What You Can Do to Treat Your Ulcer

What is an ulcer?
Ulcers are sores on the lining of your digestive tract. Your digestive tract consists of the esophagus, stomach, duodenum (the first part of the intestines) and intestines. Most ulcers are located in the duodenum. These ulcers are called duodenal ulcers. Ulcers located in the stomach are called gastric ulcers. Ulcers in the esophagus are called esophageal ulcers.

What causes ulcers?
A type of bacteria called Helicobacter pylori (H. pylori) causes many ulcers. Acid and other juices made by the stomach can contribute to ulcers by burning the lining of your digestive tract. This can happen if your body makes too much acid or if the lining of your digestive tract is damaged in some way. Physical or emotional stress may not necessarily cause an ulcer, but it can aggravate an ulcer if you have one.
Ulcers can also be caused by anti-inflammatory medicines. Although most people take these medicines without problems, long-term use may damage the stomach lining and cause ulcers. Anti-inflammatory drugs include aspirin, ibuprofen, naproxen, ketoprofen and some prescription drugs for arthritis.

How can my doctor tell if I have an ulcer?
Your doctor will ask about your symptoms and may start you on some medicine before doing tests. This is because ulcers usually feel better within a week or so of treatment. You may not need tests if you're getting better.
If you don't get better, your doctor may do an endoscopy or a special x-ray to study your digestive tract. During an endoscopy, your doctor looks into your stomach through a thin tube. He or she may take a biopsy (a sample of
the stomach lining) to test for H. pylori. Blood and breath tests can also be used to test for H. pylori.

Possible signs of an ulcer
Feel better when you eat or drink and then worse 1 or 2 hours later (duodenal ulcer)
Feel worse when you eat or drink (gastric ulcer)
Stomach pain that wakes you up at night
Feel full fast
Heavy feeling, bloating, burning or dull pain in your stomach
Vomiting
Unexpected weight loss

How can ulcers be treated?
One way to treat ulcers is to get rid of the H. pylori bacteria. Treatment may also be aimed at lowering the amount of acid that your stomach makes, neutralizing the acid and protecting the injured area so it can heal. It's also very important to stop doing things, such as smoking and drinking alcohol, that damage the lining of your digestive tract.

What is triple therapy?
Triple therapy is a treatment to eliminate H. pylori. It is a combination of 2 antibiotics and bismuth subsalicylate. Other combinations may also be effective. This treatment may be used with medicine that reduces the amount of acid your stomach makes.

What about other medicines?
Several other medicines can be used to help treat ulcers. Two types of medicines (H2 blockers and proton pump inhibitors) reduce the amount of acid that your stomach makes. They usually help people start to feel better
within 3 days.
Antacids neutralize acid that the stomach makes. A medicine called sucralfate coats the ulcer to protect it from the acid so it has time to heal.
Another medicine, misoprostol, reduces the amount of acid and protects the lining of the stomach. It is usually used to prevent gastric ulcers in people who need to take anti-inflammatory drugs and who have had stomach irritation or ulcers in the past.

How long will I have to take medicine?
Treatment to get rid of H. pylori usually takes about 2 to 3 weeks. Your doctor may want you to take medicine that lowers the stomach acid for up to 8 weeks. Most ulcers heal within this time.
If your symptoms come back after you stop taking medicine, your doctor may want you to take a different medicine or take a low dose of medicine even when you're not having symptoms to keep the ulcer from coming back.

Tips on healing your ulcer
Don't smoke.
Avoid anti-inflammatory drugs such as aspirin and ibuprofen.
Avoid caffeine and alcohol (or have them only in small amounts and on a full stomach).
Avoid spicy foods if they cause heartburn.

Does what I eat affect my ulcer?
It may. But this isn't true for everyone. Certain foods and drinks may be more likely to make your pain worse. These include both regular and decaffeinated coffee, tea, chocolate, meat extracts, alcohol, black pepper, chili powder, mustard seed and nutmeg. You may want to avoid these things if they bother you. But keep your diet balanced. Try eating small, frequent meals when you're having pain.

Are ulcers serious?
Not usually. Ulcers sometimes can lead to other problems. These problems include bleeding, perforation (the ulcer eats through the wall of the digestive tract) or obstruction (the digestive tract is blocked and food can't leave the stomach).

Warning signs that your ulcer is getting worse
You vomit blood.
You vomit food eaten hours or days before.
You feel cold or clammy.
You feel unusually weak or dizzy.
You have blood in your stools (blood may make your stools look black or like tar).
You have ongoing nausea or repeated vomiting.
You have sudden, severe pain.
You keep losing weight.
Your pain doesn't go away when you take your medicine.
Your pain reaches to your back.

[AAFP]