Acid Peptic Disorder

Acid Peptic Disorder (APD) & GERD

Peptic ulcer disease is a condition in which inflammation or painful sores or ulcers develop in the lining of the stomach or the first part of the small intestine (the duodenum). Normally, a thick layer of mucus protects the stomach lining from the effect of its digestive juices. But many things can reduce this protective layer, allowing stomach acid to damage the tissue.

One in 10 people develops an ulcer. Risk factors that make ulcers more likely include:

  • Frequent use of nonsteroidal anti-inflammatory drugs (NSAIDs), a group of common pain relievers that includes ibuprofen (Advil® or Motrin®).
  • family history of ulcers.
  • Illness such as liver, kidney or lung disease.
  • Regularly drinking alcohol.
  • Smoking.

Some people with ulcers don’t experience any symptoms. But signs of an ulcer can include:

  • Gnawing or burning pain in your middle or upper stomach between meals or at night.
  • Pain that temporarily disappears if you eat something or take an antacid.
  • Bloating.
  • Heartburn.
  • Nausea or vomiting.

In severe cases, symptoms can include:

  • Dark or black stool (due to bleeding).
  • Vomiting.
  • Weight loss.
  • Severe pain in your mid- to upper abdomen.

GERD is a disorder where the contents of your stomach flow back into your esophagus. Your esophagus is the tube that carries food and liquids from your mouth to your stomach.

GERD can be caused by many things, including:

  • Eating large meals.
  • Eating and drinking large amounts of:
    • Fried or fatty foods
    • Spicy foods
    • Citrus fruits, such as oranges, lemons, grapefruits, and limes
    • Chocolate
    • Mint
    • Tomatoes
    • Caffeinated drinks, such as coffee, tea, and soda
  • Exercising after a meal.
  • Lying down, especially after meals. This can make it easier to regurgitate food (when food moves from your stomach into your esophagus, creating a sour, acidic taste from your stomach fluid).
  • Drinking alcohol.
  • Having a hiatal hernia (when the top of your stomach bulges through your diaphragm). Your diaphragm is the muscle that separates your abdomen (belly) and chest.
  • Obesity (having a high, unhealthy amount of body fat).
  • Pressure on your abdomen. This can happen if you:
    • Strain while having a bowel movement (pooping) due to constipation (having fewer bowel movements than usual).
    • Strain while coughing, bending, or lifting.
    • Wear pants that are too tight in the waist. This pressure can squeeze stomach contents up and into your esophagus.

The symptoms of GERD may include:

  • Heartburn that usually happens 30 to 60 minutes after eating
  • Regurgitation
  • Trouble swallowing
  • Chest pain
  • Cough
  • Sore throat
  • Feeling like you have a lump in your throat

Your healthcare provider may be able to make the diagnosis just by talking with you about your symptoms. If you develop an ulcer and you’re not taking NSAIDs, the cause is likely an H. pylori infection. To confirm the diagnosis, you’ll need one of these tests:


If you have severe symptoms, your provider may recommend an upper endoscopy to determine if you have an ulcer. In this procedure, the doctor inserts an endoscope (a small, lighted tube with a tiny camera) through your throat and into your stomach to look for abnormalities.

  • Pyloritests:Tests for H. pylori are now widely used and your provider will tailor treatment to reduce your symptoms and kill the bacteria. A breath test is the easiest way to discover H. pylori. Your provider can also look for it with a blood or stool test, or by taking a sample during an upper endoscopy.

  • Imaging tests:Less frequently, imaging tests such as X-rays and CT scans are used to detect ulcers. You have to drink a specific liquid that coats the digestive tract and makes ulcers more visible to the imaging machines.

Treatment is multipronged:

  • Medications
  • Lifestyle Changes
  • Diet Restrictions
  • Regular Exercises and Meditation