What Antibiotics Are Used For Stomach Ulcers

A Natural Way To Treat Ulcers Without Antibiotics

Andrew Rubman, ND

Andrew Rubman, ND, FABNE, is medical director of Southbury Clinic for Traditional Medicines in Southbury, Connecticut. Dr. Rubman views himself as a teacher as well as a physician, helping his patients make better informed choices about their health care and become better consumers of both traditional and conventional medical options. His 35-year career started with Robert Atkins, MD, in New York City.

As a primary care provider, Dr. Rubman helps people of all ages, from infants to those in their 90s, resist illness by improving wellness and has specialty interests in gastroenterology and endocrinology. He also has a sub-specialty of diagnosing and treating peri-menopausal women, and contributed to the North American Menopause Society nutritional protocol used as a component of the curriculum of all medical schools in the US.

Dr. Rubman is a founding member of the American Association of Naturopathic Physicians , a member of the specialty society, The Endocrinology Association of Naturopathic Physicians , as well as a member of the Bottom Line Personal Panel of Experts. He is author of the Bottom Line blog, Nature Docs Patient Diary. He offers office visits and distance consultations and actively treats and consults with patients worldwide. SouthburyClinic.com

Mark Liponis, MD, chief medical officer, Canyon Ranch, Lenox, Massachusetts. CanyonRanchDestinations.com

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Symptoms Of Stomach Ulcers

Although the most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of the abdomen . Not all stomach ulcers are painful.

Some people experience:

Speak to your GP immediately if:

• your symptoms persist
• you’re vomiting blood the blood can appear bright red or have a dark brown, grainy appearance like coffee grounds
• you’re passing dark, sticky, tar-like stools
• you feel a sudden, sharp pain in your tummy that gets steadily worse

These could be a sign of a serious complication.

Treatment For A Stomach Ulcer

Special diets are now known to have very little impact on the prevention or treatment of stomach ulcers. Treatment options can include:

• medication including antibiotics, to destroy the H. pylori colony, and drugs to help speed the healing process. Different drugs need to be used in combination some of the side effects can include diarrhoea and rashes. Resistance to some of these antibiotics is becoming more common
• subsequent breath tests used to make sure the H. pylori infection has been treated successfully
• changes to existing medication the doses of arthritis medication, aspirin or other anti-inflammatory medication can be altered slightly to reduce their contributing effects on the stomach ulcer.
• reducing acid tablets are available to reduce the acid content in the gastric juices
• lifestyle modifications including quitting cigarettes, since smoking reduces the natural defences in the stomach and impairs the healing process.

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Lifestyle And Home Remedies

Adopt a healthy diet

Dietary polyphenols are shown to aid in the treatment of stomach ulcer . Its found abundantly in natural plant food sources that are rich in antioxidant properties. Examples of dietary phenols include fruits, vegetables, tea, chocolates, and extra virgin olive oil. These foods may also inhibit acid secretion and contain anti-inflammatory properties.

Cabbage juice is highly rich in vitamin C, which may help prevent and treat H. pylori infections. Doctors reportedly used cabbage juice to treat stomach ulcers decades before antibiotics were available.

Probiotics can help to reduce an H. pylori infection and achieve optimal gut health. It can also help enhance the efficacy of treatment and reduce the side effects of antibiotics. Foods that are rich in probiotics include yogurt, fermented food, miso, and sauerkraut. Alternatively, you may also want to consider probiotics supplements.

Foods to Avoid

Certain foods and drinks may increase the likelihood of developing stomach ulcers, exacerbate symptoms, and impede healing. This include:

Spicy and fatty foods take longer to digest, which can lead to abdominal pain and bloating bad news if you have an ulcer.

Caffeine and alcohol may exacerbate symptoms if consumed in excess. They can erode and irritate the mucous lining in your stomach, causing inflammation and bleeding.

Dont Smoke

Control Stress

Stress may worsen the symptoms of a stomach ulcer. Consider the sources of your stress and address it accordingly.

How Peptic Ulcers Are Treated

• Living With Peptic Ulcers

A peptic ulcer is a sore or lesion that forms in the lining of the stomach or duodenum, the first part of the small intestine. Peptic ulcers are caused by Helicobacter pylori , a bacterium that lives in the mucous lining of the stomach and intestine. Symptoms of these ulcers include pain, discomfort, heartburn, nausea, or gas, though some people may not experience any symptoms at all.

Treatment of peptic ulcers include antibiotics to clear H. pylori, prescription and over-the-counter medicines to manage symptoms, and lifestyle modifications to help ulcers heal.

A peptic ulcer is one of the most common gastrointestinal tract issues seen by healthcare providers an estimated 5% to 10% of all people will experience one in their lifetime.

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What Happens After Treatment

A repeat gastroscopy is usually advised a few weeks after treatment has finished. This is mainly to check that the ulcer has healed. It is also to be doubly certain that the ‘ulcer’ was not due to stomach cancer. If your ulcer was caused by H. pylori then a test is advised to check that the H. pylori infection has gone. This is done at least four weeks after the course of combination therapy has finished.

Peptic Ulcer Disease Treatment: Medication

Several different medication therapies are available to help reduce gastric acid and coat the ulcers:

• Antacids neutralize gastric acid. The disadvantage is that you need to take a relatively large dose for them to be effective, and they can cause unwanted side effects like diarrhea.
• Histamine blockers reduce gastric acid by blocking the H2 receptors. These medications decrease acid secretion and are a relatively safe treatment option.
• Proton pump inhibitors are drugs that block the three major pathways for acid production. PPIs suppress acid production much more effectively than H2 blockers. PPIs are the gold standard in medication therapy of peptic ulcer disease.
• Medications to protect and strengthen the mucous lining of the stomach
• Antibiotics to treat H. pylori if it is detected

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When Should I See A Doctor If I Think I Have A Peptic Ulcer

• If you have burning pain in your upper stomach that is relieved by eating or taking antacids, call a health-care professional 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.

When Scientists Experiment On Themselves: H Pylori And Ulcers

In the summer of 1984, the Australian scientist Neil Noakes took some bacteria from a petri dish, mixed them with lukewarm beef extract – the normal nutrient solution for bacteria in the lab – and filled a little more than one cup into a beaker.

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In the summer of 1984, the Australian scientist Neil Noakes took some bacteria from a petri dish, mixed them with lukewarm beef extract the normal nutrient solution for bacteria in the lab and filled a little more than one cup into a beaker. Then he handed this mix to his colleague, the gastroenterologist Barry Marshall, who downed it without complaining.

Three days later, Marshall felt nauseated and his mother told him he had bad breath. Next he started vomiting. But he still waited a few days before taking the antibiotics that were supposed to kill the bacteria in his stomach. A gastroscopy not only clarified his diagnosis, but ultimately resulted in his winning the Nobel Prize in Physiology and Medicine about twenty years later.

With his famous self-experiment, Marshall was able to demonstrate that Helicobacter pylori bacteria can cause acute gastritis which in turn may cause ulcers. He had asked neither an ethics commission nor his wife for permission to conduct this experiment. His colleagues thought him completely insane to take a risk like that.

Originally published in German with the title “Von Menschen und Mikroben Barry Marshall” in the Lindau Nobel Laureates Meeting blog. Translation: Susanne Dambeck

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Other Causes And Factors

Other causes are rare. For example, some viral infections can cause a stomach ulcer. Crohn’s disease may cause a stomach ulcer in addition to other problems of the gut.

Stomach cancer may at first look similar to an ulcer. Stomach cancer is uncommon but may need to be ‘ruled out’ if you are found to have a stomach ulcer.

Diagnosis And Treatment Of Peptic Ulcer Disease And H Pylori Infection

Am Fam Physician. 2015 Feb 15 91:236-242.

Patient information: See related handout on H. pylori and stomach ulcers, written by the authors of this article.

• References

Dyspepsia is characterized by epigastric pain, discomfort, or a burning sensation.1 An important cause of dyspepsia is peptic ulcer disease , which includes gastric and duodenal ulcers. Although PUD is most commonly caused by Helicobacter pylori infection or use of nonsteroidal anti-inflammatory drugs , other diagnoses should be considered .

SORT: KEY RECOMMENDATIONS FOR PRACTICE

Use the test-and-treat strategy for patients with dyspepsia who are younger than 55 years and have no alarm symptoms for gastric cancer. Use endoscopy for all other patients.

SORT: KEY RECOMMENDATIONS FOR PRACTICE

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What Are The Symptoms Of Peptic Ulcers

Each persons symptoms may vary. In some cases ulcers dont cause any symptoms.

The most common ulcer symptom is a dull or burning pain in your belly between your breastbone and your belly button . This pain often occurs around meal times and may wake you up at night. It can last from a few minutes to a few hours.

Less common ulcer symptoms may include:

• Feeling full after eating a small amount of food
• Burping
• Bloody or black stool
• Vomiting blood

Peptic ulcer symptoms may look like other health problems. Always see your healthcare provider to be sure.

Is There A Peptic Ulcer Diet Plan

No particular diet is helpful for people with peptic ulcers. At one time, a bland diet and avoidance of spicy or greasy foods was recommended. Milk and dairy food have been used in the past for ulcer symptoms, but have not been proven to be effective. We now know diet has little effect on ulcers. In some people, however, certain foods seem to aggravate stomach ulcer symptoms. Keep a food diary with your intake and the resulting symptoms and avoid eating any foods that aggravate symptoms.

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Can A Peptic Ulcer Come Back

Yes, a peptic ulcer can come back. If you smoke or take NSAIDs, peptic ulcers are more likely to come back. If you need to take an NSAID, your doctor may switch you to a different medicine or add medicines to help prevent a peptic ulcer. Peptic ulcer disease can return, even if you have been careful to reduce your risk.

If Your Ulcer Was Caused By An Anti

If possible, you should stop taking the anti-inflammatory medicine. This allows the ulcer to heal. You will also normally be prescribed an acid-suppressing medicine for several weeks. This stops the stomach from making acid and allows the ulcer to heal. However, in many cases, the anti-inflammatory medicine is needed to ease symptoms of arthritis or other painful conditions, or aspirin is needed to protect against blood clots. In these situations, one option is to take an acid-suppressing medicine each day indefinitely. This reduces the amount of acid made by the stomach and greatly reduces the chance of an ulcer forming again.

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What Questions Should I Ask My Doctor

If you have stomach ulcers, you may want to ask your doctor:

• What pain reliever can I use instead of an NSAID?
• How will I know if the H. pylori infection is gone?
• How do we find out if the ulcer has healed?
• What can I do relieve symptoms at home during treatment?

A note from Cleveland Clinic

Contrary to commonly held beliefs, ulcers arent caused by stress or foods you eat. Most of time, bacteria causes them. Doctors can treat the bacteria with antibiotics and other medications.

If youve been popping a lot of antacids lately, youre constantly snacking to get rid of a gnawing pain in your stomach or you have any other signs of an ulcer, the best thing you can do for your health is talk to your provider. Treatment can heal an ulcer in a matter of weeks.

How Can I Prevent Ulcers

You may be able to prevent ulcers from forming if you:

• Talk to your doctor about alternatives to NSAID medications to relieve pain.
• Discuss protective measures with your doctor, if you cant stop taking an NSAID.
• Opt for the lowest effective dose of NSAID and take it with a meal.
• Quit smoking.
• Drink alcohol in moderation, if at all.

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How Do Doctors Treat An Nsaid

If NSAIDs are causing your peptic ulcer and you dont have an H. pylori infection, your doctor may tell you to

• stop taking the NSAID
• reduce how much of the NSAID you take
• switch to another medicine that wont cause a peptic ulcer

Your doctor may also prescribe medicines to reduce stomach acid and coat and protect your peptic ulcer. Proton pump inhibitors , histamine receptor blockers, and protectants can help relieve pain and help your ulcer heal.

Tips For Living With Ulcers

• If you have an ulcer, be careful when choosing over-the-counter pain relievers. Aspirin and other nonsteroidal anti-inflammatory drugs like ibuprofen can irritate an ulcer and prevent a bleeding ulcer from healing. Avoid powdered headache medication, too. It usually contains powdered aspirin. Your best choice may be acetaminophen, which doesnât cause or worsen stomach ulcers.
• Don’t overdose on iron supplements. You may need them if you have bleeding ulcers, but taking too much can irritate your stomach lining and the ulcer. Ask the doctor how much iron you need.
• Learn how to manage stress. Relaxation techniques like deep breathing, guided imagery, and moderate exercise can help ease stress and promote healing.
• Avoid foods that irritate your stomach. Use common sense: If it upsets your stomach when you eat it, avoid it. Everyone is different, but spicy foods, citrus fruits, and fatty foods are common irritants.
• Stop smoking. Heavy smokers are more likely to get duodenal ulcers than nonsmokers.
• Practice moderation. Drinking lots of alcohol has been shown to contribute to ulcers, so keep your intake to a minimum.

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What Tests Diagnose A Peptic Ulcer

To confirm a person has an ulcer a diagnostic imaging test will usually be ordered. The two most widely used tests are:

• Upper GI series : This is a type of X-ray. The patient is given a chalky liquid to drink that increases the contrast on the X-ray, making certain features easier to see. Because this liquid contains barium, this test is sometimes called a barium swallow.
• Endoscopy : An endoscope is a thin, flexible tube with a tiny camera at the end. The patient is given a mild sedative, and then the tube is passed through the mouth into the stomach. The doctor can see the lining of the stomach to diagnose a peptic ulcer. Tiny samples of the tissue will be taken , which are examined under a microscope.

If a diagnostic imaging test reveals an ulcer, the patient will most likely have a test to see if H pylori bacteria are present.

• It is important to be certain about this, because treatment of the H pylori is likely to heal the ulcer.
• Ulcers caused by H pylori are treated differently than ulcers caused by medications.

Three types of tests are available to detect H pylori.

What Is An Ulcer

Ulcers are open sores on the inner lining of the lower esophagus, stomach, or the upper portion of the small intestine. They are often painful, particularly after eating, and can bleed into the stomach or intestines.

Ulcers are identified by the location of the sore:

• Esophageal ulcers occur on the lower part of the esophagus, the muscular tube that connects the throat to the stomach.
• Gastric ulcers form in the stomach lining.
• Duodenal ulcers form in the lining of the small intestine near the stomach called the duodenum.

Esophageal, gastric, and duodenal ulcers are collectively called peptic ulcers or peptic ulcer disease . They are closely related both in causes and treatments. Compared to gastric and duodenal ulcers, esophageal ulcers may arise from different causes and require different treatments in some cases.

Peptic ulcers are due to an erosion of the defenses the stomach or intestinal tissues use to protect themselves against harmful stomach acid. When these defenses are compromised, the acid can eat away at the lining of the stomach or duodenum, causing sores.

Lifestyle factors, such as eating spicy foods or stress, are no longer considered risk factors for developing peptic or esophageal ulcers, but they may worsen ulcer symptoms.

Peptic ulcer disease is very common. Anywhere from 5% to 10% of the population will develop a peptic ulcer at some time during their lives. About 2% to 7% will experience an esophageal ulcer in their lifetime, mostly due to GERD.

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