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Peptic Ulcers: Gastric Distress that Can Reoccur

Types of ulcers

Peptic ulcers can occur in several areas of the gastric region: the stomach, the duodenum, or small intestine; or the esophagus, the tube that connects the mouth to the stomach.

  • Gastric and duodenal peptic ulcers can occur at the same time
  • Peptic ulcers can reoccur

Stress and spicy foods do not cause peptic ulcers, but both can make ulcer symptoms worse. Smoking and drinking alcohol also can worsen ulcers and prevent healing.


medical illustration showing diseases of the stomach | GI NorthHelicobacter pylori (H. pylori) bacteria- Experts are not certain how H. pylori is transmitted, although they think it may be spread through contaminated food or water. Studies also suggest that having contact with the stool or vomit of an infected person or even the saliva can spread H. pylori infection. H. pylori has been found in the saliva of some infected people, which means infection can be spread through direct contact with saliva.

H. pylori still remains somewhat of a gastrointestinal mystery. Most people infected with H. pylori never develop ulcers, but some do. Doctors are still searching for the reason why some are afflicted by the virus and others are not.

Nonsteroidal anti-inflammatory drugs (NSAIDs):

NSAIDs such as aspirin and ibuprofen are another common cause of peptic ulcers. When used for weeks or months, NSAIDs can irritate or damage the lining of the stomach and digestive tract, and cause an ulcer or make an existing ulcer worse. Experts believe that NSAIDs may interfere with prostaglandins, which help to regulate the protective lining of the stomach. NSAID Ulcers and their complications can be prevented by not taking NSAIDs or by only taking them occasionally and in small doses.

Typical Symptoms

1) Nausea & vomiting
Pain Description – Pain when the stomach is empty, briefly relieved by eating
Emergency Symptoms – Sharp, sudden, persistent, and severe stomach pain
Alarm Symptoms – Bleeding

2) Poor appetite with weight loss
Pain Description – Pain comes and goes for several days or weeks
Emergency Symptoms – Bloody or black stools
Alarm Symptoms – Perforation

3) Bloating or Burping
Pain Description – Pain lasts for minutes to hours
Emergency Symptoms – Bloody vomit or vomit that looks like coffee grounds
Alarm Symptoms – Obstruction


If you have peptic ulcer symptoms, Dr. Simon Cofrancesco or Dr. Sergio Quijano will first ask about use of over-the-counter and prescription medications to rule that out as cause for concern Then tests may be performed to check for H. pylori bacteria. These tests are important because H. pylori-induced ulcers are treated differently from ulcers caused by NSAIDs.
H. pylori can be detected using a blood test, a urea breath test, or a stool antigen test.
The Upper Endoscopy (EGD) or an upper GI Series is recommended for folks around age 50. Both tests are painless and allow doctors to look closely at the stomach and duodenum.


Peptic Ulcers caused by H. pylori are treated with antibiotics to kill the bacteria, reduce stomach acid, and protect the stomach and duodenal lining. Medicines that reduce stomach acid include Proton Pump Inhibitors (PPIs) and Histamine Receptor Blockers (H2 blockers). Both acid-reducing medicines help relieve Peptic Ulcer pain after a few weeks and promote Ulcer healing. While PPIs cannot kill H. pylori, research shows they do help fight the H. pylori infection. Research also shows that after 4 weeks of treatment, patients taking PPIs had earlier pain relief and better healing rates than those taking H2 blockers.

  • Proton Pump Inhibitors (PPIs): suppress acid production by halting the mechanism that pumps acid into the stomach.
  • Histamine Receptor Blockers (H2 blockers): work by blocking histamine, which stimulates acid secretion.

Dr. Simon Cofrancesco or Dr. Sergio Quijano will prescribe Antibiotics or other medication according to your symptoms and individual diagnosis. Although Antibiotics can cure 80 to 90% of Ulcers caused by H. pylori, eliminating the bacteria can be difficult. You must take all medicines exactly as prescribed, even when the peptic ulcer pain is gone. If infection is still present, ulcers could recur or, less commonly, stomach cancer could develop. Thus, you may need to take more than one round of medication to kill the H. pylori bacteria.

GI North is open five days a week, treating patients from all over north Georgia including Dahlonega, Ga; Dawsonville, GA; Johns Creek, GA; Alpharetta, GA; Milton, GA; Suwanee, GA; Duluth, GA; and Canton. GA. At GI North, you can expect the latest in advanced technological care and treatment as well as personalized attention from Dr. Cofrancesco and Dr. Quijano. If you suffer from peptic ulcer disease, need a colonoscopy, or suffer from gastric distress, contact us at 404.446.0600 to schedule an appointment.

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