Information for the public
Peptic ulcer
What is a peptic ulcer?
A peptic ulcer is a break (like a sore) in the lining of the stomach or the upper part of the small intestine. Peptic ulcers can cause indigestion symptoms. The word 'peptic' comes from a digestive enzyme (chemical) called pepsin. In the stomach, acid and pepsin are produced to help digest food. Normally, they don't damage the stomach itself because the stomach protects itself in several ways. But if these defences fail, the acid and pepsin may cause an ulcer.
Treatment for a peptic ulcer
If you have a peptic ulcer, your GP should offer a test to see if you have a type of bacteria called Helicobacter pylori (H pylori for short). If you do, you should have a course of treatment to get rid of it (see Information about Helicobacter pylori to find out more). After the treatment, you may need another test to see how well it worked.
If you are taking an NSAID
If you are taking an NSAID for another condition, your GP should suggest that you stop because NSAIDs can cause ulcers or make them worse.
If you have been taking an NSAID and you have a peptic ulcer, your doctor should offer you treatment with a proton pump inhibitor (PPI for short) or an H2 blocker for 8 weeks. If you have H pylori, your doctor should offer a course of treatment to get rid of it after the PPI treatment (see Information about Helicobacter pylori to find out more).
If you carry on or resume taking your NSAID after your ulcer has healed, your GP should talk with you about how NSAIDs can harm your stomach. Your GP should regularly check whether you still need the NSAID. You should be offered the chance to try taking it only when you need it (when the condition you take the NSAID for is bad). Or your doctor may talk about lowering the dose you take, or using paracetamol or another type of painkiller instead of the NSAID.
If you need to carry on taking the NSAIDs, your doctor should offer you a medicine to protect your stomach and may discuss changing to a different type of NSAID.
If you are not taking an NSAID
If you don't have H pylori and you are not taking an NSAID, your GP should offer you treatment with either a PPI or an H2 blocker for 4 to 8 weeks.
If your symptoms come back
If your symptoms come back after treatment, your GP should offer you a PPI at the lowest dose possible to relieve your symptoms. They should discuss taking it only when you need it to control your symptoms.
If the treatment doesn't work
If you tried a PPI first but it hasn't helped, your GP should offer you an H2 blocker instead.
If your ulcer doesn't heal despite the medicines, this could be because:
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you have H pylori but it didn't show on the test
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you're not taking the medicines as prescribed
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you're taking other medicines that could be causing the symptoms or you are still taking NSAIDs
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you have another condition that could be causing the symptoms.