Peptic Ulcer

If you have burning pain in your upper stomach that is relieved by eating or taking antacids, you should call your health care provider for an appointment. Don't assume you have an ulcer. Certain other conditions can cause similar symptoms.

If you vomit blood or have other signs of gastrointestinal bleeding, go to an emergency department right away. Peptic ulcers can cause massive bleeding, which requires blood transfusion or surgery.

Severe abdominal pain  suggests perforation or tearing of an ulcer. This is an emergency that may require surgery to fix a hole in your stomach.

Vomiting and abdominal pain also can be a sign of an obstruction, another complication of peptic ulcers. This also may require emergency surgery.

Self-Care at Home

Home care for peptic ulcers often centers on neutralizing the stomach acid.

• Don't smoke, and avoid coffee and alcohol. These habits increase gastric acid production and weaken the mucosal barrier of the GI tract, thus promoting ulcer formation and slowing ulcer healing
• Don't take aspirin or no steroidal anti-inflammatory medications. Acetaminophen  is a good substitute for some conditions. If acetaminophen doesn't help, talk to your health care provider about alternatives.
• If your symptoms are mild, try an over-the-counter antacid or nonprescription histamine (H2) blocker to neutralize stomach acid. Usually, however, stronger prescription medications  are needed.

No particular diet is helpful for people with peptic ulcers.

• At one time, medical professionals recommended a bland diet and avoidance of spicy or greasy foods.
• We now know that diet has little effect on ulcers. In some people, however, certain foods seem to aggravate symptoms.
• A bland diet is no longer considered necessary as a blanket recommendation.
• Avoid eating any foods that aggravate your symptoms.

Follow-up

Follow the recommendations of your health care provider.

• Lifestyle changes can relieve your symptoms and help your ulcer heal. Stop smoking, avoid alcohol and caffeine, and avoid aspirin and no steroidal anti-inflammatory medications.
• Take your medications as prescribed.

Follow up as scheduled with your health care provider to monitor your progress and prevent complications.

Prevention

You can prevent peptic ulcers by avoiding things that break down the stomach's protective barrier and increase stomach acid secretion. These include alcohol, smoking, aspirin and no steroidal anti-inflammatory drugs, and caffeine.

Preventing infection with H pylori is a matter of avoiding contaminated food and water and adhering to strict standards of personal hygiene. Wash your hands carefully with warm water and soap every time you use the bathroom, change a diaper, and before and after preparing food.

If you need the pain relief and anti-inflammatory action of aspirin or an NSAID, you can reduce your risk of ulcers by trying the following:

• Try a different NSAID, one that is easier on the stomach.
• Reduce the dose or the number of times you take the medications.
• Substitute another medication, such as acetaminophen (Tylenol).
• Talk to your health care provider about how you can protect yourself.

Following the treatment recommendations of your health care provider can help prevent recurrence of ulcers. This includes taking all medications as prescribed, especially if you have H pylori infection

Outlook

Most people with peptic ulcers get better when treated with the appropriate medicine.

• Treatment for H pylori bacteria is usually successful if medications are taken as prescribed.
• Although ulcers can cause discomfort, they are rarely life threatening.

Ulcers can have several complications. These usually develop in people who do not receive appropriate treatment.

Bleeding: Ulcers in the stomach or duodenum may bleed.

• Usually, this is because the blood vessel (artery) supplying the area of the ulcer has been damaged by stomach acid.
• Sometimes this is the only sign of an ulcer.
• Bleeding may be slow or fast.
• Slow bleeding is typically from a small blood vessel; the usual result is low blood count (anemia), and symptoms are tiredness (fatigue), lethargy, and pallor.
• Fast bleeding is typically from a larger artery, and symptoms including vomiting acidified blood, which looks something like coffee grounds, or bloody or black, tarry stools

Perforation: When an ulcer gets very bad, it can eat all the way through the intestinal wall.

• The resulting hole in the intestine is called perforation.
• The contents of the intestine (food, bacteria, and digestive juices) can then spill out.
• These substances can injure other tissues and cause serious infection.

Obstruction: An ulcer causes inflammation.

• If this inflammation becomes chronic (ongoing, long lasting), it can cause swelling and scarring.
• Over time, this scarring can completely block off the digestive tract.
• This blocks food from passing, causing vomiting and weight loss.