What Is PUD – Peptic Ulcer Disease?


Having frequent abdominal pain especially when you eat? Did you know, it could be Peptic Ulcer Disease??? Here’s what you need to know!

Peptic ulcer disease is the presence of ulceration in your stomach. Well, we all know that ulcer happens when there is a break of the protective lining of the wall of your body (inner or outer) surface.

Now you might be wondering, is there any difference between gastritis and peptic ulcer disease? Yes, they both cause abdominal discomfort and pain. But what happens in peptic ulcer disease is, there is an ulcer in the wall, which means there is a HOLE (or multiple) in your stomach wall. While gastritis is the inflammation of the stomach lining, which means there is only presence of  REDNESS over the wall, and it is perfectly intact, no perforation.

Peptic Ulcer Disease

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First of all, what are the few causes of peptic ulcer disease?


  1. Helicopylori infection

Peptic ulceration is in fact strongly associated with Helicobacter pylori infection. The infection is usually acquired in childhood, although the exact route is not fully known, but it is strongly suggested to be oral-oral or faecal-oral.

H.pylori is a kind of bacteria that stays in your stomach when you accidentally consume it through contaminated food or drink. What is so special about this bacteria is that it will increase the pH in your stomach! In other words it causes your stomach to become more acidic, thus causing erosion and perforation to your stomach lining, and there you go, ulcers in your stomach!


  1. Consumption of anti-inflammatory drugs

People who consume NSAIDs (non steroidal anti-inflammatory drugs) for pain relief should also be careful of the side effects. In this context, there are 2 important enzymes to be introduced, namely COX-1 and COX-2. Enzyme is a substance that has wide function in chemical reactions. They release substances that will cause fever, inflammation and pain in order to fight infection.

NSAIDs work by inhibiting both the enzymes, halting the process of inflammation, thus the name anti-inflammatory drugs. However, the enzyme COX-1 at the same time carries the function of protecting our stomach wall too! Since NSAIDs inhibit the COX-1 enzyme, this leads to the loss of protection of our stomach lining.

peptic ulcer disease

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  1. Smoking and alcohol

Some suggest that smoking and drinking alcohol have some effects on causing peptic ulcer, and this is nothing but true! Although not directly causing the manifestation of ulcer, smoking increases the risk of developing H. pylori infection. Little do people know that smoking also delays healing of the ulcer and increases the complications of peptic ulcer like internal bleeding and perforation. But hey! There is a silver lining in this situation because fret not, this condition is reversible as long as you quit smoking.

On the other hand, excessive alcohol intake is a precipitating factor for peptic ulcer, as it prolongs and exacerbates the symptoms. Alcohol can irritate your stomach wall if you drink excessively. It causes inflammation and increases the risk of developing an ulcer.

Other than abdominal pain, what are the other symptoms of Peptic Ulcer Disease?

Peptic ulcer disease is a chronic condition with spontaneous relapses and remissions lasting for decades, if not for life. The most common presentation is recurrent stomach ache which localises at the epigastric region, and is usually associated with occasional vomiting and feeling of nausea.

The reason behind eating and abdominal pain is because every time after we eat something, our stomach will automatically produce acid to digest the food, and so when the acid and the ulcer meet, this explains the pain that you feel.

Sometimes, you might feel bloated or even early satiety and you tend to eat less, which explains the weight loss. If you feel dizzy and drowsy at times, do not fear to consult doctor about your problem because dizziness and drowsiness might be due to anemia caused by chronic undetected blood loss from the ulcer.

Peptic Ulcer Disease

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Who tends to get Peptic Ulcer Disease?

According to the statistics done in Malaysia, males have higher risk of developing peptic ulcer than females. The male : female ratio of peptic ulcer is 2.3 : 1. The mean age of peptic ulcer patients is between 50 and 56 years old.

How is diagnosis confirmed?

To check for peptic ulcer, these are the few options to be carried out:

  • blood test

  • breath test

  • stool antigen test

  • stomach biopsy

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How to manage Peptic Ulcer Disease?

The aims of management are to relieve symptoms, induce healing, and prevent recurrence. To eradicate H. pylori infection, the first line therapy is based upon

  • A proton pump inhibitor (eg: esomeprazole, omeprazole, pantoprazole, lansoprazole)

  • Antibiotics

  • Proton pump inhibitors are a group of drugs whose main action is to reduce gastric acid production.


As for those who are taking long term NSAIDs, they should undergo H.pylori eradication therapy before they resume their NSAIDs intake.

Lastly, ditch that cigarette!


Here is an easy way to find out if you have PUD! Just Click Here


National Institute of Health


Angie Loh

by Angie Loh

A medical student with nothing but passion and a pen. Poems and novels never fail to make me feel alive. I'm inspired to make the world a better place and fill it with a little bit more love. But first, where's my coffee? View all articles by Angie Loh.


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