Quick Answer
Peptic ulcer disease is an open sore in the stomach or first part of the small intestine, most often caused by H. pylori infection or NSAID use. It causes burning epigastric pain, hunger pangs and bloating. Dr. Anando Sengupta diagnoses it with endoscopy and treats it with a 14-day antibiotic course plus acid-suppression therapy — healing rates exceed 90%. Book a consult →
What is peptic ulcer disease?
Peptic ulcer is a break in the inner lining of the stomach (gastric ulcer) or the duodenum (duodenal ulcer) caused by an imbalance between aggressive factors (acid, pepsin, H. pylori, NSAIDs) and protective mucosal defences. Gastritis — inflammation of the stomach lining without a deep ulcer — is often the precursor.
Symptoms
- Burning or gnawing pain in the upper abdomen, classically relieved by food (duodenal ulcer) or worsened by food (gastric ulcer)
- Pain that wakes you from sleep at night
- Bloating, belching and feeling full quickly
- Nausea, occasional vomiting
- Loss of appetite or weight loss
- Black tarry stools (melaena) or vomiting blood — signs of bleeding
Causes & risk factors
- Helicobacter pylori (H. pylori) — bacterial infection responsible for the majority of ulcers in India
- NSAIDs / pain-killers — ibuprofen, diclofenac, aspirin (especially long-term)
- Smoking & excessive alcohol
- Severe physiological stress (ICU, burns, trauma)
- Rare: Zollinger-Ellison syndrome (acid-secreting tumour)
Diagnosis
| Test | Purpose |
|---|---|
| UGI endoscopy (gastroscopy) | Visualises the ulcer, takes biopsy to rule out cancer, tests for H. pylori |
| Rapid urease test (CLO test) | On-site H. pylori detection from biopsy |
| Urea breath test | Non-invasive H. pylori test, useful for follow-up |
| Stool antigen test | Confirms H. pylori; useful in children & pregnancy |
| CBC, iron studies | Detect chronic blood loss & anaemia |
Treatment options
1. H. pylori eradication therapy
A 14-day triple regimen of amoxicillin + clarithromycin + PPI, or quadruple therapy with bismuth, levofloxacin or tetracycline depending on resistance patterns. Eradication is confirmed 4–6 weeks after treatment using a urea breath test or stool antigen.
2. Acid suppression
Proton pump inhibitors (pantoprazole, esomeprazole) for 4–8 weeks promote healing of the ulcer crater.
3. Lifestyle
- Stop smoking
- Avoid all NSAIDs unless absolutely necessary
- Limit alcohol, tea, coffee and very spicy food during the healing phase
- Manage stress — sleep, exercise, mindfulness
4. Endoscopic & surgical care
Bleeding ulcers are treated endoscopically with adrenaline injection, clips or thermal coagulation. Perforation needs emergency surgery.
Why choose Dr. Anando Sengupta?
- Same-day diagnostic UGI endoscopy with on-site biopsy and H. pylori testing
- India-specific eradication regimens accounting for local antibiotic resistance
- Long-term follow-up to confirm cure and monitor recurrence
- Coordinated care with cardiology when long-term aspirin is essential
