Treating and Diagnosing Peptic Ulcers

Twenty-five million Americans will be affected with peptic ulcers at some point! Here, we'll look at how a diagnosis is made and the treatment that follows. A peptic ulcer is an open sore located in the stomach or upper portion of the small intestine. Peptic ulcers usually manifest as burning pain in the abdomen. Peptic ulcer pain may be temporarily abated by eating if the ulcer is located in the small intestine, also called the duodenum, or by taking antacids, if the ulcer is located in the stomach. If your doctor suspects that you have a peptic ulcer, he or she will generally perform one of two imaging tests - an upper gastrointestinal X-ray, or an endoscopy. An endoscopy is performed under anesthesia. During this procedure, a doctor will insert a long, thin tube with a camera attached down the throat and into the stomach. Both an endoscopy and an X-ray will allow an ulcer to be detected pictorially.If an ulcer IS present, and a doctor has performed an endoscopy, he or she will often take a biopsy, or tissue sample, of the area. The biopsy can rule out stomach cancer, and can also identify the presence of a bacterium called helicobacter pylori, or H. pylori. Most peptic ulcers are actually caused by this bacterium, which is also detectable via a blood, stool, or breath test. It's important to identify H. pylori in patients with ulcers, because not EVERY ulcer is caused by the bacteria. Sometimes, ulcers stem from repeated use of pain medications in the non-steroidal anti-inflammatory family. These NSAIDs include aspirin and ibuprofen. If H. pylori is NOT present in a diagnostic test, then a doctor will often recommend cessation of NSAID medication. If a person IS, however, infected with H. pylori, treatment will focus on two goals-killing the bacteria and reducing acid in the stomach, thereby relieving pain and encouraging healing. Since healing focuses on two different goals, treatment is complex and requires the use of multiple medications. The most effective treatment is known as triple-therapy. This involves taking a fourteen day course of two antibiotics to kill the H. pylori plus an acid suppressor, or stomach-lining shield, to reduce acid levels in the stomach. The most common antibiotics used to kill H. pylori are the prescription drugs clarithromycin and amoxicillin. As we have seen, it is not necessary to live with a painful peptic ulcer,  as treatment is entirely possible. Please speak with your doctor if you have concerns about this condition.