A Peptic ulcer is a small sore or lesion in the lining of stomach or duodenum, the first part of the intestine. This sore is often aggravated by stomach acid, but is usually not caused by the acid itself. More likely, the cause is either a bacterium known as Helicobacter pylori (H. pylori) or taking non-steroidal anti-inflammatory drugs (NSAIDs).

GERD, on the other hand, is caused by a weakened or relaxed esophageal sphincter. So that stomach acid comes up from stomach into esophagus, causing a burning sensation (sometimes referred to as acid indigestion or heartburn) and unpleasant taste in the throat. This has to occur at least twice a week to be considered GERD.

“Most patients with GERD have either heartburn or regurgitation, a sense of things coming back up into the throat,” But a small percentage of people with GERD have the same kind of “epigastric” pain that patients with peptic ulcers complain about.

Ulcer or GERD: Know the Symptoms

Patient’s description of symptoms will help doctor distinguish between a Peptic ulcer and GERD.

A Peptic ulcer often comes with these symptoms:

• Pain/Burning sensation in the epigastric region
• Pain or discomfort two to three hours after eating
• Pain that wakes a person up at night
• Pain that is eased by eating, drinking, or taking antacids
• Blood in stool or vomit

Some symptoms of GERD that do not occur with ulcers are:

• Heartburn
• Regurgitation of acid & foods
• Dry cough
• Sore throat
• Trouble swallowing
• Asthma-like symptoms
• Increased heartburn in response to some “trigger” foods
• Worsening of symptoms when lying down or bending over

Ulcer or GERD: Making the Diagnosis

Doctor needs to take the Full Medical history of a patient.

“Generally, when there is suspicion of a peptic ulcer, Endoscopy of Upper Gastro Intestinal Tract is recommending.

If the suspicion is for GERD, then do a therapeutic trial”. A therapeutic trial involves prescribing acid-suppressing medication for a while to see if that controls the symptoms.

Depending on the symptoms, following tests may be needed:

• H. pylori test
• A barium meal X-rays
• Endoscopy of upper GIT

Source:

https://www.everydayhealth.com/ulcer/differences-between-ulcers-and-gerd.aspx

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071675/

https://www.uclahealth.org/gastro/workfiles/newsletters/HealthyYearsOct2017GERDvsUlcer.pdf

Note: For informational purposes only. Consult your textbook for advising your patients.