Stomach Ulcers: What They Are, How to Avoid
Them, and Strategies to Fight Them

Part 2: Diagnosis and Treatment

Because medical treatment of the different ulcers varies, a proper diagnosis is important. This may include an upper GI (gastrointestinal) series. In this test, the patient swallows barium, a chalky liquid, making the ulcer visible on the x-ray of the esophagus, stomach, and duodenum.

Another type of test is an endoscopy, where a small flexible instrument is inserted through the mouth and into the esophagus, stomach, and duodenum. The tiny camera on the end provides a clear view of the entire upper GI tract. A small sample of the stomach lining might be taken to be tested for the Helicobacter pylori bacterium, and a biopsy performed to check for cancer.

Blood, breath, and stomach tissue tests can also be used to detect the presence of Helicobacter pylori. Not all these type tests are approved by the United States Food and Drug Administration (FDA), because they can sometimes give a false positive or a false negative result. Even so, research shows that these tests can detect the bacterium responsible for ulcers.

Treatment for gastric and duodenal ulcers is dependant upon several factors: Overall health, medical history, age, seriousness of condition, medicinal and therapy tolerance, and preferences of the patient.

Changes in lifestyle — including eating habits and alcohol intake — may be recommended. Because smoking has been proven to delay or inhibit effective treatment, people with ulcers should not smoke.

Medication with H2-blockers to reduce the amount of acid in the stomach may be prescribed. To more completely block stomach acid production, medication with acid pump inhibitors that temporarily stop the stomach’s acid pump might be prescribed, instead.

Long-term use of ulcer-fighting medications that block the secretion of acid can also interfere with absorption of nutrients essential to good health. Therefore, doctors warn patients to take these drugs no longer than absolutely necessary.

Medication with mucosal protective agents might work best for some people. Not in reducing the amount of acid in the stomach, but in protecting the mucous lining of the stomach from acid that is present.

As mentioned earlier, antibiotics are effective when the presence of the bacterium Helicobacter pylori has been detected.

Patients who develop complications, have ulcers at a more serious stage of development, or patients that do not respond well to medication may require surgery. Various types of laparoscopic surgery may be used effectively. A laparoscope is very similar to an endoscope. It is a long, thin instrument with a camera located at one end, allowing the surgeon to operate through small incisions.

When a vagotomy procedure is done, parts of a nerve that transmits messages from the brain to the stomach are severed. This helps to interrupt messages to secrete more acid, thereby reducing the amount of acid in the stomach.

In addition to a vagotomy, a pyloroplasty procedure might also be performed. In this procedure, the opening into the duodenum is enlarged to help food from the stomach to pass more easily into the small intestine.

When an antrectomy is performed, the lower part of the stomach that produces a hormone to stimulate the production of digestive juices is removed. This is sometimes done at the same time as the vagotomy.

Despite recent medical advancements, risk of acquiring an ulcer remains high. This is especially true of duodenal ulcers in persons between the ages of 30 and 50, and stomach ulcers in persons over the age of 60. It is wise, therefore, to take preventative measures.

Smoking reduces the effectiveness of medications, and inhibits effective ulcer therapy. According to an article in the Johns Hopkins Medical Letter, “Smoking doubles your chances of getting an ulcer.”

Recent research also supports the assertion that smoking is a notable factor in causing ulcer recurrence. People who stopped smoking had a lower rate of recurrent ulcers — regardless of what medications were used.

Besides not smoking, stop taking non-steroidal anti-inflammatory drugs (NSAIDs). All can cause injury to the stomach’s protective mucous lining, increasing the risk of ulcers. Persons with arthritis and other inflammation problems who must take a NSAID should ask their doctor about “Misoprostol.” This synthetic prostaglandin has been shown effective in reducing the risk of gastric ulcers in people who take NSAIDs.

Although milk was once thought to be beneficial for ulcers by coating the lining of the stomach, recent research shows that the calcium and protein in milk stimulates the production of stomach acid. Persons with sensitive stomachs should avoid milk.

Despite numerous studies and the acknowledged health benefits, no correlation between high fiber intake and lower risk of ulcers has been proven. However, one British study did show a strong connection between refined sugar intake and ulcers. Sugar stimulates intestinal bacteria. It is advisable, therefore, to increase vegetable intake, while reducing or eliminating refined sugar.

While stress is no longer considered the culprit in the development of ulcers, a study published in the Archives of Internal Medicine yielded interesting results. 4,511 people were studied over an eight year period. The study concluded that persons who perceived themselves as stressed were nearly twice as likely to suffer ulcers as persons who described themselves as “stress free.”

Regardless of whether or not it has any real bearing on the development or behavior of ulcers, reducing stress can’t hurt. Combined with proper exercise, a healthy lifestyle, adequate sleep, balanced nutrition, prayer, quiet reflection, and a positive attitude, chances of obtaining an improved, ulcer-free life are greatly enhanced.

©2006 Remedium