Peptic ulcers are open sores that develop on the inner lining of the digestive tract. They commonly occur in the stomach (gastric ulcers), the first part of the small intestine (duodenal ulcers), or the lower esophagus. Ulcers arise when protective cells on the lining become inflamed and die.
Recognizing the Symptoms
Many individuals with peptic ulcers experience no noticeable symptoms, with up to 70% remaining asymptomatic. When symptoms do occur, the most common is a dull or burning pain in the upper abdomen. This discomfort may fluctuate, appearing and disappearing, and can feel like a gnawing sensation. Pain often worsens when the stomach is empty or at night, while eating may temporarily relieve or worsen it.
Beyond abdominal pain, other symptoms can indicate a peptic ulcer. Patients often report fullness, bloating, and belching. Nausea, vomiting, and loss of appetite are common. Heartburn, a burning sensation in the chest, can also be a symptom. These symptoms vary in intensity.
Direct Visual Characteristics
When observed, peptic ulcers appear as open sores on the digestive tract’s mucosal lining. These lesions typically have a round or oval shape, often appearing cleanly punched out. Most ulcers are relatively small, often less than 2 centimeters in diameter, though larger ones, up to 10 centimeters, can be seen.
The color and texture of an ulcer provide further visual cues. The edges are usually red and inflamed, while the base often appears whitish or grayish due to fibrin, a protein involved in clotting and tissue repair. The depth of an ulcer can vary significantly, ranging from superficial erosions to deep craters that extend through the muscular layer of the digestive wall into deeper tissues.
How Doctors Visualize Ulcers
Doctors use medical procedures to identify peptic ulcers. Upper gastrointestinal endoscopy, also known as EGD, is the primary method for direct visualization. During this procedure, a flexible tube with a tiny camera, an endoscope, is guided down the throat into the esophagus, stomach, and small intestine. This allows the physician to directly view the inner lining and detect abnormalities, including ulcers.
Endoscopy also allows doctors to take small tissue samples, or biopsies, from suspicious areas. These samples are then examined in a laboratory to determine the ulcer’s cause or rule out other conditions.
Another visualization technique is the barium swallow, or upper gastrointestinal series. This involves the patient drinking a white, chalky liquid containing barium, which coats the digestive tract. X-rays are then taken, and the barium highlights the ulcer’s outline, making it visible as a “pocket” or crater on the images. This indirect method can reveal the presence and characteristics of an ulcer when direct endoscopy is not performed.