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Peptic ulcer disease - discharge

You have peptic ulcer disease (PUD). A peptic ulcer is a defect in the lining of the stomach or the first part of the small intestine. If the peptic ulcer is located in the stomach. it is called a gastric ulcer. If the ulcer is in the duodenum, it is called a duodenal ulcer.

You may have had tests to help your doctor diagnose your ulcer. You likely have had a test to see whether or not your stomach is infected by bacteria called Helicobacter pylori (H.pylori) -- a common cause of ulcers.

Most peptic ulcers will heal within about 4 - 6 weeks after treatment begins. Even if your symptoms go away quickly, DO NOT STOP taking medications your doctor prescribed for you.

Diet and Lifestyle

Overall, the best diet for people with peptic ulcer disease is one that is healthy and balanced.

  • Eating more often and eating diets with extra milk or dairy are NOT helpful and may even cause more stomach acid.
  • Avoid foods that cause problems or discomfort for you. Most often, this list may include alcohol, coffee, caffeinated soda, fatty foods, chocolate, and spicy foods.
  • Avoid late night snacks.

Other lifestyle tips that may help your ulcer healed and your symptoms better are:

  • If you smoke or chew tobacco, try to quit. Tobacco will slow the healing of your ulcer and make it more likely that the ulcer will come back. Your doctor can help.
  • Reduce your stress and watch for stressful, tense times. Stress can bother your reflux problem.

Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen (Tylenol) to relieve pain. Take any of your medicines with plenty of water.

Drug Treatment

If you have a peptic ulcer and an H. pylori infection, the standard treatment uses different combinations of medications, taken for 5 - 14 days.

  • Most often you will take two different antibiotics and a proton pump inhibitor (PPI).
  • These medicines may cause nausea, diarrhea, and other side effects. Do not just stop taking them without talking to your doctor first.

If you have an ulcer without an H. pylori infection, or one that is caused by taking aspirin or NSAIDs, your doctor will likely prescribe a proton pump inhibitor for 8 weeks.

Taking antacids as needed between meals, and then at bedtime, may help healing also. Ask your doctor.

If your ulcer was caused by aspirin, ibuprofen, or other NSAIDs, your doctor may have you take a drug called misoprostol to prevent future ulcers.

Follow-up

You will have follow-up visits with your doctor to see whether your ulcer is healing.

At times, your doctor may perform an upper endoscopy after treatment to make sure healing has taken place.

Follow-up testing to check that the H. pylori bacteria are no longer present should be done, but no sooner than 2 weeks after therapy is completed. Test results before that time may not be accurate.

When to Call the Doctor

Seek urgent help if you:

  • Develop sudden, sharp abdominal pain
  • Have a rigid, hard abdomen that is tender to touch
  • Have symptoms of shock, such as fainting, excessive sweating, or confusion
  • Vomit blood or have blood in your stool (especially if it's maroon, dark, or tarry black)

Call your doctor if:

  • You feel dizzy or light-headed
  • You have ulcer symptoms
  • A full feeling after eating a small meal portion
    • Weight loss that cannot be explained
    • Vomiting
    • Loss of appetite

Alternate Names

Ulcer - peptic - discharge; Ulcer - duodenal - discharge; Ulcer - gastric - discharge; Duodenal ulcer - discharge; Gastric ulcer - discharge; Dyspepsia - ulcer - discharge

References

Lanza FL, Chan FK, Quigley EM: Practice Parameters Committee of the American College of Gastroenterology. Guidelines for prevention of NSAID-related ulcer complications. Am J Gastroenterol. 2009;104:728-738.

Vakil, Nimish . Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 52.

Chan FKL, Lau JYW. Peptic ulcer disease. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 53.

Update Date: 8/11/2011

Updated by: George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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