Peptic Ulcers

Treatment

Treatment is unique to each individual. A bacterial infection or medication, not stress or diet, causes most ulcers. Ulcers can often be cured in two to four weeks.

If H. pylori bacteria is present, the treatment goal may be to eradicate the bacterium. No single antibiotic can do the job, so multiple antibiotics are necessary — usually two antibiotics combined with an acid reducer such as a proton pump inhibitor and sometimes a bismuth compound.

If the peptic ulcer is due to use of nonsteroidal anti-inflammatory drugs (NSAIDs), they should be discontinued because they slow or prevent healing. NSAIDs are available both by prescription and over-the-counter. Nonprescription NSAIDs include aspirin, ibuprofen (Advil, Motrin) and naproxen (Aleve). Doctors may recommend NSAIDs with a lower risk for causing ulcers, such as COX-2 inhibitors. Patients who must continue using NSAIDs may take a prostaglandin analog to protect the stomach from damage caused by frequent use of aspirin or NSAIDs, or a proton pump inhibitor (which also reduces the amount of acid produced by the stomach).

Quitting smoking, limiting consumption of caffeine and alcohol and reducing stress can speed healing and prevent ulcers from recurring. Ulcers that do not respond to treatment may have complications or be cancerous. If an ulcer eats through the wall of the stomach or intestine into the abdominal cavity or if it continues to bleed, surgery to cut the nerve to the stomach or remove part of the stomach may be required.