In the area of diet, doctors in the past had advised people with ulcers to avoid spicy, fatty and acidic foods. However, it has been shown that a bland diet is ineffective for treating or avoiding ulcers. This doesn't mean a bland diet is bad for ulcer sufferers. In fact, it may make them feel better. Some people find certain foods cause irritation and should discuss this problem with their doctor. Smoking is a different issue. It has been shown to delay ulcer healing and has been linked to ulcer recurrence. Therefore, persons with ulcers should not smoke.
Medications
Doctors treat stomach and duodenal ulcers with several types of medicals, including H2-blockers, acid pump inhibitors, and mucosal protective agents. When treating H. pylori, these medications are used in combination with antibiotics.
H2-blockers
These are acid-suppressing drugs that most doctors treat ulcers with. They reduce the amount of acid the stomach produces by blocking histamine, a powerful stimulant of acid secretion. They reduce pain significantly after several weeks. For the first few days of treatment, doctors often recommend also taking an antacid to relieve pain. The treatment initially lasts 6-8 weeks. Most ulcers caused by H. pylori do not recur following successful eradication. However, for some patients, their ulcers return, and they must continue maintenance therapy for years. H2-blockers are used to treat both stomach and duodenal ulcers. These are:
- Cimetidine (Tagamet®)
- Ranitidine (Zantac®)
- Famotidine (Pepcid®)
Acid pump inhibitors
Acid pump inhibitors change the stomach's production of acid by more completely blocking it by stopping the stomach's acid pump--the final step of acid secretion. Omeprazole has been used for short-term treatment of ulcer disease. Similar drugs, including lansoprazole, are currently being studied.
Mucosal protective medications
Mucosal protective medications protect the stomach's mucous lining from acid. These protective agents do not inhibit the release of stomach acid, but shield the stomach's mucous lining from the damage of the acid.
- Two commonly prescribed protective agents are:
- Sucralfate (Carafate®). This medication adheres to the ulcer, producing a protective barrier that allows the ulcer to heal and inhibits further damage by stomach acid. Sucralfate is approved for short-term treatment of duodenal ulcers and for maintenance treatment.
- Misoprostol (Cytotec®). This synthetic prostaglandin, a substance naturally produced by the body, protects the stomach lining by increasing mucus and bicarbonate production and by enhancing blood flow to the stomach. It is approved only for the prevention of NSAID-induced ulcers.
- Antacids. Antacids can offer temporary relief from ulcer pain by neutralizing stomach acid. They may also have a mucosal protective role. Many brands of antacids are available without prescription.
- Bismuth Subsalicylate. Bismuth subsalicylate has both a protective effect and an antibacterial effect against H. pylori.
Antibiotics
The discovery of the link between ulcers and H. pylori has resulted in a new treatment option. Now, in addition to treatment aimed at decreasing the production of stomach acid, doctors may prescribe antibiotics for patients with H. pylori. By eliminating H. pylori means the ulcer may now heal and most likely will not come back.
