What treatments are available for peptic ulcers?
There are many new ulcer treatment plans available, depending on the type and cause for the ulcer in question. Choice of treatment depends on whether the ulcer is caused by infection with H pylori. Correct diagnosis is key to whether a treatment works or not. If the bacteria are the cause, treatment focuses on killing the infection. Regardless of whether the bacteria are
the cause, reducing acid in the stomach is another important focus of treatment.
Ulcers require specific treatment. It is important for you to make every effort to contribute to this process. Smoking cigarettes has consistently been found to slow down the healing of an ulcer. Avoidance of alcohol, aspirin, and other inflammation-reducing drugs is also advisable, especially during a flare-up, because these substances cause increased stomach acid production which weakens the stomach lining and makes it vulnerable to damage. Other parts of a treatment plan may include the following recommendations:
Diet Milk and cream diets were once widely used in the treatment of ulcers, but the theory behind such treatment has since been abandoned. Currently, the main dietary rule is to eat regular, nutritious meals. Otherwise, use common sense and avoid foods that bother you.
Alcohol, nicotine, and tobacco cause the most acid production in the stomach. Other dietary factors may include tomatoes, citrus, spicy foods, chocolate, and mint.
There are many different types of drugs available today for treating ulcers. Some are over-the-counter preparations that are used to neutralize stomach acid (such as TUMS, Maalox, Mylanta, ROLAIDS), and others are prescription medications that promote healing by inhibiting acid secretion, blocking acid production, eliminating (H Pylori) if present, or providing a protective coating over the ulcer. Your doctor will prescribe these medications according to the likely cause for (your) ulcer, based on the symptoms and medical history and the type of ulcer you have. If a specific antacid was prescribed, do not switch brands without your doctor's knowledge; you may end up taking a product that does not contain sufficient acid-neutralizing potency.
For the majority of people with ulcers, the success of dietary therapy, drug therapy, or a combination of the two makes surgery unnecessary. Indications for surgery usually include perforation, obstruction due to scarring, and/or unrelenting bleeding. Uncontrollable pain may also justify surgery, but usually only after other alternatives have failed.
Most peptic ulcers heal within 1 to 3 months. Those that don't are called refractory ulcers. There are many reasons why an ulcer may fail to heal. Not taking medications according to directions is one reason. Another is that some types of H. pylori are resistant to antibiotics. Other factors that can interfere with the healing process include regular use of tobacco, alcohol or nonsteroidal anti-inflammatory drugs (NSAIDs). Sometimes the problem is accidental: People are unaware that a medication they're taking contains an NSAID.
In rare cases refractory ulcers may be a result of extreme overproduction of stomach acid, such as occurs in Zollinger-Ellison syndrome, an infection other than H. pylori, or other digestive diseases, including Crohn's disease or cancer.
Treatment for refractory ulcers generally involves eliminating factors that may interfere with healing, along with stronger doses of ulcer medications. Sometimes, additional medications may be included. Surgery to help heal an ulcer is necessary only when the ulcer doesn't respond to aggressive drug treatment.