Peptic Ulcer

Here are the most common causes that lead to peptic ulcers.

• Helicobacter pylori infection
  is the single most common cause. This bacterial infection colonises the stomach lining and gradually weakens its protective mucus layer over months or years. A significant proportion of our patients test positive, many without ever knowing they were infected.
• Regular NSAID use
  is the second major driver. Painkillers like ibuprofen, diclofenac, and aspirin are taken routinely by many patients for back pain, joint pain, or headaches. Over time, these medications erode the mucosal lining directly, independent of any infection.
• Smoking and tobacco use
  impair mucosal blood flow and slow the healing of existing ulcers considerably.
• Alcohol consumption,
  particularly on an empty stomach, increases acid production and irritates the stomach lining directly.
• Long gaps between meals
  are extremely common given work schedules in our city.
• Chronic psychological stress
  does not cause ulcers directly, but is well recognised as a contributing factor that worsens symptoms and delays recovery.

Many patients live with mild symptoms for months before seeking evaluation. Some of what they report is straightforward. Some of it warrants urgent attention.

• Burning or gnawing pain in the upper abdomen, typically between the navel and the lower chest, is the most consistently reported symptom
• Pain that worsens on an empty stomach and improves briefly after eating or taking antacids, particularly common with duodenal ulcers
• Nausea, especially in the morning or after meals
• Feeling of early fullness or bloating even after small amounts of food
• Loss of appetite and gradual unintended weight loss over weeks
• Black or tarry stools, which indicate bleeding in the upper digestive tract and require same-day evaluation
• Vomiting blood or material that resembles coffee grounds is a medical emergency
• Persistent fatigue that may point toward anaemia from slow ongoing blood loss

If you are experiencing any of the last three symptoms on that list, please do not wait for a scheduled appointment.

We typically begin with a detailed history and physical examination. Based on that, we may recommend one or more of the following:

• Upper GI endoscopy
  is the most reliable investigation. It allows direct visualization of the stomach lining and the duodenum, confirms the presence and size of the ulcer, and allows us to take biopsies where needed. Biopsies help confirm H. pylori infection and, importantly, rule out malignancy in gastric ulcers.
• The urea breath test
  is a non-invasive and accurate method of detecting H. pylori without requiring endoscopy. We use this selectively, particularly for younger patients with no alarm symptoms.
• The stool antigen test
  for H. pylori is another non-invasive option we may use, depending on clinical presentation.
• Blood tests,
  including a complete blood count, help assess whether anaemia is present, which may suggest slow or ongoing bleeding from the ulcer site.
• Barium meal studies
  are used less frequently now, given the accuracy of endoscopy, but may be considered in specific situations.

Treatment is guided by what is causing the ulcer. We do not take a one-size-fits-all approach.

• Proton pump inhibitors
  help allow the ulcer to heal. Most patients are prescribed these for four to eight weeks, depending on ulcer size and location.
• Triple therapy for H. pylori
  combines two antibiotics, typically clarithromycin and amoxicillin, with a proton pump inhibitor for 10 to 14 days.
• Stopping or reducing NSAIDs
  is a necessary part of management when these medications are identified as a contributing cause.
• Antacids and H2 blockers
  may be used alongside primary treatment to provide faster symptom relief in the initial days.
• Repeat endoscopy
  is recommended after treatment for gastric ulcers, specifically to confirm healing and ensure no underlying malignancy was missed on the first look.

We are always asked about diet. The honest answer is that no specific food causes ulcers, but several habits make symptoms significantly worse and slow healing. Eat smaller meals at regular intervals, roughly every three to four hours, to maintain a buffer in the stomach. Avoid very spicy food, excessive tea or coffee, carbonated drinks, and fried or oily food during the active treatment period. Long gaps between meals are particularly problematic. Smoking cessation is non-negotiable while on treatment. Alcohol should be avoided entirely until the ulcer has healed.

If you have had recurring upper abdominal discomfort for more than two weeks, or if you notice any of the warning signs mentioned above, come in for an evaluation. Peptic ulcer disease is highly treatable when caught early and managed properly. Consult experienced peptic gastric ulcer treatment doctors in Navi Mumbai at UMC Hospitals for comprehensive care. At UMC Hospitals, our internal medicine team brings together experienced gastroenterologists, advanced endoscopy facilities, and a diagnostic setup that gets to the root cause rather than just managing symptoms.