How do doctors treat peptic ulcers?To treat peptic ulcers, doctors typically recommend medicines to help the ulcer heal. They also look for the cause of ulcers and treat or manage the cause. Talk with your doctor about the best treatment plan for you. Show
Healing peptic ulcersMedicines that doctors recommend or prescribe to treat peptic ulcers include
Treating the causes of peptic ulcersDoctors treat the underlying causes of peptic ulcers to help the ulcers heal and prevent them from coming back. Helicobacter pylori (H. pylori) infectionDoctors treat H. pylori infection with a combination of medicines. These medicines most often include
Your doctor may avoid prescribing antibiotics you’ve taken in the past because the H. pylori bacteria may have developed antibiotic resistance to those antibiotics. If you are given medicines, take all doses exactly as your doctor prescribes. If you stop taking your medicine early, some bacteria may survive and persist in your stomach. In other words, To find out if the medicines worked, your health care professional may recommend
testing you for H. pylori at least 4 weeks after you’ve finished taking the antibiotics.2 If you still have an Nonsteroidal anti-inflammatory drugs (NSAIDs)If you have a peptic ulcer caused by taking NSAIDs, your doctor may recommend changing your medicines. If you have a peptic ulcer caused by taking NSAIDs, your doctor may recommend changing your medicines. Depending on the reason you have been taking NSAIDs, your doctor may suggest stopping NSAIDs, taking a different NSAID, taking a lower-dose NSAID, or taking a different medicine for pain. If you need to keep taking NSAIDs, your doctor may recommend you also take a PPI. Other causesIf your peptic ulcers aren’t caused by H. pylori infection or NSAIDs, doctors will check for uncommon causes. Depending on the cause, doctors may recommend additional treatments. What if an ulcer doesn’t heal or comes back after treatment?Taking medicines and treating the underlying cause heals most ulcers. However, if your ulcer doesn’t heal or comes back after treatment, your doctor may
In rare cases, doctors may recommend surgery to treat peptic ulcers that don’t heal. How do doctors treat the complications of peptic ulcers?Doctors typically treat complications of peptic ulcers in a hospital. In addition to treating the ulcer, doctors may recommend medical procedures, such as an upper GI endoscopy, or surgery to treat ulcer complications. How can I prevent peptic ulcers?If you smoke, quitting smoking can lower your risk for peptic ulcers. If your doctor thinks you have a high risk for developing peptic ulcers caused by taking NSAIDs, your doctor may recommend changes to lower your risk, such as
If you have a peptic ulcer, finding and treating the underlying cause, such as H. pylori infection, can help lower the chance of developing future ulcers. ReferenceOverviewA stomach ulcer is an open sore in your stomach lining.What is a stomach ulcer?A stomach ulcer, also called a gastric ulcer, is an open sore that develops in your stomach lining. You can also get one in your duodenum, the first part of the small intestine that your stomach feeds into. Duodenal ulcers and stomach ulcers are both types of peptic ulcers. They’re named for pepsin, one of the digestive juices that are found in the stomach and that sometimes leak into the duodenum. These juices are a contributing factor in peptic ulcer disease. Peptic ulcers occur when the protective mucous lining in your stomach and duodenum has been eroded, allowing gastric acids and digestive enzymes to eat away at your stomach and duodenal walls. This eventually results in open sores that are continually irritated by the acid. If left untreated, they can begin to cause serious complications, such as internal bleeding. Over time, they can even wear a hole all the way through. This is a medical emergency. How common are stomach ulcers?Stomach ulcers are very common in Western countries. In the United States, there are about 4 million cases per year. Some estimates say that 1 in 10 people will have one at some point in their lives. That’s because many of the causes that contribute to stomach ulcers are common in Western life. Fortunately, these causes are usually easy to trace and to reverse, giving ulcers a chance to heal and your stomach lining a chance to repair. Symptoms and CausesWhat causes stomach ulcers?The two most common causes are:
Less common causes of stomach ulcers include:
What are the symptoms of peptic ulcer disease?Some peptic ulcers don’t cause symptoms. These are called “silent ulcers." But the following symptoms are common with both duodenal and gastric ulcers:
What does a stomach ulcer feel like?The classic symptoms of peptic ulcers are stomach pain and indigestion. Ulcer pain feels like burning or gnawing inside your stomach, which is between your breastbone and your belly button. It may improve temporarily when you eat or drink or when you take an antacid, medication to reduce stomach acid. It may feel worse between meals and at night when stomach acid builds up without food to digest. It may also make you feel like you don’t want to eat. How do I know if I have an ulcer or gastritis?Gastritis and gastric ulcers share many symptoms and often go hand in hand. Gastritis can be a precursor to stomach ulcers, caused by the same conditions that will eventually cause ulcers, including H. pylori infection and mucous erosion. You may also have both. Both gastritis and stomach ulcers can cause stomach pain, as well as symptoms of indigestion. Usually, the pain from an ulcer will feel more localized — like it’s coming from one particular spot. But since some ulcers are “silent,” you might not feel it if you do have one. If you have symptoms of either gastritis or stomach ulcer, you should seek medical care. Gastritis can lead to ulcers if it hasn’t already. It can also indicate an infection or other condition that needs to be treated. Medical testing can quickly determine the causes of your stomach pain. How can I tell if I have ulcer pain or heartburn?Ulcer pain in your stomach area can feel very similar to heartburn. It’s often described as a burning kind of pain. Usually, ulcer pain will be localized at the site of the ulcer, which is in the stomach or small intestine. Heartburn covers a broader area and tends to be higher into the chest. However, you could have heartburn and ulcer pain at the same time. Heartburn is usually caused by acid reflux, which is when acid from your stomach travels back up through your esophagus. So, heartburn may start as low as your stomach, but it will also travel upwards from there. If your pain is higher than your breast bone, that’s probably heartburn — but it doesn’t mean you don’t have an ulcer too. Acid reflux can also be a symptom of a stomach ulcer. What triggers stomach ulcer symptoms?Stomach ulcers are irritated by stomach acid. Some people notice this irritation more after they eat, and some people notice it more on an empty stomach. There are also certain irritants that seem to make ulcer symptoms worse and make them more difficult to heal. Smoking and alcohol are the biggest ones. What are the possible complications of peptic ulcer disease?An ulcer left untreated may cause serious complications, including:
What are the symptoms of a bleeding ulcer?Bleeding ulcers don’t always cause pain. Sometimes the first signs of a bleeding ulcer are signs of anemia. These include:
You might have a heavier bleed if you notice:
These symptoms require urgent medical attention. Diagnosis and TestsHow is a stomach ulcer diagnosed?Your healthcare provider will ask you about your symptoms and medical history. They will want to know if you frequently use NAIDs or have a history of H. pylori infection. If signs point to an ulcer, they will want to take a look inside your stomach and duodenum. What tests will be done to diagnose a peptic ulcer?Endoscopy. An upper endoscopy exam is expedient because allows healthcare providers to see inside your digestive tract and also take a tissue sample to analyze in the lab. The test is done by passing a thin tube with a tiny camera attached down your throat and into your stomach and duodenum. You’ll have medication to numb your throat and help you relax during the test. Your healthcare provider may use the endoscope to take a tissue sample to test for signs of mucous damage, anemia, H. pylori infection or malignancy. If they take a sample, you won’t feel it. Imaging tests. Imaging tests to look inside the stomach and small intestine include:
Tests for H. pylori. Your healthcare provider might want to test you separately for H. pylori infection. Tests may include:
Breath test. The H. pylori breath test is an accurate test for diagnosing an active H. pylori infection. For the test, you’ll drink a flavored solution containing an organic chemical compound called urea. If H. pylori bacteria are present in your digestive tract, they will break down the urea and convert it to carbon dioxide. The carbon dioxide will come out in your breath. When you breathe into a bag, healthcare providers will be able to measure it. Management and TreatmentHow 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:
What about complicated ulcers?While most ulcers are successfully treated with medication, some complicated ulcers may require surgery. Ulcers that are bleeding, or that have perforated your stomach or intestinal wall, will need to be surgically repaired. An ulcer that is malignant, or obstructing a passageway, will need to be surgically removed. In severe cases, an ulcer that keeps coming back may be treated by surgery to cut off some of the nerve supply to the stomach that produces stomach acid. How soon after treatment will I feel better?If you take all medicines as prescribed and avoid irritating the ulcer with NSAIDs, alcohol or smoking, your ulcer should heal well within a few weeks. Surgical cases may take a few weeks more. Your healthcare provider will follow up with you at the end of your course of medication to make sure the ulcer has healed and any infection has cleared. They will probably take follow-up tests, including an upper endoscopy to look at the site of the ulcer and tests for H. pylori, if you had it, to make sure the infection is gone. Should I follow a diet while my ulcer is healing?It’s a good idea to be conscious of your diet and avoid things that might aggravate your ulcer and prolong the healing process. Balance overly acidic foods, including grains, dairy and meat products, with alkaline foods such as fruits and vegetables. Avoid alcohol and caffeine while healing. PreventionHow can I prevent a stomach ulcer from occurring or returning?
Outlook / PrognosisCan stomach ulcers just go away?Some ulcers follow a chronic pattern of healing temporarily on their own and then returning. This might happen if the factors contributing to your ulcer, such as NSAID use, smoking and alcohol, are temporarily reduced and then resumed. You won’t completely heal your ulcer until you eliminate the cause, whether that is chronic NSAID use, H. pylori infection or an overactive stomach. Even after successful treatment, you can get another ulcer. Living WithWhat should I do if I think I have a stomach ulcer?Always seek medical care for a stomach ulcer. While you may be able to manage symptoms temporarily with over-the-counter medications, these won’t heal the ulcer. You need to identify and treat the underlying cause. An untreated ulcer can lead to serious complications, even if your symptoms are mild. The major cause of stomach ulcers, H. pylori infection, can also lead to other complications. When should I go to ER?Seek emergency care if you have:
A note from Cleveland Clinic Stomach ulcers are common and treatable, but they should be taken seriously. Even when they don’t cause symptoms, they aren’t a good sign. A stomach ulcer means that your natural stomach acid is overwhelming your protective stomach lining. That’s a situation that can only get worse if it isn’t managed. Lifestyle changes may help, but you’ll still need to treat the underlying cause. It’s probably either NSAID use or a common bacterial infection. Your healthcare provider can help prescribe the right medicines for your condition. What is the fastest way to cure a stomach ulcer?You'll likely need to take antibiotics for two weeks, as well as additional medications to reduce stomach acid, including a proton pump inhibitor and possibly bismuth subsalicylate (Pepto-Bismol). Medications that block acid production and promote healing.
How do you know when an ulcer is cured?Your healthcare provider will follow up with you at the end of your course of medication to make sure the ulcer has healed and any infection has cleared. They will probably take follow-up tests, including an upper endoscopy to look at the site of the ulcer and tests for H.
Why is my stomach ulcer not healing?Refractory peptic ulcers are defined as ulcers that do not heal completely after 8 to 12 weeks of standard anti-secretory drug treatment. The most common causes of refractory ulcers are persistent Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs).
How long until stomach ulcer pain goes away?Most ulcers heal within about 8 weeks. Peptic ulcers come and go. You have to do what you can to reduce your risk.
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