Acid Reflux or Peptic Ulcer? Know the Difference

by Jennifer Mitchell Wilson B.S. Dietetics, Dietitian, Health Professional

Acid reflux disease is the most common upper gastrointestinal disease in Western countries, affecting over seven million Americans alone. The condition occurs when gastric acid splashes up into the esophagus, causing damage. Another common GI condition that affects 4.6 million Americans is peptic ulcer disease. Peptic ulcers can have some symptoms in common with acid reflux and are often treated with PPI medications — causing some confusion between two conditions that are actually quite different.

What is peptic ulcer disease?

Peptic ulcers occur when the acid in the digestive tract eats away at the lining of the stomach or small intestine, creating irritated or raw spots that can become painful open, bleeding sores. Some of the symptoms of peptic ulcer disease include burning stomach pain, feeling full quickly, bloating, intolerance to fatty foods, heartburn, and nausea. So it is easy to see why the initial symptoms of peptic ulcer might be confused with acid reflux disease.

What causes peptic ulcer disease?

Peptic ulcer disease is most frequently caused by a bacterial infection or the overuse of certain medications. Helicobacter pylori bacteria or H. Pylori can be found in the mucosal layer of the GI tract. In most cases it doesn’t cause any problems, but for some it can cause irritation and ulcers. Another factor that can contribute to the development of peptic ulcer disease is the overuse of NSAIDs. These medications, while great for reducing inflammation in conditions like arthritis or pulled muscles, can irritate the lining of the GI tract. As with acid reflux disease, people who smoke, drink alcohol in excess, or eat spicy foods may be more likely to develop peptic ulcers.

How are peptic ulcers treated?

Peptic ulcer treatment may vary depending on the cause contributing to the problem. If an H. Pylori infection is confirmed (usually by a simple blood or breath test) your doctor will most likely prescribe a combination of two antibiotics along with acid suppressing medications. Should the cause of your peptic ulcer be linked to NSAIDs, your doctor will usually recommend discontinuing the medication (or recommend an alternative pain reliever) along with acid suppressing medications.

While acid reflux and peptic ulcer disease may share some similar symptoms and treatments it is vital to get an accurate diagnosis**. When left untreated, peptic ulcers can cause internal bleeding, perforation of the stomach or small intestine, infection of the abdominal cavity, or an obstruction in the GI tract. If you experience significant or new abdominal pain or unexplained weight loss or appetite changes; have dark (tar-like) stools or trouble breathing; or feel faint; or are vomiting blood, seek immediate medical care.

Jennifer Mitchell Wilson
Meet Our Writer
Jennifer Mitchell Wilson

Jennifer Mitchell Wilson is a dietitian and mother of three girls. Two of her children have dealt with acid reflux disease, food allergies, migraines, and asthma. She has a Bachelor of Science in dietetics from Harding University and has done graduate work in public health and nutrition through Eastern Kentucky University. In addition to writing for HealthCentral, she does patient consults and serves on the Board of Directors for the Pediatric Adolescent Gastroesophageal Reflux Association.