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Understanding Ulcer Treatment

What Are the Treatments for an Ulcer? continued...

The chief goals of treatment are reducing the amount of acid in the stomach, strengthening the protective linings that come in direct contact with gastric acids, and -- if your ulcer is caused by bacterial infection -- treating the H. pylori infection with medication. Your doctor will likely prescribe triple therapy which is a combination of antibiotics, such as amoxicillin and clarithromycin, along with a proton pump inhibitor, such as omeprazole (Prilosec) or esomeprazole (Nexium). Metronidazole (Flagyl) can be substituted for amoxicillin in patients who are allergic to penicillin. In  patients who have been repeatedly exposed to these antibiotics, or in areas where there is resistance to clarithromycin or metronidazole, quadruple therapy with bismuth (Pepto-Bismol), a proton-pump inhibitor, and 2 antibiotics (like metronidazole and tetracycline) is more effective. Regardless of the regimen, all medications should be taken for 10-14 days.

Surgical treatment of peptic ulcers is reserved for ulcer disease unresponsive to medical management or emergency treatment of complications, such as bleeding. If your ulcer is hemorrhaging, the surgeon will identify the source of the bleeding (usually a small artery at the base of the ulcer) and repair it. Perforated ulcers -- holes in the entire stomach or duodenal wall -- must be surgically closed. This is an emergent procedure.

In some cases, an elective surgery to decrease stomach acid secretion may be necessary. However, you should have an in-depth discussion with your doctor as there are many potential complications associated with the procedures, including ulcer recurrence, liver complications, and ''dumping syndrome,'' which causes chronic abdominal pain, diarrhea, vomiting, and/or sweating after eating.

Tips for Living With Ulcers

  • If you have an ulcer, be cautious when choosing over-the-counter pain relievers. Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may not only irritate the ulcer but also prevent a bleeding ulcer from healing. Avoid powdered headache medication as well, which usually contain powdered aspirin. Your best choice may be acetaminophen, which does not cause or promote stomach ulcers.
  • Don't overdose on iron supplements. Although people with bleeding ulcers can develop anemia and may need to take iron as a treatment, taking too much can irritate the stomach lining and the ulcer. Ask your doctor how much iron you need.
  • Learn how to deal with stress. Practicing relaxation techniques -- including deep breathing, guided imagery, and moderate exercise -- can help alleviate stress and promote healing.

 

WebMD Medical Reference

Reviewed by Lisa B. Bernstein, MD on March 18, 2015
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