Ulcers in the stomach and small intestine are quite common, occurring in ten percent of people in America. An open sore or lesion in the lining of the stomach or duodenum (upper small intestine) is called a "peptic ulcer." Ulcers in the stomach are called "gastric ulcers," while those in the duodenum are called "duodenal ulcers."
Stomach acids called hydrochloric acid and pepsin contribute to ulcer formation. Lifestyle habits, such as stress and diet, can aggravate ulcer symptoms. Research shows that 80 percent of stomach ulcers and 90 percent of duodenal ulcers develop as a result of infection with a bacterium called Helicobacter pylori (H. pylori). The bacterium produces substances that weaken the stomach's protective mucus and make it more susceptible to the damaging effects of hydrochloric acid and pepsin..
Doctors in the Center for Advanced Digestive Care (CADC) of NewYork-Presbyterian/Weill Cornell Medical Center take a team approach to the care of patients with peptic ulcers. They offer a range of diagnostic approaches and medical interventions, as well as innovative surgical procedures to relieve symptoms and restore quality of life for patients.
For more information on peptic ulcers, including symptoms of stomach ulcers and risk factors, visit our Health Library
Diagnosis of Peptic Ulcers
Because the location and cause of an ulcer influence its treatment, it is important to adequately diagnose peptic ulcer disease and the presence of H. pylori infection before starting treatment. At the CADC, doctors use the following procedures to diagnose ulcers and test for H. pylori infection:
- Upper GI series (also called a barium swallow) to visualize the digestive tract on an x-ray
- Esophagogastroduodenoscopy (a means of seeing inside the esophagus and stomach with a special scope)
- Blood, breath, and stomach tissue tests to look for the presence of H. pylori
Treatment for Peptic Ulcers
Medication And Lifestyle Changes
Treatment for stomach ulcers and duodenal ulcers with a combination of antibiotics is typically the first line of therapy for patients with ulcers caused by H. pylori infection. Other therapies for peptic ulcer may include:
- Lifestyle changes, such as quitting smoking and reducing caffeine consumption, which can aggravate ulcer symptoms. Avoidance of foods that cause irritation is also recommended.
- Medications may include H2 blockers, acid pump inhibitors, and mucosal protective agents to reduce acid production and protect the stomach from the effects of acid.
Peptic Ulcer Surgery
For patients who do not respond to medication, surgery may be needed. Surgeons at NewYork-Presbyterian/Weill Cornell are highly skilled at performing surgery to treat peptic ulcers. Minimally invasive laparoscopy is used whenever possible. Surgical approaches include:
- Vagotomy. This procedure involves cutting parts of the vagus nerve (a nerve that transmits messages from the brain to the stomach) to interrupt messages sent through it, thereby reducing acid secretion.
- Antrectomy. An operation to remove the lower part of the stomach (antrum), which produces a hormone that stimulates the stomach to secrete digestive juices.
- Pyloroplasty. A surgical procedure that may be performed along with a vagotomy, in which the opening into the duodenum and small intestine (pylorus) are enlarged, enabling contents to pass more freely from the stomach.