Treatment of Stomach Ulcers

Your treatment of stomach ulcer will depend on the cause of it's occurance. With treatment, most ulcers heal in a month or two. In rare cases, surgery may be required.

Updated: June 16, 2022

Your treatment of stomach ulcer will depend on the cause of its occurrence. With treatment, most ulcers heal in a month or two. In rare cases, surgery may be required.

Nonsurgical Treatment:

If your stomach ulcer is caused by a Helicobacter pylori (H. pylori) bacterial infection or by a combination of an H. pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs), you need a course of antibiotics and a proton pump inhibitor (PPI) . PPIs block the stomach cells that produce acid. If your stomach ulcer is just caused by taking NSAIDs, a course of PPI medication is recommended.
The following things are also recommended in addition to these treatments:

  • Stopping the use of all NSAIDs.
  • Gastroscopy follows up after four to six weeks to check that the ulcer has healed.
  • Use of H2 receptor blockers that also block acid production.
  • Adding probiotics which are helpful in killing off H. pylori.
  • Bismuth supplement.


Antibiotics:

A course of two or three antibiotics is recommended if your ulcer is caused by H. pylori infection. The most commonly used antibiotics are amoxicillin, clarithromycin, and metronidazole. Each of these needs to be taken twice a day for a week. You will be reviewed at least four weeks after finishing your antibiotic course to check if there are any H. pylori bacteria left in your stomach. If so, a further course of different antibiotics may be prescribed.


Proton Pump Inhibitors (PPIs):

PPIs reduce the amount of acid your stomach produces. Thus preventing further damage to the ulcer.  The most commonly used PPIs to treat stomach ulcers are omeprazole, pantoprazole, and lansoprazole. All these are prescribed for four to eight weeks.


H2 Receptor Blockers:

It blocks acid production in your stomach. The most widely used H2 receptor blocker for treating stomach ulcers is ranitidine.


Antacids and Alginates:

Additional antacid medication is prescribed to neutralize your stomach acid and provide immediate symptom relief. As all of the above treatments can take several hours to start working you can get short term relief from these antacids. Some antacids also contain alginate, which produces a protective coating on the lining of your stomach. These medications are easily available to buy at all pharmaceutical stores. When you experience symptoms or when you expect them, you can always have an antacid.


Reviewing NSAID use:

Risks associated with continued NSAID use is to develop another stomach ulcer and could experience a serious complication such as internal bleeding. If your stomach ulcer is caused by taking NSAIDs, alternative medications are advised to take. An alternative painkiller such as paracetamol or an alternative type of NSAID called a COX-2 inhibitor may be recommended. These are less likely to cause stomach ulcers.

Medications used to treat stomach ulcers can have some side effects such as:

  • Abdominal pain
  • Headaches
  • Diarrhea
  • Nausea
  • Dizziness
  • A metallic taste in your mouth
  • Feeling sick 

If these symptoms cause severe discomfort, change your medication after talking to your doctor.

Surgical Treatment:

Stomach ulcer will require surgery in very rare cases such as:

  • If it does not heal.
  • If it continues to return
  • In case of bleeding or tear through the stomach.
  • Keep food from flowing out of the stomach into the small intestine.

Surgery may require:

  • taking tissue from another part of the intestines and patching it over the ulcer site.
  • cutting off the nerve supply to the stomach to reduce the production of stomach acid.
  • tying off a bleeding artery
  • removal of the entire ulcer


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