The level of acid inside the stomach increases because some factors interfere in its production. For example, following a treatment with NSAIDs for a long time could increase the level of produced acid inside your stomach. To prevent ulcer from occurring your current doctor will prescribe some antacids, inhibitors of the proton pump (Omeprazole, Lansoprazole, and Pantoprazole), and H2-Receptor antagonists (Famotidine, Cimetidine, Nizatidine, and Ranitidine).
There is also a bacterium responsible for peptic ulcer: Helicobacter Pylori. For killing the bacterium, the doctor will prescribe antibiotic drugs. The most efficient antibiotic drugs are: Metronidazole, Tetracycline, Clarithromycin and Amoxicillin. This treatment must be followed for at least two weeks. Bismuth salicylate is also useful for killing the bacterium and is available over the counter. It also protects the stomach from the damage produced by the acid.
Also, a lifestyle change must be done. Smoking and drinking alcohol and coffee must be eliminated or at least reduced. Stress is also a factor that contributes to the extent of ulcer, so you should avoid getting stressed.
Try to avoid the following aliments because they only injure your stomach line: pepper, chilly, peppermint, citrus fruits, cocoa, chocolate, cola, and fried fatty foods. This list can be adjusted according to your tolerances but the doctors should be consulted about it too. Cranberries, apples, onions kill the H. Pylori; fruits and vegetable that are rich in fiber are also good for you. If you have an alcohol problem your doctor can advise you on receiving appropriate care.
Pay attention to the foods that cause you pain and burnings and try not to eat them any more.
For protecting the line of your stomach and duodenum, you will receive antacids like TUMS and ROLAIDS that will preserve the lining from the acid's action.
Also if ulcer lesions are present, Sucralfate is helpful because it covers them up and helps them heal faster.
The most indicated drugs in ulcer are the proton pumps because they decrease gastric acid production. They are: esomeprazole, lansoprazole, omeprazole, pantoprazole, and rabeprazole.
There are some rare cases when treatment is not effective and other measures must be applied. Surgery is a solution for treating peptic ulcers but only the doctor will be able to pronounce whether you need a surgery or not.
Some of the peptic ulcers may heal without treatment, spontaneously. But if they complicate the whole situation is severe, there may appear ulcer bleeding, ulcer perforation, and gastric obstruction. Ulcer bleeding manifests as: melena or black stools, weakness, orthostatic syncope, hematemesis meaning blood vomiting. Treatment may be the rapid replacement of the lost fluids on venous line, even blood transfusion in more severe cases. To establish the exact portion of the affected mucous and the bleeding spot upper endoscopy is performed and the bleeding may be stopped with the aid of heated instruments.
If the ulcer is perforated the gastric contents are leaked in the peritoneal cavity and results in acute peritonitis. Those cases are very severe and surgery is required immediately, because the abdomen muscles become rigid and any motion determines extreme abdominal pain.
If gastric obstruction occurs near the pyloric canal which joins the stomach to the duodenum the patient reports increasing abdominal pain, diminished appetite, vomiting of undigested or partially digested food and weight loss. Upper endoscopy is recommended to exclude the gastric cancer as a cause of obstruction. If the gastric contents are evacuated from the stomach and cimetidine and ranitidine are administered intravenously the gastric obstruction is resolved. Patients with persistent obstruction require surgery.
Treatments
First of all prevention is very important reducing cigarettes and non-inflammatory steroids drugs, to relieve pain there are administrated antiacids such as: Maalox, Mylanta, and Amphojel, but watch out ulcers frequently return when you cease taking the antiacids medication. Histamine antagonists are cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid) are effective in the healing of ulcers because that reduce the acid output but ulcers return when this medication is stopped. Patients may experience during the treatment: hallucinations, headache, confusion, lethargy. Cimetidine and ranitidine should't be taken in combination with alcohol, anyway those doses must be adjusted and monitored.
Asomeprazole (Prilosec), lansoprazole (Prevacid), pantoprazole (Protonix), esomeprazole (Nexium), and rabeprazole (Aciphex) are proton-pump inhibitors are used in the treatment of gastric and duodenal ulcers and esophageal ulcers. They have no side effects even after long time using them and do not affect the digestion and absorption. Sucralfate and misoprostol promotes healing and protects the lining against acid attacks, Cytotec protects the lining from the effect of non-inflammatory steroids drugs. One of the adverse reactions of Cytotec is miscarriage. More studies suggest the use of combined antibiotics, tetracycline, amoxicillin, metronidazole (Flagyl), clarithromycin (Biaxin), and levofloxacin to eradicate H. Pylori. By elminating H. Pylori bacteria you will decrease the risk of gastric cancer in the future and the return of ulcer. There are no suficient proves that intake of coffee and alcohol determines peptic ulcers, dietary restrictions and bland diets may not have the expected result.
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