Peptic Ulcer

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, and aspirin inhibit the enzymes COX-1 and COX-2. COX-1 is responsible for producing prostaglandins that stimulate the protective mucus layer and blood flow within the stomach wall. Without sufficient prostaglandins, the stomach lining is vulnerable to gastric acid erosion. Patients with active or prior peptic ulcers should avoid routine NSAID use and consider acetaminophen for mild pain, or talk to their physician about alternatives such as topical analgesics or a selective COX-2 inhibitor paired with a protective acid reducer. How is Helicobacter pylori eradication verified after finishing treatment?::To ensure the bacteria have been eliminated, doctors typically perform a urea breath test or a stool antigen test at least four weeks after the patient completes the antibiotic regimen and at least one to two weeks after stopping proton pump inhibitors. Blood antibody tests should never be used to evaluate treatment success, as H. pylori antibodies can remain positive in the blood for months or years after the active infection has been successfully cleared. What are the critical warning signs that a peptic ulcer has perforated or is bleeding heavily?::Seek emergency medical attention if you vomit bright red blood, vomit dark material resembling coffee grounds, or pass stools that are black, tarry, and sticky (melena). A sudden, severe, knife-like pain across the entire abdomen that causes the stomach to feel rigid or "board-like" is the classic sign of a perforated ulcer, where stomach acid spills into the abdominal cavity. Both scenarios can lead to life-threatening shock or peritonitis and require urgent hospital intervention.