Peptic ulcers are open sores that develop in the stomach, small intestine or esophageal lining. The causes of peptic ulcers include infection, particularly Helicobacter pylori or H. pylori and/or medication. Peptic ulcers can be aggravated by regular use of pain killers, smoking, excessive alcohol consumption or stress. If left untreated, peptic ulcers can result in internal bleeding, infection and scar tissue. The main goals of treatment include killing the bacteria and reducing the level of acid in the digestive system to help relieve pain and promote healing.
Medications
No single antibiotic can treat H. pylori bacteria so multiple antibiotics are necessary. Typically two antibiotics are prescribed and combined with an acid reducer such as a proton pump inhibitor. Acid blockers or histamine blockers can also reduce the amount of hydrochloric acid to relieve ulcer pain and help encourage healing. An antacid may also be prescribed to neutralize existing stomach acid. Cytoprotective agents are used to help protect the tissues that line the stomach and small intestine.
Surgery
The appropriate surgical procedure depends on the location and nature of the ulcer. If an ulcer eats through the stomach or intestinal lining and into the abdominal cavity or if it continues to bleed, surgery may be required. Surgical options include vagotomy and pyloroplasty, vagotomy and gastroduodenal reconstruction (Billroth I) or gastrojejunal reconstruction (Billroth II).
Quit Smoking
If you smoke, quitting is recommended to promote healing or the ulcers. Nicotine will delay the healing of a peptic ulcer by interfering with the protective lining of the stomach. Smoking can also increase the amount of acid in the stomach.
Diet: Limit Alcohol and Caffiene
Alcohol and caffeine can stimulate the secretion of stomach acid. Excessive alcohol consumption can irritate or erode the mucous lining of the stomach and intestine that causes inflammation and bleeding. Avoiding fatty or spicy foods and raising the head of the bed may also help control acid reflux. If you are overweight, reducing your weight may also help control symptoms of acid reflux.
Avoid NSAID's
If a peptic ulcer is due to the use of non-steroidal anti-inflammatory drugs or NSAIDs, they should be discontinued to avoid any delay in healing. Active ulcers associated with NSAID use are treated with an appropriate course of proton pump inhibitor therapy along with the cessation of NSAID. If pain relievers are used regularly an acetaminophen, such as Tylenol, is recommended.
