A stomach ulcer (also called a peptic ulcer) is a small erosion (hole) in the gastrointestinal tract. The most common type, duodenal, occurs in the first twelve inches of small intestine beyond the stomach. Ulcers that form in the stomach are called gastric ulcers. An ulcer is not contagious or cancerous. Duodenal ulcers are almost always benign, while stomach ulcers may become malignant. Stomach ulcer disease is common, affecting millions of Americans yearly. The size of a stomach ulcer can range between one-eighths of an inch to three-fourths of an inch.
Ulcers are common in people of all ages for a variety of reasons. Basically, ulcers (also called gastric or peptic ulcers) are eroding holes in the lining of the stomach or intestinal tracts caused by inflammation. Getting rid of ulcers is a long (can take about two months or longer), careful process—and if you’re not careful, an ulcer can turn into something worse that could kill you, like a bleeding ulcer. In any case, below are the steps you can take–as prescribed by doctors—to get rid of your ulcer.
Causes of Stomach Ulcers
The direct cause of peptic ulcers is the destruction of the gastric or intestinal mucosal lining of the stomach by hydrochloric acid, an acid normally present in the digestive juices of the stomach. Infection with the bacterium Helicobacter pylori is thought to play an important role in causing both gastric and duodenal ulcers. H. pylori may be transmitted from person to person through contaminated food and water. Antibiotics are the most effective treatment for H. pylori peptic ulcers.
Injury of the gastric mucosal lining and weakening of the mucous defenses are also responsible for gastric ulcers. Excess secretion of hydrochloric acid, genetic predisposition and psychological stress are important contributing factors in the formation and worsening of duodenal ulcers. Another major cause of ulcers is the chronic use of anti-inflammatory medications, such as aspirin. Cigarette smoking is also an important cause of ulcer formation and ulcer treatment failure.
Treatment of Stomach Ulcers
- See the Doctor: If you have any unexplainable stomach pain, see a doctor immediately to diagnose ulcers. The first step to getting rid of an ulcer is identifying it, otherwise you run the risk of doing more damage to your already fragile stomach. If a doctor can’t positively identify an ulcer, or the treatments are ineffective, he will probably test you with an upper endoscopy, a blood test for hereditary or bacterial predisposition to ulcers, and/or a CAT scan.
- Acid Blockers and Antacids: To get rid of ulcers, take medication to reduce the acid in your digestive system, relieve pain and encourage healing. Acid blockers, antacids and proton pump inhibitors are most frequently used to do this. Acid blockers reduce the amount of hydrochloric acid in your system by stopping histamine from reacting with histamine receptors and signaling the release of acid.Antacids, like Rolaids or Tums, simply neutralize acids already in your system and can be taken alone or with an acid blocker. A proton pump inhibitor, like Prilosec OTC, blocks the “pumps” within acid-secreting cells. Proton pump inhibitors are most often prescribed to heal ulcers.
- Don’t take NSAIDs: Stop taking non-steroidal anti-inflammatory drugs (NSAIDs) immediately. NSAIDs are used to treat pain and inflammation and are popular because of their low addiction rate; the two most recognized NSAIDs are ibuprofen and aspirin. Nevertheless, NSAIDs can contribute to and even cause ulcers because they work against three things necessary to getting rid of ulcers: the production of the mucus that coats the stomach lining, the chemical bicarbonate that neutralizes stomach acid and blood circulation to the stomach that helps repair and renew damaged cells. For this reason, it’s never a good idea to take NSAIDs too frequently or in large doses, and it’s a really bad idea to take them if you have diagnosed ulcers.
- Be Careful What you Eat: What you eat may affect your ulcer, but this isn’t true for everyone. Certain foods like black pepper, meat extracts, mustard seeds, nutmeg and even decaffeinated coffee can affect ulcer patients. You may want to avoid these things if they bother you, but keep your diet mostly balanced. Try eating small, frequent meals when you’re having pain.
- Cutting Acid from your Diet: Cutting acid out of your diet will help you get rid of ulcers. A significant change in diet is an important (and difficult) part of treating an ulcer. This change doesn’t have to be permanent, but it is essential for true healing. Because ulcers are caused by damage from acid, acid can’t be a part of your diet. This means no tomatoes or foods containing tomato products (red pasta sauce, ketchup, pizza and salsa), no citrus fruit or foods containing citric acid (Who knew ginger ale had citric acid in it?) and definitely no alcohol. You have no idea how hard this is until you try it.
- Cutting Caffeine from your Diet: Cutting caffeine out of your diet will help get rid of ulcers too. Caffeine can stimulate the secretion of stomach acid, which will keep your ulcers from healing and worsen your pain. These are a list of foods that you should avoid containing caffeine: coffee, tea (decaffeinated herbal is okay), chocolate, mint and soda. Even though it’s a challenge, it’s extremely important to hold to these dietary restrictions; ulcers can easily progress into something more complicated and dangerous if you’re not careful.
- Dairy Products: Dairy products like milk, cheese, and yogurt can help to neutralize stomach acid. Increasing your dairy products may help your tummy to feel better while treating your ulcers.
- Massage: A gentle massage can relieve stomach pain from ulcers. Have someone (or do it yourself) softly massage your abdomen, alternating kneading motions with circular strokes.
- Heat: Applying soothing heat (either a heating pad or a warm washcloth) on your abdomen can relieve ulcer pain.
Treatment of Helicobacter Pylori Infection
- Triple Therapy: When Helicobacter pylori infection is present with the ulcer, the most effective treatments are combinations of 2 antibiotics (e.g., any combination of Clarithromycin, Amoxicillin, Tetracycline and Metronidazole) and 1 proton pump inhibitor (PPI), sometimes together with a bismuth compound. (one brand name: Pepto-Bismol). Other combinations may also be effective. This treatment may be used with medicine that reduces the amount of acid your stomach makes (antacids).
- Advanced Therapy: In complicated, treatment-resistant cases, 3 antibiotics (e.g. Amoxicillin + Clarithromycin + Metronidazole) may be used together with a PPI and sometimes with the bismuth compound. An effective first-line therapy for uncomplicated cases would be Amoxicillin + Metronidazole + Rabeprazole (a PPI). In the absence of H. pylori, long-term higher dose PPIs are often used.
- H2 Antagonists: Younger patients with ulcer-like symptoms are often treated with antacids or H2 antagonists before EGD is undertaken. Bismuth compounds may actually reduce or even clear organisms. Patients who are taking nonsteroidal anti-inflammatories (NSAIDs) may also be prescribed a prostaglandin analogue (Misoprostol) in order to help prevent peptic ulcers, which may be a side effect of the NSAIDs.
Treatment of H. pylori usually leads to the clearing of infection, relief of symptoms and eventual healing of ulcers. Recurrence of infection can occur and retreatment may be required, if necessary with other antibiotics.
Since the widespread use of PPIs in the 1990s, surgical procedures (like “highly selective vagotomy”) for uncomplicated peptic ulcers became obsolete. Perforated peptic ulcer is a surgical emergency and requires surgical repair of the perforation. Most bleeding ulcers require endoscopy urgently to stop bleeding with cautery or injection.
Indeed, ulcers are a hassle to deal with because only time can tell when these pains will go away. Still, now that you know most everything there is to know about ulcers, your digestive and physical health should be relatively safe once again. Just remember to make use of these tips and information properly before it’s too late.
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