Diagnosis and treatment





An endoscopy operation involves inserting a retentive, flexible tube ( endoscope ) down your throat and into your esophagus. A bantam television camera on the goal of the endoscope lets your doctor of the church examine your esophagus, digest and the begin of your little intestine ( duodenum ) .
To detect an ulcer, your sophisticate may first take a medical history and perform a physical examination. You then may need to undergo diagnostic tests, such as :

  • Laboratory tests for H. pylori. Your sophisticate may recommend tests to determine whether the bacteria H. pylorus is show in your body. He or she may look for H. pylorus using a blood, toilet or breath test. The hint test is the most accurate.

    For the hint test, you drink or eat something that contains radioactive carbon. H. pylorus breaks down the substance in your stomach. late, you blow into a bag, which is then sealed. If you ‘re infected with H. pylorus, your breath sample will contain the radioactive carbon in the imprint of carbon dioxide .
    If you are taking an antacid prior to the testing for H. pylorus, make indisputable to let your doctor know. Depending on which test is used, you may need to discontinue the medication for a period of time because antacids can lead to false-negative results .

  • Endoscopy. Your doctor of the church may use a telescope to examine your upper digestive system ( endoscopy ). During endoscopy, your doctor passes a empty tube equipped with a lens ( endoscope ) down your throat and into your esophagus, stomach and belittled intestine. Using the endoscope, your doctor of the church looks for ulcers .
    If your doctor detects an ulcer, a small tissue sample ( biopsy ) may be removed for examen in a lab. A biopsy can besides identify whether H. pylorus is in your stomach line .
    Your doctor is more likely to recommend endoscopy if you are older, have signs of bleed, or have experienced late weight personnel casualty or difficulty eat and immerse. If the endoscopy shows an ulcer in your digest, a follow-up endoscopy should be performed after treatment to show that it has healed, tied if your symptoms improve .
  • Upper gastrointestinal series. Sometimes called a barium swallow, this series of X-rays of your upper digestive system creates images of your esophagus, stomach and small intestine. During the X-ray, you swallow a white liquid (containing barium) that coats your digestive tract and makes an ulcer more visible.

Care at Mayo Clinic

Our caring team of Mayo Clinic experts can help you with your peptic ulcer-related health concerns Start here


treatment for peptic ulcers depends on the lawsuit. Usually treatment will involve killing the H. pylorus bacteria if present, eliminating or reducing use of NSAIDs if possible, and helping your ulcer to heal with medicine .
Medications can include :

  • Antibiotic medications to kill H. pylori. If H. pylorus is found in your digestive tract, your doctor of the church may recommend a combination of antibiotics to kill the bacteria. These may include amoxicillin ( Amoxil ), clarithromycin ( Biaxin ), metronidazole ( Flagyl ), tinidazole ( Tindamax ), tetracycline and levofloxacin .
    The antibiotics used will be determined by where you live and current antibiotic resistor rates. You ‘ll likely need to take antibiotics for two weeks, arsenic well as extra medications to reduce stomach acid, including a proton pump inhibitor and possibly bismuth subsalicylate ( Pepto-Bismol ) .
  • Medications that block acid production and promote healing. Proton pump inhibitors — besides called PPIs — reduce stomach acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole ( Prilosec ), lansoprazole ( Prevacid ), rabeprazole ( Aciphex ), esomeprazole ( Nexium ) and pantoprazole ( Protonix ) .
    long-run use of proton pump inhibitors, particularly at high doses, may increase your gamble of hip, wrist and spur fracture. Ask your repair whether a calcium addendum may reduce this hazard .
  • Medications to reduce acid production. Acid blockers — besides called histamine ( H-2 ) blockers — reduce the measure of stomach acerb released into your digestive tract, which relieves ulcer annoyance and encourages healing .
    available by prescription or over the counter, acid blockers include the medications famotidine ( Pepcid AC ), cimetidine ( Tagamet HB ) and nizatidine ( Axid AR ) .
  • Antacids that neutralize stomach acid. Your doctor may include an antacid in your drug regimen. Antacids neutralize existing abdomen acid and can provide rapid pain relief. side effects can include stultification or diarrhea, depending on the main ingredients .
    Antacids can provide symptom relief but generally are n’t used to heal your ulcer .
  • Medications that protect the lining of your stomach and small intestine. In some cases, your sophisticate may prescribe medications called cytoprotective agents that help protect the tissues that credit line your stomach and little intestine .
    Options include the prescription medications sucralfate ( Carafate ) and misoprostol ( Cytotec ) .

Follow-up after initial treatment

treatment for peptic ulcers is much successful, leading to ulcer healing. But if your symptoms are dangerous or if they continue despite discussion, your doctor of the church may recommend endoscopy to rule out early potential causes for your symptoms .
If an ulcer is detected during endoscopy, your doctor may recommend another endoscopy after your treatment to make certain your ulcer has healed. Ask your doctor whether you should undergo follow-up tests after your treatment .

Ulcers that fail to heal

peptic ulcers that do n’t heal with treatment are called fractious ulcers. There are many reasons why an ulcer may fail to heal, including :

  • Not taking medications according to directions
  • The fact that some types of H. pylori are resistant to antibiotics
  • Regular use of tobacco
  • Regular use of pain relievers — such as NSAIDs — that increase the risk of ulcers

Less frequently, fractious ulcers may be a result of :

  • Extreme overproduction of stomach acid, such as occurs in Zollinger-Ellison syndrome
  • An infection other than H. pylori
  • Stomach cancer
  • Other diseases that may cause ulcerlike sores in the stomach and small intestine, such as Crohn’s disease

treatment for fractious ulcers by and large involves eliminating factors that may interfere with healing, along with using different antibiotics .
If you have a dangerous complication from an ulcer, such as acute bleed or a perforation, you may require operation. however, surgery is needed far less much now than previously because of the many effective medications available.

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Lifestyle and home remedies

You may find easing from the trouble of a stomach ulcer if you :

  • Consider switching pain relievers. If you use pain relievers regularly, ask your doctor whether acetaminophen (Tylenol, others) may be an option for you.
  • Control stress. Stress may worsen the signs and symptoms of a peptic ulcer. Consider the sources of your stress and do what you can to address the causes. Some stress is unavoidable, but you can learn to cope with stress with exercise, spending time with friends or writing in a journal.
  • Don’t smoke. Smoking may interfere with the protective lining of the stomach, making your stomach more susceptible to the development of an ulcer. Smoking also increases stomach acid.
  • Limit or avoid alcohol. Excessive use of alcohol can irritate and erode the mucous lining in your stomach and intestines, causing inflammation and bleeding.

Alternative medicine

Products containing bismuth may help with symptoms of a peptic ulcer. There is besides some evidence that zinc can help heal ulcers. mastic powder, the product of a type of evergreen shrub, may besides help improve symptoms and speed bring around of peptic ulcers .
While certain over-the-counter and alternative medications may be helpful, tell on potency is lacking. Therefore they are not recommended as the elementary treatment for peptic ulcers .

Preparing for your appointment

Make an appointment with your regular repair if you have signs or symptoms that worry you. Your doctor may refer you to a specialist in the digestive system ( gastroenterologist ) .
It ‘s a good estimate to be well fix for your appointment. here ‘s some data to help you get fix, and what you can expect from your doctor of the church .

What you can do

  • Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there’s anything you need to do in advance, such as restrict your diet. Certain medications can affect peptic ulcer tests, so your doctor may want you to stop taking them. He or she may be able to suggest alternatives to these drugs.
  • Write down any symptoms you’re experiencing, as well as the food you’re eating. People with peptic ulcers often experience more symptoms when their stomachs are empty.
  • Write down key personal information, including any other medical problems, major stresses or recent life changes.
  • Make a list of all medications, including over-the-counter medications, vitamins or supplements that you’re taking. It’s especially important to note any pain reliever use and the usual dose that you take.
  • Write down questions to ask your doctor.

For peptic ulcers, some questions you might want to ask your doctor of the church include :

  • What’s the most likely cause of my symptoms?
  • What kinds of tests do I need, and how do I need to prepare for them?
  • Is my condition likely temporary or chronic?
  • Am I at risk of complications related to this condition?
  • What treatment do you recommend?
  • If the initial treatment doesn’t work, what will you recommend next?
  • Are there any dietary restrictions that I need to follow?
  • I have other medical problems. How can I manage these along with ulcers?

In accession to the questions that you ‘ve prepared to ask your doctor, do n’t hesitate to ask early questions during your date .

What to expect from your doctor

Your sophisticate is likely to ask you a count of questions. Being fix to answer them may reserve time to go over points you want to cover. Your repair may ask :

  • When did you first begin experiencing symptoms?
  • Have your symptoms been continuous or intermittent?
  • How severe are your symptoms?
  • Are your symptoms worse when you’re hungry?
  • What, if anything, have you been taking to relieve your symptoms?
  • Does anything seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Do you take pain relievers or aspirin? If yes, how often?
  • Do you feel nauseated or have you been vomiting?
  • Have you ever vomited blood or black material?
  • Have you noticed blood in your stool or black stools?

What you can do in the meantime

While you ‘re waiting to see your doctor, avoiding tobacco, alcohol, hot foods and try may help lessen your discomfort .

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