A hole in the stomach lining, severe bleeding, or scar tissue blocking passage through the digestive tract are complications that require immediate medical care. Go to the emergency room if you experience severe abdominal pain, black tarry stools, or vomit blood or what looks like coffee grounds. About 15% of people with ulcers suffer from some bleeding and the condition is a medical emergency. About 10% of those with bleeding peptic ulcers die. Bleeding is more common with ulcers caused by NSAIDs.
There are several things you can do to help yourself recover from an ulcer.
- If you smoke, quit. Smoking increases acid production, and acid irritates the ulcer.
- Avoid alcohol.
- Do not take NSAIDs, including aspirin unless medically indicated.
- Avoid eating large meals. Stretching the stomach can increase pain.
- Foods high in fiber may speed healing.
- Do not eat foods that seem to aggravate your symptoms. Coffee, soft drinks, and citrus juices can increase acid production. Drink these beverages in moderation.
Emotional stress does not cause ulcers, but it can make you feel worse. Learning and practicing stress management techniques may help you feel better, promote healing, and decrease your ulcer risk.
Your doctor is the best source of information on the drug treatment choices available to you.
Since peptic ulcer disease has become a curable condition, surgery is no longer considered an acceptable treatment for ulcers, except for patients experiencing an emergency complication that cannot be managed by medical or endoscopic treatment. Surgical resection of the gastrinoma is the optimal treatment for patients with ZES.
Endoscopy is a procedure used to treat most bleeding ulcers. The doctor inserts a long, thin instrument with a tiny camera on the end through your mouth and into your stomach and duodenum Heat or electricity can be applied to the sore, which makes the blood clot. Treatment may include injecting epinephrine or another medication into the ulcer. Bleeding may recur after treatment.
Older adults are at greater risk for NSAID-related ulcers. While NSAIDs are often prescribed for older patients with arthritis, they pose a greater risk for this population. Take the smallest dose possible to relieve symptoms. Check with your doctor before taking an over-the-counter pain medication.
Killing off H. pylori usually cures peptic ulcer disease caused by the bacteria. After successful multi-drug treatment, ulcers heal, usually do not come back, and do not progress or cause complications. Becoming infected again is uncommon although possible.
An ulcer generally heals in about 8 to 12 weeks. The pain may subside in a week or two. But you must continue taking the drugs, even if you feel fine. If an ulcer does not heal, a biopsy is needed to check for cancer. The risk of stomach cancer for people with H. pylori ulcers is double that of those without ulcers.
Each year about 1% of patients experience a complication. Complications include bleeding, the ulcer eating through the lining of the stomach, or scar tissue blocking the passage of food through the system.
After completing treatment, patients must return to the doctor, who will order tests to confirm the cure. Generally, a breath test is ordered to check for H. pylori. Therapy is considered successful if no H. pylori bacteria are found four or more weeks after you finish the medications. A lack of symptoms does not always mean the disease is cured.
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