How Are Duodenal Ulcers Treated
If your ulcer is caused by H pylori, the usual treatment is ‘triple therapy’. This involves taking 2 antibiotics and a medicine. The antibiotics kill the bacteria, while the medicine reduces the acid made by your stomach.
If you don’t have an H. pylori infection, and you have been using anti-inflammatory drugs, you will need to stop taking them . You will also need to start taking a drug to reduce the acid production in your stomach.
You can make some other changes to improve your symptoms, such as:
- taking antacids
What Are Some Ulcer Symptoms
Some people with ulcers dont experience any symptoms. But signs of an ulcer can include:
- Gnawing or burning pain in your middle or upper stomach between meals or at night.
- Pain that temporarily disappears if you eat something or take an antacid.
In severe cases, symptoms can include:
- Dark or black stool .
- Severe pain in your mid- to upper abdomen.
Treatment Options For Stomach Ulcers
Depending on the cause of your stomach ulcer, treatment options will vary. If your stomach ulcer is not caused by H. pylori, your doctor will most likely prescribe antacids or other medications. Proton pump inhibitors and histamine receptor antagonists are common medications that doctors may prescribe to relieve your symptoms of a stomach ulcer.
PPI medications may include:
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What Are The Complications Of Duodenal Ulcers
If left untreated, your duodenal ulcers may get worse. This can cause other complications, such as:
- broken blood vessels
- obstructing food from leaving your stomach
- perforation in the duodenal wall
These complications require emergency treatment, and can cause sharp pain, bloody vomit, or bloody faeces .
When To Contact A Doctor
Anyone who thinks they may have an ulcer in their stomach should consult a doctor. Any stomach symptoms that last for more than a few days or keep happening need evaluation and treatment.
Symptoms of anemia, such as tiredness and breathlessness, may signal a slow-bleeding ulcer. More serious bleeding is an urgent medical problem, as people may vomit up blood, or stools are black and sticky.
Perforation is also an emergency. Without quick treatment, the wall of the stomach can become infected. Sudden stomach pain that gets worse can indicate perforation, and any signs of being very unwell with infection need treatment as soon as possible.
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Bleeding Ulcers Symptoms And Causes
Bleeding ulcers are a big deal. Often having endoscopy is diagnostic and therapeutic. A gastroenterologist can use a fiberoptic camera to view the inside of the stomach and duodenum, searching for a source of bleeding.
Symptoms of a bleeding ulcer include:
- Abdominal discomfort after eating
- Upper abdominal burning or hunger pain 1 to 3 hours after eating or in the middle of the night
History Of Ulcer Causes
Ulcers have a unique and interesting history when it comes to their suspected causes. For decades, stomach ulcers were considered to be psychosomatic, meaning a high-stress lifestyle was to blame. At the time doctors started identifying high rates of ulcers in hard-working businessmen who smoked a lot of cigarettes and were likely sleep-deprived, and then animal studies further confirmed stress-triggered ulcers. Rats producing high amounts of stomach acid experienced a decrease in stomach ulcer symptoms when researchers fed them antacids, so a connection was then drawn between ulcers, chronic stress and an increase in stomach acid, which changed ulcer treatment approaches forever.
A bacterium called Helicobacter pylori was then discovered that seemed to be present in nearly everyone suffering from ulcers. It was also found to run in families and was connected to other digestive disorders, including stomach cancer. In patients given medications/antibiotics to kill H. pylori, ulcers were often resolved at least for a period of time.
However, today its more common to treat ulcers using less risky acid-reducing drugs in combination with lifestyle and dietary changes, rather than prescribing antibiotics to kill H. pylori, which can come with complications and lead to antibiotic resistance. Antibiotics used to combat H. pylori can work short term to lower the bacteria, but dont seem to keep it from returning without other interventions.
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How Are Stomach Ulcers Treated
Ulcers can heal if they are given a rest from the factors that created them. Healthcare providers treat uncomplicated ulcers with a combination of medicines to reduce stomach acid, coat and protect the ulcer during healing and kill any bacterial infection that may be involved. Medicines may include:
- Antibiotics. If H. pylori was found in your digestive tract, your healthcare provider will prescribe some combination of antibiotics to kill the bacteria, based on your medical history and condition. Commonly prescribed antibiotics include tetracycline, metronidazole, clarithromycin and amoxicillin.
- Proton pump inhibitors . These drugs help reduce stomach acid and protect your stomach lining. PPIs include esomeprazole,dexlansoprazole,lansoprazole, omeprazole,pantoprazole and rabeprazole.
- Histamine receptor blockers . These reduce stomach acid by blocking the chemical that tells your body to produce it . H2 blockers include famotidine, cimetidine and nizatidine.
- Antacids. These common over-the-counter medicines help to neutralize stomach acid. They may bring some symptom relief, but they arent enough to heal your ulcer. They also might interfere with some antibiotics.
- Cytoprotective agents. These medicines help to coat and protect your stomach lining. They include sucralfate and misoprostol.
- Bismuth Subsalicylate. This over-the-counter medicine, commonly found as Pepto-Bismol, can help coat and protect your ulcer from stomach acid.
What Causes Duodenal Ulcers
Your stomach makes a strong acid that helps you digest food and kills germs. The cells of the stomach and duodenum make a barrier from mucus, to protect themselves against this acid. If the mucus barrier is damaged, an ulcer can form.
The main cause of this damage is infection with bacteria called Helicobacter pylori, or H. pylori. The bacteria can cause the lining of your duodenum to become inflamed and an ulcer can form.
Some medications can also cause duodenal ulcers, particularly anti-inflammatory medicines such as ibuprofen and aspirin. It is rare that other medicines or medical conditions cause an ulcer.
There are some lifestyle factors that may make you more likely to get a duodenal ulcer, such as:
However, these things are less important than infection with H. pylori.
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How Are Stomach And Duodenal Ulcers Diagnosed In A Child
Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is.
Your childs treatment will also depend on whats causing his or her ulcer. For instance, ulcers caused by H. pylori need different treatment from ulcers caused by using NSAIDs.
Your childs healthcare provider will ask about his or her health history. He or she will also give your child an exam. Your child may need more tests before his or her ulcer is diagnosed.
Stomach Ulcers: How Dangerous Are They
Ulcers generally are sores that are slow in healing or keep returning after it has been treated. They can appear both on the inside as well as outside of the body taking different forms, depending on the conditions the body was exposed.
Injuries or diseases, even infections can cause you to have an ulcer. Their appearance depends on whether it is on the outside or inside your body and the cause behind you getting them. While some may not require much attention and go away on their own, others can create severe health problems if you dont treat them in time.
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How Are Ulcers Treated
If you have a peptic ulcer, your doctor will recommend a treatment plan based on whatÃ¢s causing it:
- The most common remedy is a combination of antibiotic drugs to kill the H. pylori bacteria and medications to get rid of acid in your stomach. These typically include proton pump inhibitors , and antibiotics. YouÃ¢ll take PPIs for several weeks.
- If your ulcer is caused by over-the-counter painkillers, youÃ¢ll need to quit taking them.
- They also may give you a drug called a protectant, which coats ulcers to protect them from stomach acid.
Lifestyle changes can help, too. You might need to:
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What Can I Do To Prevent Stomach And Duodenal Ulcers In My Child
Preventing H. pylori can reduce your childs risk of ulcers. It isnt fully understood how this infection is spread. But the following may lower your childs risk of H. pylori:
Washing hands often
Not having close contact with someone who has H. pylori
Not eating or drinking contaminated food or water
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How Is An Ulcer Diagnosed
Your doctor will ask you about your symptoms. They may do an endoscopy. This procedure involves inserting a thin, flexible tube attached to a camera down your throat and into your stomach. Your doctor will test your blood, breath or stool for H. pylori. They also can test a sample of your stomach lining. Your doctor also will ask you if you regularly take aspirin or anti-inflammatory medicines.
When Should I Call The Doctor
- sudden, sharp, lasting belly pain
- bloody or black bowel movements
- bloody vomit or vomit that looks like coffee grounds
These could be signs of a serious problem for a child whos had a peptic ulcer, such as:
If your child takes NSAIDs and shows signs of a peptic ulcer, get medical help right away. Delaying diagnosis and treatment can lead to more problems and, possibly, the need for surgery. But with quick treatment, almost all peptic ulcers can be cured.
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How Can I Prevent A Stomach Ulcer From Occurring Or Returning
- Reduce NSAID use, if possible. Consider whether acetaminophen might substitute. If you take NSAIDs for medical reasons, talk to your doctor about reducing your dosage or switching your medication. Your doctor may also prescribe another medicine to take with NSAIDs to protect your stomach lining.
- Reduce other irritants that may contribute to too much stomach acid or erode your stomach lining, including smoking and alcohol use.
- Take an H. pylori breath test to find out if you have an overgrowth of the bacteria.
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1. Boost Immunity Against H.pylori
Many people host H. pylori in their bodies, but only a minority of people infected with H. pylori develop ulcers. A highly inflammatory lifestyle weakens the immune system and makes the digestive system more susceptible to an infection caused by H. pylori bacterium. H. pylori itself can then cause even more inflammation within the stomach and small intestine, creating a vicious cycle thats hard to break.
Research shows that today about 30 percent to 40 percent of people in the U.S. get an H. pylori infection, but usually the infection remains dormant, without any noticeable symptoms emerging for years or even ever. Other research suggests that H. pylori is present in more than 90 percent of duodenal ulcers and about 80 percent of stomach ulcers.
H. pylori contributes to ulcers by damaging the mucous coating that protects the lining of the stomach and duodenum from acids. Once damaged, stomach acid is able to get through to the sensitive lining, causing burning and irritation. H. pylori can be spread through unclean water, food or utensils, plus through bodily fluids but its only likely to cause an ulcer when someones immunity is low for other reasons.
You can also protect yourself from H. pylori infection by frequently washing your hands with soap and water and by eating foods that have been cooked completely.
2. Limit Use of NSAID Pain Relievers
3. Manage Stress
4. Eat A Stomach Ulcer Diet
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Symptoms Of Stomach Ulcers
Although the most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of the abdomen . Not all stomach ulcers are painful.
Some people experience:
Speak to your GP immediately if:
- your symptoms persist
- you’re vomiting blood the blood can appear bright red or have a dark brown, grainy appearance like coffee grounds
- you’re passing dark, sticky, tar-like stools
- you feel a sudden, sharp pain in your tummy that gets steadily worse
These could be a sign of a serious complication.
How Common Are Stomach Ulcers
It’s not known exactly how common stomach ulcers are. They have become much less common since the 1980s because of much more effective treatments. So people with stomach ulcers now usually get better much more quickly.
The term ‘peptic ulcer’ is used to describe ulcers that are caused by too much acid in the stomach. This includes stomach ulcers and also ulcers in the first part of the gut known as the duodenum. Stomach ulcers are less common than duodenal ulcers.
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How Are Peptic Ulcers Diagnosed
Your healthcare provider will look at your past health and give you a physical exam. You may also have some tests.
Imaging tests used to diagnose ulcers include:
- Upper GI series or barium swallow. This test looks at the organs of the top part of your digestive system. It checks your food pipe , stomach, and the first part of the small intestine . You will swallow a metallic fluid called barium. Barium coats the organs so that they can be seen on an X-ray.
- Upper endoscopy or EGD . This test looks at the lining of your esophagus, stomach, and duodenum. It uses a thin lighted tube called an endoscope. The tube has a camera at one end. The tube is put into your mouth and throat. Then it goes into your esophagus, stomach, and duodenum. Your health care provider can see the inside of these organs. A small tissue sample can be taken. This can be checked for H. pylori.
You may also have the following lab tests to see if you have an H. pylori infection:
Rare Causes Of Peptic Ulcers
Zollinger-Ellison syndrome is a rare cause of peptic ulcers. People with this condition have a tumour , usually in their duodenum or pancreas, that releases a hormone called gastrin. This hormone causes the stomach to make more acid than usual, and the excess acid can cause peptic ulcers to develop.
Peptic ulcers can also sometimes develop in people who are very unwell . These so-called stress ulcers are actually caused by a lack of blood flow to the stomach. People who are seriously ill are usually given acid-suppressing medicines to try to prevent this type of peptic ulcer developing.
Some infections and medicines other than NSAIDs can also rarely cause peptic ulcers. In other cases, no obvious cause can be found.
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What Causes Peptic Ulcers
In the past, experts thought lifestyle factors such as stress and diet caused ulcers. Today we know that stomach acids and other digestive juices help create ulcers. These fluids burn the linings of your organs.
Causes of peptic ulcers include:
- H. pylori bacteria . Most ulcers are caused by an infection from a bacteria or germ called H. pylori. This bacteria hurts the mucus that protects the lining of your stomach and the first part of your small intestine . Stomach acid then gets through to the lining.
- NSAIDs . These are over-the-counter pain and fever medicines such as aspirin, ibuprofen, and naproxen. Over time they can damage the mucus that protects the lining of your stomach.
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Who Is More Likely To Develop Peptic Ulcers
People are more likely to develop peptic ulcers if they are
- taking nonsteroidal anti-inflammatory drugs , such as aspirin, ibuprofen, and naproxen
H. pylori infection and taking NSAIDs are the two most common causes of peptic ulcers.
People also are more likely to develop peptic ulcers if they
- are older adults
- had a peptic ulcer before
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How Are Stomach Ulcers Diagnosed
Diagnosis and treatment will depend on your symptoms and the severity of your ulcer. To diagnose a stomach ulcer, your doctor will review your medical history along with your symptoms and any prescription or over-the-counter medications youre taking.
To rule out H. pylori infection, a blood, stool, or breath test may be ordered. With a breath test, youll be instructed to drink a clear liquid and breathe into a bag, which is then sealed. If H. pylori is present, the breath sample will contain higher-than-normal levels of carbon dioxide.
Other tests and procedures used to diagnose stomach ulcers include:
- Barium swallow: You drink a thick white liquid that coats your upper gastrointestinal tract and helps your doctor see your stomach and small intestine on X-rays.
- Endoscopy : A thin, lighted tube is inserted through your mouth and into the stomach and the first part of the small intestine. This test is used to look for ulcers, bleeding, and any tissue that looks abnormal.
- Endoscopic biopsy: A piece of stomach tissue is removed so it can be analyzed in a lab.
What Are The Symptoms Of A Stomach Ulcer
Most people with a stomach ulcer do not experience any symptoms. The most common symptom is burning pain in the upper abdomen. The pain can travel to the chest and neck, bellybutton, or back.
Other less common symptoms include:
- feeling full and bloated, or belching
- not being able to tolerate fatty foods
Sometimes, stomach ulcers can lead to more serious symptoms, such as:
- a sudden sharp pain in the stomach that gets worse
- blood in your stool or black, tarry stools
If you have any of these symptoms, see a doctor immediately.
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