The goal of ulcer treatment is to relieve pain and to prevent
ulcer
complications, such as bleeding, obstruction, and perforation.
The first
step in treatment involves the reduction of risk factors
(NSAIDs and
cigarettes). The next step is medications.
Antacids neutralize existing acid in the stomach. Antacids
such as Maalox, Mylanta, and Amphojel are safe and effective
treatments. However,
the neutralizing action of these agents is short-lived, and
frequent
dosages are required. Magnesium containing antacids, such as Maalox and Mylanta, can cause diarrhea, while aluminum agents like
Amphojel can cause
constipation. Ulcers frequently return when antacids are
discontinued.
Studies have shown that a protein in the stomach called
histamine
stimulates gastric acid secretion. Histamine antagonists (H2
blockers) are
drugs designed to block the action of histamine on gastric
cells, hence
reducing acid output. Examples of H2 blockers are cimetidine (Tagamet),
ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid). While H2
blockers are effective in ulcer healing, they have limited role
in
eradicating H. pylori without antibiotics. Therefore, ulcers
frequently
return when H2 blockers are stopped. Generally, these drugs are
well
tolerated and have few side effects even with long term use. In
rare
instances, patients report headache, confusion, lethargy, or
hallucinations. Chronic use of cimetidine may rarely cause
impotence or breast swelling. Both cimetidine and ranitidine can interfere
with body's
ability to handle alcohol. Patients on these drugs who drink
alcohol may
have elevated blood alcohol levels. These drugs may also
interfere with
the liver's handling of other medications like Dilantin, Coumadin, and
theophylline. Frequent monitoring and adjustments of the
dosages of these
medications may be needed.
Proton-pump inhibitors such as omeprazole (Prilosec),
lansoprazole
(Prevacid), pantoprazole
(Protonix), esomeprazole
(Nexium), and rabeprazole
(Aciphex) are more potent than H2 blockers in suppressing acid
secretion. Different proton-pump
inhibitors are very similar in action and there is no evidence that one is more
effective than another in healing ulcers.
While proton-pump inhibitors are comparable to H2 blockers in
effectiveness
in treating gastric and duodenal ulcers, it is superior
to
H2 blockers in treating esophageal ulcers. Esophageal ulcers are
more
sensitive than gastric and duodenal ulcers to minute amounts
of
acid. Therefore, more complete acid suppression accomplished by proton-pump
inhibitors are
important for esophageal ulcer healing. Proton-pump inhibitors are well tolerated. Side
effects are
uncommon; they include headache, diarrhea, constipation, nausea and rash. Interestingly, proton-pump
inhibitors do not
have any effect on a person's ability to digest and absorb nutrients. Proton-pump
inhibitors have
also been found to be safe when used long term, without serious
adverse health effects reported.
Sucralfate (Carafate) and misoprostol (Cytotec)
are agents that strengthen the gut lining against attacks by acid digestive
juices. Carafate coats the ulcer surface and promotes healing. The medication
has very few side effects. The most common side effect is constipation and the
interference with the absorption of other medications. Cytotec is a
prostaglandin-like substance commonly used to counteract the ulcer effects of
NSAIDs. Studies suggest that Cytotec may protect the stomach from ulceration in
those who take NSAIDs on a chronic basis. Diarrhea is a common side effect.
Cytotec can cause miscarriages when given to pregnant women, and should be
avoided by women of childbearing age.
Many people harbor H. pylori
in their stomachs without ever having pain
or ulcers.
It is not completely clear whether these patients should be
treated with
antibiotics. More studies are needed to answer this question.
Patients with
documented ulcer disease and H. pylori infection should be
treated with
antibiotic combinations. H. pylori can be very difficult to
completely eradicate.
Treatment requires a combination of several antibiotics,
sometimes
in combination with a proton-pump inhibitor, H2
blockers or Pepto-Bismol. Commonly used antibiotics are tetracycline,
amoxicillin,
metronidazole (Flagyl), clarithromycin (Biaxin),
and levofloxacin (Levaquin).
Eradication of H.
pylori prevents the return of ulcers (a major problem with all
other ulcer
treatment options). Elimination of this bacteria may also
decrease the
risk of developing gastric cancer in the future. Treatment with
antibiotics carries the risk of allergic reactions, diarrhea,
and
sometimes severe antibiotic-induced colitis (inflammation of
the colon).
There is no conclusive evidence that dietary restrictions and
bland
diets play a role in ulcer healing. No proven relationship
exists between
peptic ulcer disease and the intake of coffee and alcohol.
However, since
coffee stimulates gastric acid secretion, and alcohol can cause
gastritis,
moderation in alcohol and coffee consumption is often
recommended.
Peptic Ulcer - Symptoms At Onset Of DiseaseQuestion: The symptoms of peptic ulcer can vary greatly from patient to patient. What were your symptoms at the onset of your disease?
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Low blood pressure, also referred to as hypotension, is blood pressure that is so low that it causes symptoms or signs due to the low flow of blood through the arteries and veins. Some of the symptoms of low blood pressure include light-headedness, dizziness, or even fainting if not enough blood is getting to the brain. Diseases and medications can also cause low blood pressure. When the flow of blood is too low to deliver enough oxygen and nutrients to vital organs such as the brain, heart, and kidneys; the organs do not function normally and may be permanently damaged.
GERD (gastroesophageal reflux disease) is a condition in which the acidified liquid
contents of the stomach backs up into the esophagus. The symptoms of uncomplicated GERD are heartburn,
regurgitation, and nausea. Effective treatment is available for most patients with GERD.
Blood clots can occur in the venous and arterial vascular system. Blood clots can form in the heart, legs, arteries, veins, bladder, urinary tract and uterus. Risk factors for blood clots include high blood pressure and cholesterol, diabetes, smoking, and family history. Symptoms of a blood clot depend on the location of the clot. Some blood clots are a medical emergency. Blood clots are treated depending upon the cause of the clot. Blood clots can be prevented by lowering the risk factors for developing blood clots.
Though the cause of stomach cancer is unknown, risk factors for stomach cancer include diet, H. pylori infection, smoking age, gastritis, stomach surgery, family history, and pernicious anemia. Symptoms include stomach discomfort, feeling full after a small meal, nausea and vomiting, and weight loss. Treatment depends upon staging and may involve surgery, radiation therapy, or chemotherapy.
Helicobacter pylori (H. pylori) is a bacterium that causes chronic inflammation (gastritis) of the inner lining of the stomach in humans. This bacteria also is the most common cause of ulcers worldwide.
Dyspepsia (indigestion) is a functional disease in which the gastrointestinal organs, primarily the stomach and first part of the small intestine, function abnormally. It is a chronic disease in which the symptoms fluctuate infrequency and intensity. Symptoms of dyspepsia include upper abdominal pain, belching, nausea, vomiting, abdominal bloating, early satiety, and abdominal distention (swelling). These symptoms are most often provoked by eating.
Gastritis is an inflammation of the stomach lining. Causes of gastritis include drinking too much alcohol, medications such as NSAIDs, ibuprofen, aspirin, H. pylori infection, severe infections, burns, anemia, and autoimmune disorders. Gastritis is diagnosed with endoscopy, blood tests, or stool tests. Treatment depends upon the cause of gastritis.
Nausea and vomiting are symptoms that may be caused by many conditions. Antiemetics are drugs that treat nausea and vomiting. Though some antiemetics for motion sickness and mild nausea are available over the counter (OTC), most require a medical evaluation and prescription.
Prolactinoma is an adenoma (benign tumor) of the pituitary gland. Causes of many prolactinomas are unknown. Symptoms in women include changes in menstruation and infertility, decreased libido, or painful intercourse due to vaginal dryness. The most common symptom in men is impotence (erectile dysfunction). Treatment of prolactinomas are medication or surgery.
Hypercalcemia is a condition in which calcium levels in the blood are elevated. Hypercalcemia is associated with other conditions such as hyperparathyroidism, lung cancer, breast cancer, kidney failure, and elevated levels of vitamin D. Symptoms of hypercalcemia include constipation, nausea, abdominal pain, kidney stones, to name a few. Treatment depends on the cause of hypercalcemia.
Iron is a mineral our bodies need. Iron deficiency is a condition resulting from not enough iron in the body. It is the most common nutritional deficiency and the leading cause in the US. Iron deficiency is caused due to increased iron deficiency from diseases, nutritional deficiency, or blood loss and the body's inability to intake or absorb iron. Children, teen girls, pregnant women, and babies are at most risk for developing iron deficiency. Symptoms of iron deficiency include feeling weak and tired, decreased work or school performance, slow social development, difficulty maintaining body temperature, decreased immune function, and an inflamed tongue. Blood tests can confirm an iron deficiency in an individual. Treatment depends on the cause of the deficiency. Proper diet that includes recommended daily allowances of iron may prevent some cases of iron deficiency.
Digestion is the complex process of turning food you eat into the energy you need to survive. The digestive process also involves creating waste to be eliminated, and is made of a series of muscles that coordinate the movement of food.
Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed medications for the treatment of inflammatory conditions. Examples of NSAIDs include aspirin, ibuprofen, naproxen, and more. One common side effect of NSAIDs is peptic ulcer (ulcers of the esophagus, stomach, or duodenum). Side effects, drug interactions, warnings and precautions, and patient safety information should be reviewed prior to taking NSAIDs.
Biologic rhythms, or biorhythms, are how our bodies respond to the regular phases of the sun, moon, and seasons. A medical chronobiologist studies how the "body clock" or biorhythms affect diseases and how the body clock responds to treatment of diseases and conditions at different times of the day.
Bernard-Soulier disease is a rare inherited bleeding disorder caused by a defect in the platelet glycoprotein complex 1b-IX-V. Symptoms and signs include bruising, nosebleeds, gum bleeding, and problems with anything that induces bleeding, such as surgery, ulcers, trauma, and menstruation. Treatment involves avoiding medications that interfere with clot formation, such as naproxen, ibuprofen, and aspirin. People with Bernard-Soulier syndrome should avoid contact sports.
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