily, and sour foods. Include cooling foods like cucumber, coconut water, and milk.
• Herbs: Licorice (Yashtimadhu), Amla (Indian gooseberry), and Shatavari help soothe the stomach lining.
• Formulations: Triphala, Kamadudha, and Sutshekhar Rasa are used under Ayurvedic guidance.
• Lifestyle: Regular meal timings, yoga, and pranayama (breathing exercises) to reduce stress.

Always consult a qualified Ayurvedic practitioner before starting any remedy.