Patient information from the BMJ Group
Stomach ulcers
If the lining of your stomach or bowels gets damaged, it can cause an ulcer.
Stomach ulcers are sometimes called peptic ulcers. They can be very painful, but
there are treatments that can help.

We've brought together the best and most up-to-date research about stomach
ulcers to see what treatments work. You can use our information to talk to your
doctor and decide which treatments are best for you.

What are stomach ulcers?
Ulcers happen when the lining of your stomach gets damaged, and the acid in yourstomach goes through the damaged lining to the tissue underneath. This can be painful.
Ulcers can also happen in the top part of your bowels.
Most stomach ulcers are caused by one of the bacteria that can live in your stomach,called Helicobacter pylori (H. pylori for short). Treatment for a stomach ulcer is usuallyaimed at killing H. pylori.
There are simple tests that can tell your doctor if you have H. pylori. Your doctor may doa breath test or ask you for a stool sample. There's a blood test too, but it's not asaccurate.
What are the symptoms?
Stomach ulcers can be painful. Some people say it feels like a burning pain betweentheir breastbone and belly button. The pain is usually worse when your stomach is empty,between meals. It may get better if you eat or if you take antacids (such as Maalox,Mylanta, or Tums).
You may also get heartburn, feel bloated, or have gas. But having heartburn on its owndoesn't usually mean you have a stomach ulcer.
Occasionally, stomach problems can be a sign of a more serious illness. If you haveblack stools or you are vomiting blood, you should call your doctor or go to an emergencyroom as soon as possible. You could have bleeding in your stomach or your bowel.
You should also tell your doctor if you feel that food sticks in your throat when you swallow,if you are losing weight without trying, or if you are feeling tired for no reason.Your doctormay suggest some more tests, just to be safe. People older than 55 may also need moretests. But most people who have these tests turn out not to have anything seriouslywrong.
BMJ Publishing Group Limited 2013. All rights reserved.
Stomach ulcers
What treatments work?
If tests show that you have H. pylori bacteria in your stomach, killing the bacteria canhelp your ulcer. About 7 in 10 people who have treatment for H. pylori get rid of theirulcer. Getting rid of H. pylori also means your ulcer is less likely to come back.
Treatment for getting rid of H. pylori can consist of two, three, or four drugs. Drugs called
proton pump inhibitors and H2 blockers reduce the amount of acid in your stomach.
You'll only need to take one of these. Some examples of proton pump inhibitors are
lansoprazole (brand name Prevacid) and omeprazole (Prilosec). Some H2 blockers are
cimetidine (Tagamet), famotidine (Pepcid), and ranitidine (Zantac).
You'll also be given antibiotics to kill the bacteria. Doctors usually use two antibiotics
together. The most commonly used antibiotics are amoxicillin (Amoxil, Trimox),
clarithromycin (Biaxin), metronidazole (Flagyl), and tetracycline (Sumycin).
Your doctor may also suggest a fourth drug called bismuth (Pepto-Bismol). Bismuth
helps protect the lining of your stomach from acid and bacteria.
There's good research to show that taking three drugs can get rid of H. pylori. They workfor about 7 in 10 people who take them for a week. Having treatment for two weeks worksbetter. It helps 8 in 10 people. But it's not as convenient to keep taking tablets for longer,and the side effects last longer. That's why your doctor might give you the tablets for justone week, or sometimes for even less than a week.
Adding bismuth as a fourth drug may mean your treatment works faster. In one study,taking four drugs for three days helped nearly 9 in 10 people get rid of H. pylori.
You may get side effects from your treatment. The most common side effects are feelingsick to your stomach and getting diarrhea. Bismuth can turn your stools black. But theseproblems should go away when you finish taking your treatment.
If your treatment causes diarrhea that doesn't go away, talk to your doctor.
Even if you get side effects, it's important to keep taking your drugs the way your
doctor asked you to
. You should finish all of the pills you've been given, even if you
start to feel better. This gives you the best chance of getting rid of your ulcer for good.
If you don't take your treatment properly, some bacteria may survive and your ulcer could
come back. Also, the bacteria in your stomach may be stronger than before, making it
less likely that treatment will get rid of them in the future.
What will happen to me?
Getting rid of H. pylori usually cures ulcers. In one study, people had less pain, gas, andheartburn after treatment, and found it easier to get on with their life. If treatment doesn'thelp you, your doctor will probably arrange more tests.
Doctors sometimes suggest things that might reduce your discomfort from an ulcer, suchas avoiding alcohol and spicy food, not eating late in the evening, or giving up smoking.
BMJ Publishing Group Limited 2013. All rights reserved.
Stomach ulcers
This information is aimed at a US patient audience. This information however does not replace medical advice.
If you have a medical problem please see your doctor. for this content.
For more information about this condition and sources of the information contained in this leaflet please visit the BestHealth websiteThese leaflets are reviewed annually.
BMJ Publishing Group Limited 2013. All rights reserved.
Last published: Nov 11, 2013

Source: http://bestpracticedx.bmj.com/best-practice/pdf/patient-summaries/en-us/532980.pdf


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